Nutrition services: An essential component of the medical/health home

Public health based on social justice gives rise to important policy imperatives such as improving the public health system through the “patient-centered medical home”, often more appropriately referred to as “health home” to better reflect the full range of health care providers and its focus on prevention/wellness. The model addresses improving access to care, reducing disparities, and reducing emergency department utilization. Central Valley Health Network (CVHN) is a consortium of 13 Federally Qualified Health Centers that are “health homes” to the low-income and medically underserved in 21 counties of California. Implementing the “health home” model requires a team approach with a credentialed nutrition professional as a component of this team. Nutrition education plays a critical role in both disease prevention and management. Healthy eating and/or active living are associated with a decreased incidence of obesity, cancer, dental caries, type 2 diabetes, and cardiovascular disease. The “health home” allows for integration of preventive nutrition education into existing health care services (i.e. dental). Nutrition counseling as a component of disease management decreases complications as well as emergency room visits. Electronic Health Records with population management capabilities are instrumental in tracking indicators that measure disease management such as Hemoglobin A1c. Nutrition professionals are instrumental in care coordination (e.g., collaboration with social work to ensure food access). Policies to support implementation and reimbursement of nutrition services for both disease prevention and treatment are crucial. Without the inclusion of nutrition services, the “health home” will not meet APHA's public health priorities.