The Future of Nutrition Care in Health Systems

Leading health systems of the future will embed support for healthy eating as a core component of care. In this chapter, we describe three ways that health systems can act to provide support for healthy eating: (1) being agile in service delivery to adapt to individual's ever-changing support needs, as well as contribute to broader health and food system decision-making; (2) prioritize food as an individual’s right to health, and take responsibility for ensuring access to nutritious foods when required; and (3) upholding evidence-informed implementation strategies to underpin evolving healthcare systems. These three interconnected strategies will support the future of nutrition care considering individual and system level factors.

 Agile Healthcare Systems 

Within an agile healthcare system, the changing needs of individuals need to be considered within the interconnected aspects of a complex system. Leading health systems of the future need to focus on individual needs while maintaining sustainability and equity across populations. Food and healthcare systems are, and should be, strongly interconnected due to the significant role of food in human health. However, food systems have changed significantly as technology and agriculture have advanced. Not only do these changes impact food quality and access, they also impact the healthcare system. The COVID-19 pandemic clearly illustrated the interdependence between health and food systems. For example, disruptions to food supply chains limited access to certain foods and products, which impacted people’s health and put additional strain on individuals and healthcare services.¹ The pandemic also strained business operations in the food industry. The interconnected nature of these systems cannot be ignored and learnings from the COVID-19 pandemic need to be considered in developing more agile, equitable, and sustainable food and healthcare systems that acknowledge their connection and interdependence. 

An Individual’s Right to Health 

The right to health and the right to food are highly connected. While healthcare systems need to be agile to rapidly provide what is needed for the societies that we live in regarding healthy food and quality of care, there are differences in how this looks between countries and populations. Equitable access to health services and high-quality food is a longstanding issue in many countries. In the past, healthcare actions have not genuinely demonstrated the vast impact of these issues, and this cannot be ignored any longer. Change is needed to find equitable and sustainable approaches to provide long-term access to healthy, high-quality food, regardless of why people do not have access, e.g., socioeconomic, geographical, or natural disaster. 

Evidence-Informed Implementation Strategies 

To develop agile food and healthcare systems, evidence-informed implementation strategies at the individual, organizational, and systems levels are needed. At the individual level, behavior change theories can be crucial to support sustained change. For example, the COM-B model articulates how individuals need the Capability, Opportunity, and Motivation to change behavior² For example, for an individual to move toward eating a healthier diet, they need the knowledge and skills (Capability) to know what to buy and how to prepare it. Individuals also need opportunities, such as an income that allows them to buy healthier food, access to food to purchase, and space to prepare the food. Motivation is also needed to change their eating patterns. All three elements are needed to encourage behavior change. However, individuals live in systems, and each aspect of the COM-B model is impacted by where people live, the availability of food, the political structure, and other complex and systems-level factors. 

References 

1 Hobbs, JE. Food supply chains during the COVID-19 pandemic. Can J Agr Econ. 2020;68:171–6. 

2 Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011 Apr 23;6:42.