How do you share your gift?
Many of you could not make our seminar, Vitamin D and Public Health - Integrating Sunshine, Supplements and Measurement for Optimal Health, on December 9-10 in San Diego. This week we will summarize a talk entitled "Vitamin D and Public Health Practice". It was given by Mary Pittaway, MA, RD, of the Global Clinical Advisor-Health Promotion for Special Olympics. She recently retired from her position as Nutrition Services Manager for the Missoula City-County Health Department (MCCHD) in Montana.
Mary shared that in her role at MCCHD, they considered the entire community of Missoula as their patient. In public health it is important to try and prevent health issues, not necessarily to treat sick people. This is very different from a doctor's point of view - as they see individuals and try to make them better one at a time. Mary used the keyword "upstream" to describe a practice of public health officials. They try to find the core cause of many health issues and address that cause, in order to improve health and reduce overall community health care costs. Here is an article in Huffington Post that talks about this "upstream" practice.
Recognizing the importance of vitamin D for many aspects of public health, Mary and her colleagues have used vitamin D sufficiency as a model for upstream health in Missoula. Here are some great tools she has made in order to better communicate with the public about the importance of vitamin D. The goal is to quickly understand and act on the problem.
She uses the analogy of the three bears. Are you getting too much vitamin D? Too little? Or is it just right? When you make this statement in conjunction with our Disease Incidence and Prevention Chart it becomes very clear that it is optimal to keep your vitamin D blood level between 40-60 ng/ml.
Another analogy that works great in Missoula is gardening. Vitamin D is like compost to health - it is required. It makes a good garden. Vitamin D helps over 2000 cell processes in the body - thus helping the body function properly and alleviate disease before it starts. These pictures are great!
After we agree that each of us needs enough vitamin D (40-60 ng/ml) in the blood for healthy function, then how do you proceed? Mary's next step was to encourage everyone on her public health staff and those that worked with the public daily, to be tested. Why? Because it is eye opening. Many of you have had your first vitamin D test - wasn't it lower than you thought? That information, coupled with the Disease Incidence Prevention Chart quickly gets everyone asking, "How do I get to 50 ng/ml?" Then the discussion becomes how to obtain vitamin D in your blood.
Many people think that you can get enough vitamin D through milk and a daily multi-vitamin. This is a great slide to show how much milk you would have to drink a day if that is how you want to get your vitamin D. Would you want to drink all that? These kinds of graphic tools can be developed to emphasize a health promotion point. They involve translating science into real life behaviors and they get us all thinking about how to make positive changes.
Mary was able to obtain vitamin D supplement donations through  vendors and small grants. Using these donations, Missoula has run different programs including one where they gave out a free family supply of vitamin D to those that came in with their vitamin D test results. This influenced the medical community, as they became aware of how low the public's general serum levels were. (Remember knowledge first, act second!) Another effect was community acceptance that much higher doses of supplements are needed to maintain healthy blood levels of vitamin D. The community norms around vitamin D changed, as the conversation moved from skepticism to acceptance of this opportunity to improve our community's health.
The basic research on Vitamin D is in, facts are known and it's time to share this wealth of knowledge. Opportunities to change norms around vitamin D related behaviors exist in all communities; e.g. safe sun exposure, baseline testing and effective supplementation.Mary's presentation described how one county public health department promoted vitamin D testing with appropriate supplementation as an initiative to mobilize a community to action to enhance public health.
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