Nutrition services in state and local public health agencies: how do we measure up in 1987?

In 1987, a second biennial mail survey of public health nutritionists in 54 state official public health agencies identified 2,048 budgeted positions compared with 2,931 in 1985, a 30% loss in the state and local health agencies. To achieve the recommended staffing ratio of one public health nutritionist per 50,000 population for policy, program planning, and program management, an estimated 2,812 more nutritionists are needed for a total of 4,850, or a 60% increase. The number of state personnel systems requiring graduate public health training decreased from 19 to 6, while the number requiring R.D./registration eligibility increased from 24 to 33. Fifty-five percent of positions for public health nutritionists are funded from the Special Supplemental Food Program for Women, Infants, and Children, and 10% from the Maternal and Child Health Block Grant. Positions funded from state general revenue doubled from 8% in 1985 to 15% in 1987, while local revenue stayed at about 10%. The midpoint of state salary ranges for the public health nutritionists varied from $14,310 to $38,310. Perceived constraints to expanding nutrition services were inadequate state funding, low agency visibility, and low legislative priority. At a time when consumer interest in nutrition is high and research associates dietary factors with major public health problems, the challenge is to advocate more aggressively for public health nutrition services and funding.