Dr. Yvonne D. Greer, DrPH, RD, CD, a practicing registered dietitian with decades of experience, was recently awarded the Walden Leadership Excellence Award for her groundbreaking research on the role of social connections in promoting healthy eating habits as part of her Doctorate in Public Health (DrPH). Through her work with patients, Dr. Greer noticed that social connectedness was a critical factor in determining the success of dietary interventions. However, she found that this aspect of care was often overlooked in the field of dietetics.
“My biggest goal was for dietitians to know that you cannot just give out a meal plan or throw some education at patients. You have to assess their social environment and level of social functioning. You have to take the time to understand their context before giving advice.”
Dr. Greer’s research focused on the concept of social capital, which refers to existing connections and networks within an individual’s social environment and community setting. In her thesis, she leveraged existing data from the Survey of the Health of Wisconsin (SHOW) to examine the levels and types of social capital available in congressional districts with the highest food hardship in Wisconsin, specifically within Milwaukee and Dane counties. She found that the level of bonding social capital (e.g., intimate family, friends, or neighbor connections) and community-structural social capital (connections to food assistance programs, grocery stores, and farmers’ markets) played a significant role in determining a person’s food security and ability to access healthy foods.
“I believe the biggest takeaway is that it’s not enough just to give food vouchers, to just supplement with food resources. Social connectedness is so much more important than we ever thought. You know, the idea is that if someone’s not socially connected, they have higher food insecurity; and that when we start looking at food insecurity and how detrimental it is to your health, those social connections mean so much.”
However, Dr. Greer discovered that little research was available on the role of social capital in dietary interventions. She faced numerous challenges in her research, particularly in analyzing data on social capital, which, as Dr. Greer pointed out, “doesn’t have standard survey tools.”
Despite the obstacles, Dr. Greer persevered and found that building social capital could be a powerful tool for promoting healthy eating habits. She emphasized that healthcare providers, including dietitians, could play a vital role in creating opportunities for social connectedness and building social capital. She said, “I was able to find that there were different groups that were working on how to foster bonds and create a sense of belonging. How thick the social connections are within a healthy community had very positive results.”
“You know, and then I started thinking about dietetics and the practice of it. Do we have nutritional support groups? Not usually. Do we have cooking clubs? Do we have things that build a sense of belonging? No,” Dr. Greer said. “So, when we think of Dietetic practice, we need to start looking at coaching. We need to start looking at how we are developing relationships and how we create situations that can create social capital and create bonding and a sense of belonging and take people from that stage of just trying to survive into self-efficacy.”
Informed by her research and experience, Dr. Greer emphasizes the importance of being socially connected and that it motivates people to adopt healthier lifestyles. “From working with patients, I knew social connectedness mattered a lot to how likely the uptake of healthy behaviors was but didn’t see others having the same understanding in their practice.”
Dr. Greer stresses the importance of understanding patients’ social environments to assist them in creating effective nutritional plans. She notes that dietitians should assess patients’ social level of functioning and assist them in accessing healthy food options, which could involve sending them to a food pantry or WIC, if necessary, to enable them to cook healthy meals. This approach is more effective than just providing education and meal plans. “If I start going into all the different things you should get and using olive oil and doing this and that, after a while, it’s like it’s on deaf ears. It’s going in one ear out the other because they don’t have the ability to do it,” she says.
Dr. Greer’s research emphasizes the need for a more holistic approach to dietetic practice. Dietitians can motivate individuals to make lasting lifestyle changes by addressing patients’ social environments and connections. “My research was a validation that social capital does make a difference. Addressing social capital through different means can make a difference in somebody’s life,” Dr. Greer notes. She suggests that practitioners must change how they instruct people and become an ally in helping patients gain and incorporate nutrition into their lives.
The key takeaway from Dr. Greer’s work is that dietitians should focus on building social capital and fostering relationships with patients using a coaching model.
By doing so, they can help individuals achieve better health outcomes and improve their quality of life. As Dr. Greer notes, “It’s always your choice to eat whatever you want. I can say don’t eat this, don’t eat that. But if you wanna eat it, that is your life.” However, dietitians and patients can achieve better health outcomes and make lasting changes by working together to create supportive social environments.
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