Why Representation Matters in Public Health: A Practitioner’s Perspective
It me.
As a second-generation Vietnamese-American, growing up in a middle-class household, I was fortunate to have parents who instilled the value of education. But even with those advantages, pursuing higher education meant taking out loans just to afford college. When I entered the field of dietetics, I was struck by a startling reality: currently, only about 3% of dietitians in the U.S. are male, and even fewer come from BIPOC (Black, Indigenous, and People of Color) backgrounds. Socioeconomic barriers are a major reason for this.
Becoming a dietitian requires a significant financial commitment: completing a bachelor’s degree, and now a master’s, alongside the often year-long unpaid internship. This is all before you can even sit for the licensing exam. These financial hurdles disproportionately affect those from lower-income families, making the field less accessible to many who could bring valuable perspectives.
Why Representation in Dietetics Matters for Public Health
The U.S. has many cultural backgrounds, whether native or from abroad, and nutrition is deeply intertwined with culture. The way people eat, their food preferences, and their access to healthy options are shaped by their cultural and socioeconomic backgrounds, and much more. Yet, most dietitians in the U.S. come from suburban or metropolitan, middle-to-upper-class upbringings, and many have limited exposure to the diverse ways food is prepared, celebrated, or even accessed. This creates a disconnect.
Imagine trying to guide someone on nutrition without understanding their cultural staples or the constraints of their environment, like limited grocery options in rural areas or a dependence on hunting, fishing, and preserved foods. For public health initiatives to succeed, they need to resonate with the populations they aim to serve. This requires practitioners who can relate to and respect the lived experiences of those they work with.
Improving representation in dietetics isn’t just about race or ethnicity; it’s also about understanding the unique challenges faced by rural and lower-socioeconomic communities. A family in a rural area may prioritize hearty, calorie-dense meals to sustain a day of hard labor, while someone in a suburban environment might focus on convenience or trendy health foods. Neither approach is inherently better, but understanding both perspectives is crucial for effective nutrition counseling and public health outreach.
Similarly, immigrant families bring unique traditions and staples to their tables that often don’t fit neatly into a “one-size-fits-all” nutrition plan. If dietitians lack the cultural competency to bridge those gaps, we risk providing guidance that feels disconnected, irrelevant, or even dismissive to the people we aim to serve. This disconnect can lead to frustration, mistrust, and ultimately a lack of adherence to nutritional recommendations. It’s not that these families are unwilling to make changes; it’s that the advice needs to be tailored to their realities, balancing cultural traditions, budget constraints, and access to food.
Without cultural competency, dietitians may unintentionally reinforce disparities, offering plans that feel impossible to follow. However, when practitioners understand and respect these nuances, they can build trust and provide guidance that resonates. Whether it’s adapting a traditional recipe to make it healthier or recommending accessible alternatives to costly health foods, a culturally aware approach empowers individuals to take actionable steps toward better health without feeling alienated or judged.
When the dietetics field is overwhelmingly homogeneous, we risk leaving large segments of the population underserved. It’s not a political issue—it’s about better outcomes. When practitioners understand the cultural and economic factors influencing a person’s diet, they can provide tailored, practical advice that’s far more likely to be effective.
Expanding the Conversation on Diversity in Dietetics
Expanding access to the dietetics field means addressing some of the systemic barriers that discourage talented individuals from pursuing this career path. The current requirement to complete a year-long, unpaid internship poses a significant financial challenge. For many, taking on unpaid work while covering living expenses is simply not feasible. Adding a mandatory master’s degree to the process further exacerbates these barriers, making the path to becoming a dietitian even more inaccessible for individuals from lower-income families.
But why does this matter for public health? Because nutrition isn’t just about food—it’s about connection, culture, and trust. A dietitian who understands the nuances of a traditional Southern Sunday dinner, the complexities of halal or kosher diets, or the cultural significance of certain foods in immigrant households can provide care that feels relevant and respectful. Without this cultural competency, the guidance offered may feel out of touch, leading to missed opportunities for positive change.
The importance of bridging this gap is evident in rural communities as well. For individuals in these areas, nutritional guidance often needs to consider limited access to fresh produce, reliance on canned or frozen options, and the cultural value placed on large, family-style meals. Dietitians from urban or suburban backgrounds may unintentionally provide advice that doesn’t align with these realities, making it harder for patients to adopt healthier habits. This isn’t a failing of their skill but a gap in experience that can be bridged by increasing diversity within the profession.
To truly improve public health outcomes, the dietetics profession must evolve to become more inclusive. This doesn’t mean lowering standards—it means creating pathways that allow people from all walks of life to pursue this field without insurmountable financial and logistical hurdles. Scholarships, paid internships, and mentorship programs can help level the playing field, ensuring that the dietetics workforce is as varied as the communities it serves.
The Path Forward
To ensure better public health outcomes, we need to make the field of dietetics more accessible.
This means rethinking the financial and structural barriers that prevent diverse individuals from entering the profession. Scholarships, paid internships, and alternative pathways could help open the door for those who have been historically excluded.
Representation matters because nutrition is not a one-size-fits-all solution. As practitioners, our goal is to meet people where they are, understand their challenges, and guide them in ways that are realistic and sustainable for their lives. By addressing these disparities, we not only strengthen our profession but also contribute to a healthier, more equitable society.
In the end, diversity in dietetics isn’t just about representation….it’s about impact. A more inclusive profession means better, more personalized care for patients. It means creating solutions that reflect the rich tapestry of our nation’s food traditions and health challenges. And most importantly, it means moving closer to a vision of public health that truly serves everyone, regardless of where they live, how much they earn, or where their ancestors came from.
