Women, Food and Nutrition

Most of the students in my nutrition graduate program were women. I graduated with one guy in my class, am one of thirteen female dietetic interns and am supervised by female dietitians. Nutrition is traditionally known as a "women's field." But my interest was piqued when I received this email from the American Dietetic Association (ADA) earlier in the year:

Over 84 percent of food and nutrition professionals are white and over 94 percent are women. How do you feel about this? What should ADA do to increase diversity? ADA wants your opinion.

Well it may be a few months late, but here are my thoughts.

I am proud to be part of a profession that is working toward the betterment of health and wellbeing of all citizens, regardless of age, race or gender. I firmly believe in the power of nutrition, of food and eating and nourishment, of the potential for improving quality of life through prevention and management of chronic disease.  I can only imagine that others who go into this field do so out of similar conviction, since I have learned that there isn't a whole lot of money to be made helping people in this way, unless you plan to create a functional food, write a fad-diet bestseller, manage a large scale food service site or sell a lot of supplements. Most insurance companies do not cover nutrition services unless a patient is diabetic or perhaps has renal impairment. Even morbidly obese patients who qualify for bariatric surgery are only entitled to one to two nutrition education sessions, when clearly nutrition plays a major role in the success or failure of their surgery. And so while nutrition may have played a key role as a mode of early intervention to prevent disease progression, most patient do not qualify for such benefits until they have fully developed a condition that needs to be managed. This is simply unjust.  And I believe it is largely because nutrition is viewed as a nice but nonessential "women's field."

I could surmise the origins of this phenomenon. Perhaps working in dietetics is a natural progression from working in the kitchen, so it was reasonable for women to flock toward this field. But such an argument  collapses when you look at the statistics on male vs. female chefs who actually work in the kitchen. Women are underrepresented in the executive chef category overall and they tend to earn significantly less than their male counterparts. A better comparison might be to the medical profession, where nursing reports similar gender statistics (only 5.% of nurses were male in 2009), or even the case of female physicians who earn 40% less than their male counterparts on average.

So why haven't men and minorities been flocking to the field in droves? Looking at the numbers, why would they? It is extremely competitive (in 2009, only 52% of nutrition graduates matched for dietetic internships, required for credentialing). Internships are almost a year long and not only are they unpaid, but most require tuition (ranging up to $40,000), typically without financial aid eligibility.  For the most part nutrition services are not covered by insurance. See below for the Department of Labor, salaries of dietitians vs. nurses, just as a point of comparison:

Registered Nurses Wages, May 2010

Dietitians and Nutritionists Wages, May 2010

Gender studies is not my area of expertise, and my rationale is not evidence-based.  But the numbers speak for themselves. There are financial barriers to entering the field and it's not a very lucrative profession. I haven't even started my career and yet I fear that my outrage will continue to grow and then eventually fade into apathy.  At the end of the day, most nutrition jobs tend to have more flexibility for working moms and that is an important feature for many women. A few months ago, a friend posted this TEDTalk on Facebook and I found it hit the nail on the head. Discussions of women in the workplace inevitably involve complicated questions of childrearing and priorities and failure to fight for a "place at the table." I have very mixed feelings about the American Dietetic Association but I am happy there is an organization in place to advocate for my field.

So, ADA, what can you do to increase diversity? Might I offer the following:

1. Remove the insurmountable barriers to receiving dietetics credentials by reinstating alternate routes to the RD that would allow competent, educated graduates to practice in the field and offer financially viable ways to complete the credentialing process.

2. Advocate for expanded insurance coverage, relying on the data supporting nutrition as a crucial mode of prevention and treatment of chronic disease, reducing length of hospital stays, healthcare costs, employee absence and improved quality of life.

3. Boost your own credibility by displaying greater transparency in regard to sponsorships, demanding more accountability from the food industry giants who fund your nutrition initiatives by profiting from the sale of food-like items that undermine the very dietary guidelines you espouse.

Signed,
A white, female nutrition professional