About the ENRICH Act
The Expanding Nutrition’s Role in Curricula and Healthcare (ENRICH) Act (H.R. 4427) is sponsored by Rep. Tim Ryan (D-Ohio), along with Rep. Bill Cassidy (R-LA) and Rep. Raul Grijalva (R-Ariz).
Important things to keep in mind:
- This bill does not require any new money.
- Integrating nutrition education into curricula means offering nutrition education throughout medical school and residency programs and can also mean offering additional opportunities such as CME and seminars.
Questions and Answers
1) What are medical schools currently doing about nutrition education?
Despite the fact that medical school students want more nutrition education, the amount of nutrition education is very low and actually declining. A 1985 National Academy of Sciences (NAS) report recommended that all medical schools require at least 25 contact hours of nutrition education. In 2004, only 38 percent of medical schools met these minimum standards by requiring 25 hours of nutrition education as part of their general curricula. By 2010, that number had shrunk to 27 percent. In 2004, 30 percent of United States medical schools required a dedicated nutrition course. In 2010, only 25 percent of U.S. medical schools required such a course.
2) Why aren’t more medical schools offering nutrition education?
Despite nutrition being an important crosscutting issue for all specialties and chronic diseases, medical schools are only starting to consider nutrition as an important part of improving the health and well-being of patients. Many of them see cost as a barrier, despite how little integration can cost and, once integrated, how little it costs to sustain.
3) Why would ENRICH grants be administered by the Health Resources and Services Administration (HRSA)?
HRSA will coordinate with the NIH’s National Heart, Lung, and Blood Institute (NHLBI) in the development of the ENRICH grant program since the NHLBI had previously funded a similar grant program for medical schools under the Nutrition Academic Award program.
HRSA is under the Department of Health and Human Services (HHS) and works to strengthen the healthcare workforce, build healthy communities, and improve health equity. HRSA supports the training of health professionals, the distribution of providers to areas where they are needed most, and improvements in healthcare delivery. To this end, HRSA is positioned to oversee grants to medical schools to increase nutrition education among training healthcare professionals.
4) What is the precedent for this bill?
There is no dedicated funding to increase nutrition education for healthcare professionals in medical schools and residency programs. The Nutrition Academic Award (NAA), funded primarily by the NIH National Heart, Lung, and Blood Institute (NHLBI), provided more than $15 million to 21 of the 126 existing medical institutions ($150,000 per school) to integrate nutrition education into medical school curricula from 1998 to 2005.
The ENRICH Act would fund at least 30 medical schools and will further build on initiatives like the NAA that sustained and increased nutrition education and awareness among training physicians:
- Medical students in NAA schools viewed their nutrition education as more adequate than in non-NAA schools (about half of NAA students v. about one-third of non-NAA students) and this increased over the length of the program.
- More than 50 percent of NAA schools show consistent inclusion of nutrition in their curricula.
- More than 25 non-NAA schools increased nutrition in their curricula because of NAA efforts.
- More than 10,000 medical students were affected by the collective NAA efforts.
5) What is the cost of integrating nutrition education into medical school curricula?
While the NAA gave $150,000 per school to integrate nutrition, the costs of integrating nutrition into curricula may be much lower and schools have been able to maintain the courses. The ENRICH Act would fund $15 million in grants. Using the NAA as example, at $150,000 per school the ENRICH grant program could fund more than 30 medical schools.
6) What are some examples of integration?
Integration means offering nutrition education as an integral part of the school’s curriculum and throughout the student’s tenure in medical school and residency:
- Offering a nutrition course
- Integrating nutrition into existing courses for all specialties
- Integrating nutrition into clerkships and outpatient electives
- Providing CME, workshops, lectures, and seminars on nutrition
- Offering nutrition research electives
- Residency includes rotation in nutrition
7) Will schools be able to maintain integrated curricula after ENRICH no longer funds them?
More than 50 percent of NAA schools still show consistent inclusion of nutrition in their curriculum.
8) How is this bill funded?
This bill does not specify how it will be funded but that, if enacted, it would be funded from existing funds. Therefore, it does not require any new money.
For more information, please contact Colin Schwartz at CSchwartz@pcrm.org.