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In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
The decade ahead will test the nation's nearly 4 million nurses in new and complex ways. Nurses live and work at the intersection of health, education, and communities. Nurses work in a wide array of settings and practice at a range of professional levels. They are often the first and most frequent line of contact with people of all backgrounds and experiences seeking care and they represent the largest of the health care professions. A nation cannot fully thrive until everyone - no matter who they are, where they live, or how much money they make - can live their healthiest possible life, and helping people live their healthiest life is and has always been the essential role of nurses. Nurses have a critical role to play in achieving the goal of health equity, but they need robust education, supportive work environments, and autonomy. Accordingly, at the request of the Robert Wood Johnson Foundation, on behalf of the National Academy of Medicine, an ad hoc committee under the auspices of the National Academies of Sciences, Engineering, and Medicine conducted a study aimed at envisioning and charting a path forward for the nursing profession to help reduce inequities in people's ability to achieve their full health potential. The ultimate goal is the achievement of health equity in the United States built on strengthened nursing capacity and expertise. By leveraging these attributes, nursing will help to create and contribute comprehensively to equitable public health and health care systems that are designed to work for everyone. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity explores how nurses can work to reduce health disparities and promote equity, while keeping costs at bay, utilizing technology, and maintaining patient and family-focused care into 2030. This work builds on the foundation set out by The Future of Nursing: Leading Change, Advancing Health (2011) report.
Authored by highly respected nurse educators, leaders, and scholars, this text focuses on the power of nurses and how they can make substantial contributions to improve the health of all populations. It delivers an in-depth examination and analysis of current issues and determinants of health as outlined by Healthy People 2020 and addresses AACN’s Essentials of Doctoral Education for Advanced Nursing Practice. Along with principles, pathways, and imperatives pertinent to achieving health equity, thetext discusses the evolution of thinking from eliminating health disparities to achieving health equity, and examines population-based and population-specific inequities in health status and outcomes. Highlighting the importance of interprofessional collaboration, it surveys timely initiatives, programs, and professionals—within and outside of the health sciences—who are important partners in efforts toward achieving health equity. Chapters are highly templated to include objectives, key concepts, critical-thinking questions, discussion questions, and resources. Key Features: Focuses on the power of nursing to make substantive contributions to improving the health of all populations Examines principles, pathways, and imperatives pertinent to achieving health equity Discusses economic, environmental, personal, social, and structural factors that impact health status and outcomes Highlights the importance of interprofessional collaboration in achieving health equity Addresses AACN’s Essentials of Doctoral Education for Advanced Nursing Practice Demonstrates key concepts and stimulates reflection through critical-thinking and discussion questions Purchase includes digital access for use on most mobile devices or computers
The definitive guide to CBPR concepts and practice, updated and expanded Community-Based Participatory Research for Health: Advancing Health and Social Equity provides a comprehensive reference for this rapidly growing field in participatory and community-engaged research. Hailed as effective by the Centers for Disease Control and Prevention, CBPR and CEnR represent the link between researchers and community and lead to improved public health outcomes. This book provides practitioner-focused guidance on CBPR and CEnR to help public health professionals, students, and practitioners from multiple other clinical, planning, education, social work, and social science fields to successfully work towards social and health equity. With a majority of new chapters, the book provides a thorough overview of CBPR history, theories of action and participatory research, emerging trends of knowledge democracy, and promising practices. Drawn from a ten-year research effort, this new material is organized around the CBPR Conceptual Model, illustrating the importance of social context, promising partnering practices, and the added value of community and other stakeholder engagement for intervention development and research design. Partnership evaluation, measures, and outcomes are highlighted, with a revised section on policy outcomes, including global health case studies. For the first time, this updated edition also includes access to the companion website, featuring lecture slides of conceptual and partnership evaluation-focused chapters, with resources from appendices to help bring CBPR concepts and practices directly into the classroom. Proven effective year after year, CBPR has become a critically important framework for public health, and this book provides clear reference for all aspects of the practice. Readers will: Examine the latest research on CPBR, and incorporate new insights into practice Understand the history and theoretical basis of CPBR, and why it has been so effective Reflect on critical issues of racism, power, and privilege; trust development; ethical practice within and beyond IRBs; and cultural humility Learn new partnership evaluation and collective reflection strategies, including measures and metrics, to enhance their own practice for improved health and social equity outcomes
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
The case for evidence and collaboration in pursuit of health equity In this second volume of the Culture of Health series, Advancing Health and Well-Being convenes experts from academia, policy, journalism, and community-based organizations, among other sectors, to examine how data and narrative can catalyze progress toward building a national Culture of Health. Tackling topics such as health inequity, mass incarceration, and climate change, Advancing Health and Well-Being does more than draw lines between cause and effect; its 70+ voices lend context and lived experience to critical conversations that may lack such elements. The result is a work that shows the power and promise of evidence and collaboration. Amid continued interest in population health and well-being, this book offers essential reading for those advancing such efforts, and those seeking an early grounding, in pursuit of a Culture of Health.
This workbook is for public health practitioners and partners interested in addressing social determinants of health in order to promote health and achieve health equity. In its 1988 landmark report, and again in 2003 in an updated report, the Institute of Medicine defined public health as “what we as a society do to collectively assure the conditions in which people can be healthy.” Early efforts to describe the relationship between these conditions and health or health outcomes focused on factors such as water and air quality and food safety. More recent public health efforts, particularly in the past decade, have identified a broader array of conditions affecting health, including community design, housing, employment, access to health care, access to healthy foods, environmental pollutants, and occupational safety. The link between social determinants of health, including social, economic, and environmental conditions, and health outcomes is widely recognized in the public health literature. Moreover, it is increasingly understood that inequitable distribution of these conditions across various populations is a significant contributor to persistent and pervasive health disparities. One effort to address these conditions and subsequent health disparities is the development of national guidelines, Healthy People 2010 (HP 2010). Developed by the U.S. Department of Health and Human Services, HP 2010 has the vision of “healthy people living in healthy communities” and identifies two major goals: increasing the quality and years of healthy life and eliminating health disparities. To achieve this vision, HP 2010 acknowledges “that communities, States, and national organizations will need to take a multidisciplinary approach to achieving health equity — an approach that involves improving health, education, housing, labor, justice, transportation, agriculture, and the environment, as well as data collection itself”. To be successful, this approach requires community-, policy-, and system-level changes that combine social, organizational, environmental, economic, and policy strategies along with individual behavioral change and clinical services. The approach also requires developing partnerships with groups that traditionally may not have been part of public health initiatives, including community organizations and representatives from government, academia, business, and civil society. This workbook was created to encourage and support the development of new and the expansion of existing, initiatives and partnerships to address the social determinants of health inequities. Content is drawn from Social Determinants of Disparities in Health: Learning from Doing, a forum sponsored by the U.S. Centers for Disease Control and Prevention in October 2003. Forum participants included representatives from community organizations, academic settings, and public health practice who have experience developing, implementing, and evaluating interventions to address conditions contributing to health inequities. The workbook reflects the views of experts from multiple arenas, including local community knowledge, public health, medicine, social work, sociology, psychology, urban planning, community economic development, environmental sciences, and housing. It is designed for a wide range of users interested in developing initiatives to increase health equity in their communities. The workbook builds on existing resources and highlights lessons learned by communities working toward this end.
Gain the knowledge and skills you need to promote equity in health care! Focused on what nurses can do to address health disparities, The Social and Structural Determinants of Health: Educating Nurses to Advance Health Equity provides a comprehensive look at how factors such as income, education, and race can lead to systemic disadvantage in health and well-being. It shows how nurses can partner with communities and organizations to understand the root causes of inequities in health, develop equity-minded skills, and take action to advance long-lasting progress. Written by Teri A. Murray, a noted nursing educator with rich expertise in health equity, this text makes it easy to learn and apply the principles that can lead to better health outcomes and healthier communities. Coverage of the social determinants of health (SDOH) addresses the environmental conditions in which people are born, live, learn, work, play, worship, and age, and how these conditions lead to systemic disadvantage in health and all aspects of life. Descriptions of the health disparities seen in marginalized and minoritized populations include structural determinants such as the distribution of wealth, power, social and cultural norms, and economic and political factors. Context for the health disparities seen at the population level includes both structural and social determinants. Consistent format of chapters includes a chapter overview, learning objectives, Reflection questions, a case study or community-based experience, and more. Unit I of the book includes five chapters patterned after the framework used by Healthy People 2030: Social Determinants of Health, with a sixth chapter on the historical context of race and racism in health and how it is an underlying factor for the inequities that lead to health disparities. Chapters in Unit II provide strategies and approaches that nurses can employ to advance health equity.