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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 United States is viewed by the world as a country with plenty of food, yet not all households in America are food secure, meaning access at all times to enough food for an active, healthy life. A proportion of the population experiences food insecurity at some time in a given year because of food deprivation and lack of access to food due to economic resource constraints. Still, food insecurity in the United States is not of the same intensity as in some developing countries. Since 1995 the U.S. Department of Agriculture (USDA) has annually published statistics on the extent of food insecurity and food insecurity with hunger in U.S. households. These estimates are based on a survey measure developed by the U.S. Food Security Measurement Project, an ongoing collaboration among federal agencies, academic researchers, and private organizations. USDA requested the Committee on National Statistics of the National Academies to convene a panel of experts to undertake a two-year study in two phases to review at this 10-year mark the concepts and methodology for measuring food insecurity and hunger and the uses of the measure. In Phase 2 of the study the panel was to consider in more depth the issues raised in Phase 1 relating to the concepts and methods used to measure food security and make recommendations as appropriate. The Committee on National Statistics appointed a panel of 10 experts to examine the above issues. In order to provide timely guidance to USDA, the panel issued an interim Phase 1 report, Measuring Food Insecurity and Hunger: Phase 1 Report. That report presented the panel's preliminary assessments of the food security concepts and definitions; the appropriateness of identifying hunger as a severe range of food insecurity in such a survey-based measurement method; questions for measuring these concepts; and the appropriateness of a household survey for regularly monitoring food security in the U.S. population. It provided interim guidance for the continued production of the food security estimates. This final report primarily focuses on the Phase 2 charge. The major findings and conclusions based on the panel's review and deliberations are summarized.
Health Equity: A Solutions-Focused Approach is a comprehensive textbook that illustrates existing conditions of health disparities across a range of populations in the United States, positions those disparities within the broader sociopolitical framework that leads to their existence, and most importantly, presents specific ways in which health equity solutions can be designed and implemented. Presenting current theoretical foundations, cultural context, and evidence-based models and interventions all in one, this textbook provides students with the basis to achieve greater health equity in their communities. Edited by award-winning authors and featuring contributions from diverse experts in public health, sociology, psychology, and medicine, this groundbreaking text goes beyond a traditional approach to risk factors and disparities and emphasizes the central role that health equity initiatives must play in public health research and practice. The book is divided into three sections, with Section I focusing on providing the context of health equity research and practice. Chapters are structured in such a way that both new and experienced students in the field will develop a deeper understanding of topics such as prejudice and discrimination; frameworks and theories; and research and collaboration approaches. Section II addresses the current knowledge of specific populations impacted by issues related to health equity, including African American, Latinx and Hispanic, Asian, American Indian and Alaska Native, Native Hawaiian and Pacific Islander, LGBTQ, Veteran, People with Disabilities, and many more. Authored or co-authored by members of the community being discussed, each of these chapters summarizes how health disparities impact the group, ongoing population-specific models of disparities and equity, emerging programs for achieving health equity, coverage of the most relevant aspects of intersectionality, and concluding exercises such as case studies and current events. Section III then highlights the role of cultural humility in achieving health equity. With its solutions-focused and community-affirming approach, Health Equity provides graduate and undergraduate students of public health with evidence-based models to help advance health through diversity, inclusion, and social justice. Key Features: Origins and Theories – Discusses the sociocultural and political origins of health disparities and the major theories that underlie an understanding of health equity Solutions-Focused – Describes emerging models and gives best practices in designing new programs Diverse Population Coverage – Provides historical context, sociocultural dynamics, and population-specific evidence-based programs from the voices of the communities being discussed Intersectionality Perspective – Highlights the role that overlapping and interdependent identities play in promoting health equity and the interventions that build from this perspective Case Studies and Real-World Examples – Demonstrates how to apply health equity improvement approaches in different contexts eBook access –Included with print purchase for use on most mobile devices or computers Instructor’s Packet – With an Instructor’s Manual, PowerPoint slides, Test Bank, and a Sample Syllabus
For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families. In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA's Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments. Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.
Most U.S. households have consistent, dependable access to enough food for active, healthy living-they are food secure. But a minority of American households experience food insecurity at times during the year, meaning that their access to adequate food is limited by a lack of money and other resources. USDA's food and nutrition assistance programs increase food security by providing low-income households access to food, a healthful diet, and nutrition education. USDA also monitors the extent and severity of food insecurity in U.S. households through an annual, nationally representative survey sponsored by USDA's Economic Research Service. Reliable monitoring of food security contributes to the effective operation of the Federal programs as well as private food assistance programs and other government initiatives aimed at reducing food insecurity. This report presents statistics from the survey covering households' food security, food expenditures, and use of food and nutrition assistance programs in 2013.