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This salient resource offers clinicians a comprehensive multi-tiered framework for identifying, addressing, and reducing food insecurity among children and their families. Reinforcing the importance of food insecurity as a key social determinant of health, this monograph reviews the epidemiology and presents in-depth guidelines for screening for food insecurity and hunger. Recommendations for screening in a busy clinical setting as well as the strengths and limitations of widely-used instruments are discussed. The monograph also outlines a variety of clinic-level interventions, potential community-based resources, and opportunities for clinical-community partnerships to improve families’ food access and security. Further, contributors provide workable plans for large-scale advocacy through greater engagement with professional and community resources as well as policymakers. The monograph concludes with an outline of the critical steps to implement a food insecurity screening process and the key components to train the next generation of provider-advocates. Included in the coverage: Epidemiology and pathophysiology of food insecurity Screening tools and training Scope of interventions to address food insecurity Creation and evaluation of the impact of food insecurity-focused clinical-community partnerships on patients and populations Development of an action plan to fight food insecurity Identifying and Addressing Childhood Food Insecurity in Healthcare and Community Settings will find an engaged audience among physicians and other clinicians who want to address food insecurity in their healthcare and/or community setting. Institutions that are starting to address social determinants of health, including food insecurity, will find guidance on screening tools, processes and evaluation of impact.
With U.S. health care costs projected to grow at an average rate of 5.5 percent per year from 2018 to 2027, or 0.8 percentage points faster than the gross domestic product, and reach nearly $6.0 trillion per year by 2027, policy makers and a wide range of stakeholders are searching for plausible actions the nation can take to slow this rise and keep health expenditures from consuming an ever greater portion of U.S. economic output. While health care services are essential to heath, there is growing recognition that social determinants of health are important influences on population health. Supporting this idea are estimates that while health care accounts for some 10 to 20 percent of the determinants of health, socioeconomic factors and factors related to the physical environment are estimated to account for up to 50 percent of the determinants of health. Challenges related to the social determinants of health at the individual level include housing insecurity and poor housing quality, food insecurity, limitations in access to transportation, and lack of social support. These social needs affect access to care and health care utilization as well as health outcomes. Health care systems have begun exploring ways to address non-medical, health-related social needs as a way to reduce health care costs. To explore the potential effect of addressing non-medical health-related social needs on improving population health and reducing health care spending in a value-driven health care delivery system, the National Academies of Science, Engineering, and Medicine held a full-day public workshop titled Investing in Interventions that Address Non-Medical, Health-Related Social Needs on April 26, 2019, in Washington, DC. The objectives of the workshop were to explore effective practices and the supporting evidence base for addressing the non-medical health-related social needs of individuals, such as housing and food insecurities; review assessments of return on investment (ROI) for payers, healthy systems, and communities; and identify gaps and opportunities for research and steps that could help to further the understanding of the ROI on addressing non-medical health-related social needs. This publication summarizes the presentations and discussions from the workshop.
Each year, Advances in Family Practice Nursing focuses on providing current clinical information on important topics in primary care aimed aimed at the family care nurse practitioner. Dr. Geri Reeves and her editorial board, comprised of top experts in the areas of pediatrics, adult/geriatric, and women's health have assembled authors to bring the following topics to publication in this year's edition: Falls in Older Adults: Prevention and Assessment of Risk in Primary Care; Challenges of Treating Extended Spectrum Beta-Lactamase (ESBL) in Long-Term Care; Serious Illness Conversations with Older Adults in Primary Care; The Role of the Primary Care Nurse Practitioner in Work-Up and Management of Parkinson's Disease; Irregularly Irregular: Atrial Fibrillation for Primary Care; Insights into the Management of Older Adults with Type 2 Diabetes; Sexual violence screening for women across the lifespan; Self-management Apps for provider or patient use; Hypertension disorders in pregnancy; Caring for women with circumcision: A primary care perspective; Brief behavioral therapy for insomnia; Teens and Vaping: What you need to know; Autism for the PC Provider: Importance of Early Intervention; Human Trafficking: Identifying and Helping Victims; Encopresis Management in Primary Care; Childhood Obesity: Management and Evaluation for Primary Care; and HPV: How to Address Prevention and Vaccine Hesitancy. Readers will come away with the clinical information that supplements their professional knowledge so they can make informed clinical decisions that improve patient outcomes in pediatric, adult/geriatric, and female patients.
Food for the Future: Stories from the Alternative Agro-food Movement is about different foods, the stories they contain, and most of all the people in the stories. John Brueggemann interviewed dozens of farmers, chefs, non-profit managers, consumers, teachers, and healthcare providers. He argues that their individual stories point towards larger patterns that have shaped the alternative agro-food movement, and that other factors, including the environmental movement, farms, lifestyle movements, and consumers have all played a crucial role in its rise. The author concludes that the alternative agro-food movement is providing a countervailing force relative to mainstream market culture, and that instead of efficiency, profit, consumption, individualism and short-term thinking, the alternative agro-food movement emphasizes meaning, need, creation, community, and long-term thinking.
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 Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.
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.
A new introduction to public health's most elemental topic Food is baked in to most things that public health is and does. But for a field charged with carrying torches as divergent as anti-hunger and anti-obesity, it's unlikely, even impossible, to shape a unified approach to complex concepts like food environment, food access, or even nutrition. Food and Public Health offers a contextualized, accessible introduction to understanding the foundations (and contradictions) at the intersection of these two topics. It distills the historical, political, sociological, and scientific factors influencing what we eat and where our food comes from, then offers actionable insights for future nutritionists, social workers, dietitians, and researchers in public health. Guiding the reader through more than a century of food-focused regulation, policy, and education, Food and Public Health is an essential introduction to: · food production and availability on a global and neighborhood scale · dietary guidelines, agricultural subsidies, rationing, and other attempts by governments to shape their citizens' diets · best practices in health promotion and chronic disease prevention · food insecurity and its paradoxical role as driver of both hunger and obesity Enriched with real-world examples and case studies, Food and Public Health offers a crucial link between kitchen tables and populations for the classroom.
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.
New evidence this year corroborates the rise in world hunger observed in this report last year, sending a warning that more action is needed if we aspire to end world hunger and malnutrition in all its forms by 2030. Updated estimates show the number of people who suffer from hunger has been growing over the past three years, returning to prevailing levels from almost a decade ago. Although progress continues to be made in reducing child stunting, over 22 percent of children under five years of age are still affected. Other forms of malnutrition are also growing: adult obesity continues to increase in countries irrespective of their income levels, and many countries are coping with multiple forms of malnutrition at the same time – overweight and obesity, as well as anaemia in women, and child stunting and wasting.