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The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.
This is a thoroughgoing revision of the first edition of this classic text and reference, published by Plenum in 1992. The authors convey the general principles that underlie this applied subdiscipline and demonstrate how the merging of demography and health care impacts on the planning processes of a range of health care organizations.
The publication is an international standard on the design and operation of an efficient and accurate vital statistics system at national level. It provides guidelines on collection, compiling and disseminating vital statistics. More specifically it contains (a) basic principles for a vital statistics system; (b) uses of vital statistics and civil registration records; (c) topics to be covered in a vital statistics system; (d) sources of vital statistics and how they function; (e) quality assurance in the vital statistics system and (f) strategies in improving civil registration and vital statistics systems in countries. It also informs policy makers and the general public on the importance of vital statistics and hence further improving the vital statistics system.
In 1997 the committee published Reproductive Health in Developing Countries: Expanding Dimensions, Building Solutions, a report that recommended actions to improve reproductive health for women around the world. As a follow- on activity, the committee proposed an investigation into the social and economic consequences of maternal morbidity and mortality. With funding from the William and Flora Hewlett Foundation, the Andrew W. Mellon Foundation, and the U.S. Agency for International Development, the committee organized a workshop on this topic in Washington, DC, on October 19-20, 1998. The Consequences of Maternal Morbidity and Maternal Mortality assesses the scientific knowledge about the consequences of maternal morbidity and mortality and discusses key findings from recent research. Although the existing research on this topic is scarce, the report drew on similar literature on the consequences of adult disease and death, especially the growing literature on the socioeconomic consequences of AIDS, to look at potential consequences from maternal disability and death.
Chronic diseases are common and costly, yet they are also among the most preventable health problems. Comprehensive and accurate disease surveillance systems are needed to implement successful efforts which will reduce the burden of chronic diseases on the U.S. population. A number of sources of surveillance data-including population surveys, cohort studies, disease registries, administrative health data, and vital statistics-contribute critical information about chronic disease. But no central surveillance system provides the information needed to analyze how chronic disease impacts the U.S. population, to identify public health priorities, or to track the progress of preventive efforts. A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases outlines a conceptual framework for building a national chronic disease surveillance system focused primarily on cardiovascular and chronic lung diseases. This system should be capable of providing data on disparities in incidence and prevalence of the diseases by race, ethnicity, socioeconomic status, and geographic region, along with data on disease risk factors, clinical care delivery, and functional health outcomes. This coordinated surveillance system is needed to integrate and expand existing information across the multiple levels of decision making in order to generate actionable, timely knowledge for a range of stakeholders at the local, state or regional, and national levels. The recommendations presented in A Nationwide Framework for Surveillance of Cardiovascular and Chronic Lung Diseases focus on data collection, resource allocation, monitoring activities, and implementation. The report also recommends that systems evolve along with new knowledge about emerging risk factors, advancing technologies, and new understanding of the basis for disease. This report will inform decision-making among federal health agencies, especially the Department of Health and Human Services; public health and clinical practitioners; non-governmental organizations; and policy makers, among others.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
Information on future mortality trends is essential for population forecasts, public health policy, actuarial studies, and many other purposes. Realising the importance of such needs, this volume contains contributions to the theory and practice of forecasting mortality in the relatively favourable circumstances in developed countries of Western Europe. In this context techniques from mathematical statistics and econometrics can provide useful descriptions of past mortality. The naive forecast obtained by extrapolating a fitted model may give as good a forecast as any but forecasting by extrapolation requires careful justification since it assumes the prolongation of historical conditions. On the other hand, whilst it is generally accepted that scientific and other advances will continue to impact on mortality, perhaps dramatically so, it is impossible to quantify more than the outline of future consequences with a strong degree of confidence. The decision to modify an extrapolation of a model fitted to historical data (or conversely choosing not to modify it) in order to obtain a forecast is therefore strongly influenced by subjective and judgmental elements, with the quality of the latter dependent on demographic, epidemiological and indeed perhaps more general considerations. The thread running through the book reflects therefore the necessity of integrating demographic, epidemiological, and statistical factors to obtain an improvement in the prediction of mortality.