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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.
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.
Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.
Climate change represents one of the most alarming long-term threats to ecosystems the world over. This new collection of papers provides, for the first time, an overview of the potentially serious impact that climate change may have on tropical forests. The authors, a multi-disciplinary group of leading experts in climatology, forestry, ecology and conservation biology, present a state-of-knowledge snapshot of how tropical forests are likely to react to the changes being wrought on our planet's atmosphere and climate. Tropical forests represent extraordinary harbours for biological diversity, and yet as deforestation and degradation continue apace, they are under greater pressure from human impacts than ever before. Climate change adds yet another threat to these valuable ecosystems, and this volume demonstrates just how significant a problem this may really be. The authors identify certain types of forest, including tropical montane cloud forest that may be particularly vulnerable. They also show the strong likelihood of global warming aggravating problems in already fragmented forest areas.
Many federal funding requests for more advanced computer resources assume implicitly that greater computing power creates opportunities for advancement in science and engineering. This has often been a good assumption. Given stringent pressures on the federal budget, the White House Office of Management and Budget (OMB) and Office of Science and Technology Policy (OSTP) are seeking an improved approach to the formulation and review of requests from the agencies for new computing funds. This book examines, for four illustrative fields of science and engineering, how one can start with an understanding of their major challenges and discern how progress against those challenges depends on high-end capability computing (HECC). The four fields covered are: atmospheric science astrophysics chemical separations evolutionary biology This book finds that all four of these fields are critically dependent on HECC, but in different ways. The book characterizes the components that combine to enable new advances in computational science and engineering and identifies aspects that apply to multiple fields.