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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.
Children are the foundation of the United States, and supporting them is a key component of building a successful future. However, millions of children face health inequities that compromise their development, well-being, and long-term outcomes, despite substantial scientific evidence about how those adversities contribute to poor health. Advancements in neurobiological and socio-behavioral science show that critical biological systems develop in the prenatal through early childhood periods, and neurobiological development is extremely responsive to environmental influences during these stages. Consequently, social, economic, cultural, and environmental factors significantly affect a child's health ecosystem and ability to thrive throughout adulthood. Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity builds upon and updates research from Communities in Action: Pathways to Health Equity (2017) and From Neurons to Neighborhoods: The Science of Early Childhood Development (2000). This report provides a brief overview of stressors that affect childhood development and health, a framework for applying current brain and development science to the real world, a roadmap for implementing tailored interventions, and recommendations about improving systems to better align with our understanding of the significant impact of health equity.
"Supporting a Movement for Health and Health Equity" is the summary of a workshop convened in December 2013 by the Institute of Medicine Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities and the Roundtable on Population Health Improvement to explore the lessons that may be gleaned from social movements, both those that are health-related and those that are not primarily focused on health. Participants and presenters focused on elements identified from the history and sociology of social change movements and how such elements can be applied to present-day efforts nationally and across communities to improve the chances for long, healthy lives for all. The idea of movements and movement building is inextricably linked with the history of public health. Historically, most movements - including, for example, those for safer working conditions, for clean water, and for safe food - have emerged from the sustained efforts of many different groups of individuals, which were often organized in order to protest and advocate for changes in the name of such values as fairness and human rights. The purpose of the workshop was to have a conversation about how to support the fragments of health movements that roundtable members believed they could see occurring in society and in the health field. Recent reports from the National Academies have highlighted evidence that the United States gets poor value on its extraordinary investments in health - in particular, on its investments in health care - as American life expectancy lags behind that of other wealthy nations. As a result, many individuals and organizations, including the Healthy People 2020 initiative, have called for better health and longer lives.
Evidence indicates that actions within four main themes (early child development fair employment and decent work social protection and the living environment) are likely to have the greatest impact on the social determinants of health and health inequities. A systematic search and analysis of recommendations and policy guidelines from intergovernmental organizations and international bodies identified practical policy options for action on social determinants within these four themes. Policy options focused on early childhood education and care; child poverty; investment strategies for an inclusive economy; active labour market programmes; working conditions; social cash transfers; affordable housing; and planning and regulatory mechanisms to improve air quality and mitigate climate change. Applying combinations of these policy options alongside effective governance for health equity should enable WHO European Region Member States to reduce health inequities and synergize efforts to achieve the United Nations Sustainable Development Goals.
Health care is in the midst of a dramatic transformation in the United States. Spurred by technological advances, economic imperatives, and governmental policies, information technologies are rapidly being applied to health care in an effort to improve access, enhance quality, and decrease costs. At the same time, the use of technologies by the consumers of health care is changing how people interact with the health care system and with health information. These changes in health care have the potential both to exacerbate and to diminish the stark disparities in health and well-being that exist among population groups in the United States. If the benefits of technology flow disproportionately to those who already enjoy better coverage, use, and outcomes than disadvantaged groups, heath disparities could increase. But if technologies can be developed and implemented in such a way to improve access and enhance quality for the members of all groups, the ongoing transformation of health care could reduce the gaps among groups while improving health care for all. To explore the potential for further insights into, and opportunities to address, disparities in underserved populations the National Academies of Sciences, Engineering, and Medicine held a workshop in October 2014. The workshop focused on (1) how communities are using digital health technologies to improve health outcomes for racial and ethnic minority populations, (2) how community engagement can improve access to high-quality health information for members of these groups, and (3) on models of successful technology-based strategies to reduce health disparities. This report summarizes the presentations and discussions at the workshop.
Integrates the various disciplines of the science of health disparities in one comprehensive volume The Science of Health Disparities Research is an indispensable source of up-to-date information on clinical and translational health disparities science. Building upon the advances in health disparities research over the past decade, this authoritative volume informs policies and practices addressing the diseases, disorders, and gaps in health outcomes that are more prevalent in minority populations and socially disadvantaged communities. Contributions by recognized scholars and leaders in the field—featuring contemporary research, conceptual models, and a broad range of scientific perspectives—provide an interdisciplinary approach to reducing inequalities in population health, encouraging community engagement in the research process, and promoting social justice. In-depth chapters help readers better understand the specifics of minority health and health disparities while demonstrating the importance of advancing theory, refining measurement, improving investigative methods, and diversifying scientific research. In 26 chapters, the book examines topics including the etiology of health disparities research, the determinants of population health, research ethics, and research in African American, Asians, Latino, American Indian, and other vulnerable populations. Providing a unified framework on the principles and applications of the science of health disparities research, this important volume: Defines the field of health disparities science and suggests new directions in scholarship and research Explains basic definitions, principles, and concepts for identifying, understanding and addressing health disparities Provides guidance on both conducting health disparities research and translating the results Examines how social, historical and contemporary injustices may influence the health of racial and ethnic minorities Illustrates the increasing national and global importance of addressing health disparities Discusses population health training, capacity-building, and the transdisciplinary tools needed to advance health equity A significant contribution to the field, The Science of Health Disparities Research is an essential resource for students and basic and clinical researchers in genetics, population genetics, and public health, health care policymakers, and epidemiologists, medical students, and clinicians, particularly those working with minority, vulnerable, or underserved populations.
This book focuses on promoting health equity and addressing health disparities among Indigenous peoples of the United States (U.S.) and associated Territories in the Pacific Islands and Caribbean. It provides an overview of the current state of health equity across social, physical, and mental health domains to provide a preliminary understanding of the state of Indigenous health equity. Part 1 of the book traces the promotive, protective, and risk factors related to Indigenous health equity. Part 2 reports promising pathways to achieving and transcending health equity through the description of interventions that address and promote wellness related to key outcomes. The chapters in this book were originally published as a special issue of the Journal of Ethnic & Cultural Diversity in Social Work.
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
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