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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.
Building on the innovative Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Quality Through Collaboration: The Future of Rural Health offers a strategy to address the quality challenges in rural communities. Rural America is a vital, diverse component of the American community, representing nearly 20% of the population of the United States. Rural communities are heterogeneous and differ in population density, remoteness from urban areas, and the cultural norms of the regions of which they are a part. As a result, rural communities range in their demographics and environmental, economic, and social characteristics. These differences influence the magnitude and types of health problems these communities face. Quality Through Collaboration: The Future of Rural Health assesses the quality of health care in rural areas and provides a framework for core set of services and essential infrastructure to deliver those services to rural communities. The book recommends: Adopting an integrated approach to addressing both personal and population health needs Establishing a stronger health care quality improvement support structure to assist rural health systems and professionals Enhancing the human resource capacity of health care professionals in rural communities and expanding the preparedness of rural residents to actively engage in improving their health and health care Assuring that rural health care systems are financially stable Investing in an information and communications technology infrastructure It is critical that existing and new resources be deployed strategically, recognizing the need to improve both the quality of individual-level care and the health of rural communities and populations.
Rural counties make up about 80 percent of the land area of the United States, but they contain less than 20 percent of the U.S. population. The relative sparseness of the population in rural areas is one of many factors that influence the health and well-being of rural Americans. Rural areas have histories, economies, and cultures that differ from those of cities and from one rural area to another. Understanding these differences is critical to taking steps to improve health and well-being in rural areas and to reduce health disparities among rural populations. To explore the impacts of economic, demographic, and social issues in rural communities and to learn about asset-based approaches to addressing the associated challenges, the National Academies of Sciences, Engineering, and Medicine held a workshop on June 13, 2017. This publication summarizes the presentations and discussions from the workshop.
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
Race, Ethnicity and Health, Second Edition, is a critical selection of hallmark articles that address health disparities in America. It effectively documents the need for equal treatment and equal health status for minorities. Intended as a resource for faculty and students in public health as well as the social sciences, it will be also be valuable to public health administrators and frontline staff who serve diverse racial and ethnic populations. The book brings together the best peer reviewed research literature from the leading scholars and faculty in this growing field, providing a historical and political context for the study of health, race, and ethnicity, with key findings on disparities in access, use, and quality. This volume also examines the role of health care providers in health disparities and discusses the issue of matching patients and doctors by race. New chapters cover: reflections on demographic changes in the US based on the current census; metrics and nomenclature for disparities; theories of genetic basis for disparities; the built environment; residential segregation; environmental health; occupational health; health disparities in integrated communities; Latino health; Asian populations; stress and health; physician/patient relationships; hospital treatment of minorities; the slavery hypertension hypothesis; geographic disparities; and intervention design.
The thoroughly revised and updated Third Edition of the acclaimed Modern Epidemiology reflects both the conceptual development of this evolving science and the increasingly focal role that epidemiology plays in dealing with public health and medical problems. Coauthored by three leading epidemiologists, with sixteen additional contributors, this Third Edition is the most comprehensive and cohesive text on the principles and methods of epidemiologic research. The book covers a broad range of concepts and methods, such as basic measures of disease frequency and associations, study design, field methods, threats to validity, and assessing precision. It also covers advanced topics in data analysis such as Bayesian analysis, bias analysis, and hierarchical regression. Chapters examine specific areas of research such as disease surveillance, ecologic studies, social epidemiology, infectious disease epidemiology, genetic and molecular epidemiology, nutritional epidemiology, environmental epidemiology, reproductive epidemiology, and clinical epidemiology.
Featuring contributions from practitioners, researchers, and academics, this volume synthesizes and analyzes current trends in rural social work practice and considers the most effective ways to serve rural communities. Contributors consider the history and development of rural social work from its beginnings to the present day, addressing the value of the Internet and other new information technologies in helping clients. They also examine the effects of nonprofit organizations and welfare reform on poor rural areas. Coverage of specific client populations and fields of practice includes services for rural mental healthcare; the chronically mentally ill; healthcare for minorities; and the challenges faced by the elderly in rural areas. The contributors also consider issues affecting gays and lesbians living in rural communities and the role of religiosity and social support in the well-being of HIV/AIDS clients. The book concludes with a consideration of the unique issues associated with educating social workers for rural practice.
In early 2007, the Institute of Medicine convened the Roundtable on Health Disparities to increase the visibility of racial and ethnic health disparities as a national problem, to further the development of programs and strategies to reduce disparities, to foster the emergence of leadership on this issue, and to track promising activities and developments in health care that could lead to dramatically reducing or eliminating disparities. The Roundtable's first workshop, Challenges and Successes in Reducing Health Disparities, was held in St. Louis, Missouri, on July 31, 2007, and examined (1) the importance of differences in life expectancy within the United States, (2) the reasons for those differences, and (3) the implications of this information for programs and policy makers.