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This revised and updated edition of an important report looks at macro public policy interventions, community interventions, and individual level interventions in a variety of areas to ascertain 'what works' in practice. It includes new case studies, updated research references, and reference to cost effectiveness.
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 strengths and abilities children develop from infancy through adolescence are crucial for their physical, emotional, and cognitive growth, which in turn help them to achieve success in school and to become responsible, economically self-sufficient, and healthy adults. Capable, responsible, and healthy adults are clearly the foundation of a well-functioning and prosperous society, yet America's future is not as secure as it could be because millions of American children live in families with incomes below the poverty line. A wealth of evidence suggests that a lack of adequate economic resources for families with children compromises these children's ability to grow and achieve adult success, hurting them and the broader society. A Roadmap to Reducing Child Poverty reviews the research on linkages between child poverty and child well-being, and analyzes the poverty-reducing effects of major assistance programs directed at children and families. This report also provides policy and program recommendations for reducing the number of children living in poverty in the United States by half within 10 years.
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.
Adolescenceâ€"beginning with the onset of puberty and ending in the mid-20sâ€"is a critical period of development during which key areas of the brain mature and develop. These changes in brain structure, function, and connectivity mark adolescence as a period of opportunity to discover new vistas, to form relationships with peers and adults, and to explore one's developing identity. It is also a period of resilience that can ameliorate childhood setbacks and set the stage for a thriving trajectory over the life course. Because adolescents comprise nearly one-fourth of the entire U.S. population, the nation needs policies and practices that will better leverage these developmental opportunities to harness the promise of adolescenceâ€"rather than focusing myopically on containing its risks. This report examines the neurobiological and socio-behavioral science of adolescent development and outlines how this knowledge can be applied, both to promote adolescent well-being, resilience, and development, and to rectify structural barriers and inequalities in opportunity, enabling all adolescents to flourish.
This revised edition of Helen Roberts' classic study of child health inequalities features new case studies, updated research references, and a new section on cost effectiveness--an important tool in an era of government spending cutbacks. Applying tools from a variety of disciplines and drawing on evidence from the UK and beyond, Roberts tests the effectiveness of public policy, community, and individual efforts to reduce health inequalities among children at different life stages--including infancy, early years, middle childhood, and adolescence--and to address the particular needs of disabled children. A companion website, including resources for students and teachers, can be found at: http://www.policypress.co.uk/resources/roberts/
'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.
Eight papers, both theoretical and applied, on the concept of equality of opportunity which says that a society should guarantee its members equal access to advantage regardless of their circumstances, while holding them responsible for turning that access into actual advantage by the application of effort.
The WHO European Region has seen remarkable health gains, though inequities persist both between and within countries. Much more is understood now about the extent and social causes of these inequities, particularly since the 2008 report of the Commission on Social Determinants of Health. This review of inequities in health across the 53 Member States of the Region was commissioned to support the development of the new European policy framework for health and well-being, Health 2020. It builds on the global evidence and recommends policies to reduce health inequities and the health divide across all countries, including those with low incomes. The report is presented in four parts. Part I provides the context and background to the review, and sets out the key principles underpinning the recommendations and the rationale for grouping them into four broad themes: life-course stages, wider society, the broader macro-level context, and governance, delivery and monitoring systems. Part II summarizes current evidence on the magnitude of the health divide among European Region countries, describing the inequities in health and their social determinants. Part III focuses on the four themes, making recommendations with supporting evidence. Part IV outlines the implementation issues, summarizes the framework for action, discusses reasons for failure, provides guidance on good practice and summarizes the review's conclusions and recommendations. The review is a wake-up call to political and professional leaders alike, an opportunity for them to facilitate the work of those dedicated to improving health outcomes and narrow the health gap between and within the countries of the Region.