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Drug overdose, driven largely by overdose related to the use of opioids, is now the leading cause of unintentional injury death in the United States. The ongoing opioid crisis lies at the intersection of two public health challenges: reducing the burden of suffering from pain and containing the rising toll of the harms that can arise from the use of opioid medications. Chronic pain and opioid use disorder both represent complex human conditions affecting millions of Americans and causing untold disability and loss of function. In the context of the growing opioid problem, the U.S. Food and Drug Administration (FDA) launched an Opioids Action Plan in early 2016. As part of this plan, the FDA asked the National Academies of Sciences, Engineering, and Medicine to convene a committee to update the state of the science on pain research, care, and education and to identify actions the FDA and others can take to respond to the opioid epidemic, with a particular focus on informing FDA's development of a formal method for incorporating individual and societal considerations into its risk-benefit framework for opioid approval and monitoring.
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.
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.
Disparities in health and health care across racial, ethnic, and socioeconomic backgrounds in the United States are well documented. The reasons for these disparities are, however, not well understood. Current data available on race, ethnicity, SEP, and accumulation and language use are severely limited. The report examines data collection and reporting systems relating to the collection of data on race, ethnicity, and socioeconomic position and offers recommendations.
Social factors, signals, and biases shape the health of our nation. In Perspectives on Health Equity and Social Determinants of Health, authors call for collective action across sectors to reverse the debilitating and often lethal consequences of health inequity.
Decades of research have demonstrated that the parent-child dyad and the environment of the familyâ€"which includes all primary caregiversâ€"are at the foundation of children's well- being and healthy development. From birth, children are learning and rely on parents and the other caregivers in their lives to protect and care for them. The impact of parents may never be greater than during the earliest years of life, when a child's brain is rapidly developing and when nearly all of her or his experiences are created and shaped by parents and the family environment. Parents help children build and refine their knowledge and skills, charting a trajectory for their health and well-being during childhood and beyond. The experience of parenting also impacts parents themselves. For instance, parenting can enrich and give focus to parents' lives; generate stress or calm; and create any number of emotions, including feelings of happiness, sadness, fulfillment, and anger. Parenting of young children today takes place in the context of significant ongoing developments. These include: a rapidly growing body of science on early childhood, increases in funding for programs and services for families, changing demographics of the U.S. population, and greater diversity of family structure. Additionally, parenting is increasingly being shaped by technology and increased access to information about parenting. Parenting Matters identifies parenting knowledge, attitudes, and practices associated with positive developmental outcomes in children ages 0-8; universal/preventive and targeted strategies used in a variety of settings that have been effective with parents of young children and that support the identified knowledge, attitudes, and practices; and barriers to and facilitators for parents' use of practices that lead to healthy child outcomes as well as their participation in effective programs and services. This report makes recommendations directed at an array of stakeholders, for promoting the wide-scale adoption of effective programs and services for parents and on areas that warrant further research to inform policy and practice. It is meant to serve as a roadmap for the future of parenting policy, research, and practice in the United States.
Care and support affects a large number of people: eight out of 10 people aged 65 will need some care and support in their later years; some people have impairments from birth or develop them during their working life; some 5 million people care for a friend or relative, some for more than 50 hours a week. The current system does not offer enough support until a crisis point is reached, the quality of care is variable and inconsistent, and the growing and ageing population is only going to increase the pressure. Consequently, two core principles lie at the heart of this White Paper. The first is that individuals, communities and Government should do everything possible to prevent, postpone and minimise people's need for formal care and support. The system should be built around the promotion of people's independence and well-being. The second principle is that people should be in control of their own care and support, with personal budgets and direct payments, backed by clear, comparable information and advice that will allow individuals and their carers to make the choices that are right for them. This paper sets out the principles and approach, with sections covering: strengthening support within communities; housing; better information and advice; assessment, eligibility and portability for people who use care services; carers' support; defining high-quality care; improving quality; keeping people safe; a better local care market; workforce; personalised care and support; integration and joined-up care.
In 2014, many provisions of the Patient Protection and Affordable Care Act (ACA) went into effect, providing a "marketplace" for consumers to choose affordable health insurance. This report presents statistics on health insurance coverage in the U.S. in 2014 and also focuses on changes between 2013 and 2014. The statistics are based on information collected in two surveys conducted by the U.S. Census Bureau. The report shows that the percentage of people without health insurance coverage decreased sharply between 2013 and 2014 by just under 3.0 percentage points. The uninsured rate, which represents the percentage of the population who had no health insurance coverage during the entire year, changed from 13.3% in 2013 to 10.4% in 2014. Figures and tables. This is a print on demand report.
"[The report] finds that supervision -– probation and parole -– drives high numbers of people, disproportionately those who are Black and brown, right back to jail or prison, while in large part failing to help them get needed services and resources. In states examined in the report, people are often incarcerated for violating the rules of their supervision or for low-level crimes, and receive disproportionate punishment following proceedings that fail to adequately protect their fair trial rights."--Publisher website.