Climate change is occurring. It is very likely caused by the emission of greenhouse gases from human activities, and poses significant risks for a range of human and natural systems. And these emissions continue to increase, which will result in further change and greater risks. America's Climate Choices makes the case that the environmental, economic, and humanitarian risks posed by climate change indicate a pressing need for substantial action now to limit the magnitude of climate change and to prepare for adapting to its impacts. Although there is some uncertainty about future risk, acting now will reduce the risks posed by climate change and the pressure to make larger, more rapid, and potentially more expensive reductions later. Most actions taken to reduce vulnerability to climate change impacts are common sense investments that will offer protection against natural climate variations and extreme events. In addition, crucial investment decisions made now about equipment and infrastructure can "lock in" commitments to greenhouse gas emissions for decades to come. Finally, while it may be possible to scale back or reverse many responses to climate change, it is difficult or impossible to "undo" climate change, once manifested. Current efforts of local, state, and private-sector actors are important, but not likely to yield progress comparable to what could be achieved with the addition of strong federal policies that establish coherent national goals and incentives, and that promote strong U.S. engagement in international-level response efforts. The inherent complexities and uncertainties of climate change are best met by applying an iterative risk management framework and making efforts to significantly reduce greenhouse gas emissions; prepare for adapting to impacts; invest in scientific research, technology development, and information systems; and facilitate engagement between scientific and technical experts and the many types of stakeholders making America's climate choices.
Children are already learning at birth, and they develop and learn at a rapid pace in their early years. This provides a critical foundation for lifelong progress, and the adults who provide for the care and the education of young children bear a great responsibility for their health, development, and learning. Despite the fact that they share the same objective - to nurture young children and secure their future success - the various practitioners who contribute to the care and the education of children from birth through age 8 are not acknowledged as a workforce unified by the common knowledge and competencies needed to do their jobs well. Transforming the Workforce for Children Birth Through Age 8 explores the science of child development, particularly looking at implications for the professionals who work with children. This report examines the current capacities and practices of the workforce, the settings in which they work, the policies and infrastructure that set qualifications and provide professional learning, and the government agencies and other funders who support and oversee these systems. This book then makes recommendations to improve the quality of professional practice and the practice environment for care and education professionals. These detailed recommendations create a blueprint for action that builds on a unifying foundation of child development and early learning, shared knowledge and competencies for care and education professionals, and principles for effective professional learning. Young children thrive and learn best when they have secure, positive relationships with adults who are knowledgeable about how to support their development and learning and are responsive to their individual progress. Transforming the Workforce for Children Birth Through Age 8 offers guidance on system changes to improve the quality of professional practice, specific actions to improve professional learning systems and workforce development, and research to continue to build the knowledge base in ways that will directly advance and inform future actions. The recommendations of this book provide an opportunity to improve the quality of the care and the education that children receive, and ultimately improve outcomes for children.
The rapid conversion of land to urban and suburban areas has profoundly altered how water flows during and following storm events, putting higher volumes of water and more pollutants into the nation's rivers, lakes, and estuaries. These changes have degraded water quality and habitat in virtually every urban stream system. The Clean Water Act regulatory framework for addressing sewage and industrial wastes is not well suited to the more difficult problem of stormwater discharges. This book calls for an entirely new permitting structure that would put authority and accountability for stormwater discharges at the municipal level. A number of additional actions, such as conserving natural areas, reducing hard surface cover (e.g., roads and parking lots), and retrofitting urban areas with features that hold and treat stormwater, are recommended.
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.
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.