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.
Not every illness has a biological remedy. Poverty, Health and Law presents health in the broader social context of people''s lives, providing insights into the advancement of health through legal advocacy and interdisciplinary solutions to complex social problems. Focusing on basic legal rights and their relation to health--income and employment, housing, education, legal status, and personal safety--the authors provide information and insight into how the law may be used as a tool to improve health and how health care providers and lawyers can work together to invoke more effective and preventive remedies for patients and clients. As America prepares for major reform of its health care system, Poverty, Health and Law brings to the forefront the need to address the root causes of illness and poor health, particularly among vulnerable populations, by exploring remedies and innovations both within and outside of the health care system. "[T]his book is a helpful resource for existing and emerging MLPs that is sure to inspire improved care for the poor." -- World Medical & Health Policy "This book is intended to be used in at least three ways: (1) as a teaching tool primarily for legal and medical educators; (2) as a guidebook for newer or contemplated MLP programs; and (3) as a resource and reference work for MLP practitioners. It succeeds in each of these categories. ...The chief pedagogical goal, whose attainment is likely to be aided immeasurably by this volume, is not to get physicians and attorneys to think alike, but rather to teach members of each profession how and why the other professional thinks as he or she does. ...Taking on an ambitious and provocative agenda, they have done an excellent job of preparing future and current medical and legal practitioners to work collaboratively on behalf of patients/clients who need their joint advocacy. Any reader interested in the ways in which law and medicine might intersect on behalf of consumers'' well-being will benefit from attention to ''the'' book on the current achievements and future promise of MLPs." -- Journal of Law, Medicine & Ethics, Marshall B. Kapp, J.D., M.P.H., Director of the Florida State University Center for Innovative Collaboration in Medicine & Law "[This book] is an invaluable compendium of collective wisdom concerning the theory and practice of MLP--a gift. Those new to the field, whether practitioners, students, academics or bureaucrats, will scarcely believe their luck that such an impressive resource now exists; an exhaustive treatment of MLP from the foundations up. But Poverty, Health and Law isn''t just an edited collection of pieces from legal and medical practitioners from around the States--it is a thoughtful and strategic treatment of the subject with a unified structure and consistent educative approach. Intended as both a teaching tool and a resource for those engaged or interested in MLP, the book boasts numerous valuable features...[w]hether you are beginning to explore MLP or wanting to supercharge an existing partnership or alliance, Poverty, Health and Law will prove to be an indispensible reference." -- Peter Noble, Advocacy Health Alliances blog "Poverty, Health and Law is a valuable resource to enhance understanding of the non-medical factors that affect health. Garnering the expertise of authors from healthcare and law, Poverty, Health and Law is intentionally written to be accessible to students across disciplines of medicine, law, social work and public health. It is a crucial step in advancing the medical-legal partnership model and will also serve as a catalyst to stimulate further research about addressing the social determinants of health." -- David R. Williams, Ph.D., M.P.H., Florence Sprague Norman and Laura Smart Norman Professor of Public Health, Professor of African and African American Studies and of Sociology, Harvard University "This ground-breaking work shows how doctors and lawyers across the country can work together to protect the health of our most vulnerable populations. A comprehensive collection of compelling essays written by national experts, this volume is an invaluable teaching tool for the next generation of legal and health professionals to help guide and inspire such innovative interdisciplinary collaborations in the future. It is also a must-read for practitioners and policy-makers alike who want to understand how real health reform can happen at the grass-roots level." -- Charity Scott, J.D., Professor of Law and Director of the Center for Law, Health & Society, Georgia State University College of Law "Medical-legal partnerships unite the medical and legal professions in a common goal and create the ideal team to serve the healthcare and legal needs of vulnerable populations including children, cancer patients, senior citizens, and HIV/AIDS patients. Not only do they provide critical direct services to patients, they also promote systemic advocacy efforts that have an enormously positive impact on healthcare policies and practices. Poverty, Health and Law is an important guide that could not have been published at a more vital time." -- Steven B. Scudder, J.D., Committee Counsel, ABA Standing Committee on Pro Bono and Public Service
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.
Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.
Countless public health agencies are trying to solve our most intractable public health problems -- among them, the obesity and opioid epidemics -- by partnering with corporations responsible for creating or exacerbating those problems. We are told industry must be part of the solution. But is it time to challenge the partnership paradigm and the popular narratives that sustain it? In The Perils of Partnership, Jonathan H. Marks argues that public-private partnerships and multi-stakeholder initiatives create "webs of influence" that undermine the integrity of public health agencies; distort public health research and policy; and reinforce the framing of public health problems and their solutions in ways that are least threatening to the commercial interests of corporate "partners". We should expect multinational corporations to develop strategies of influence -- but public bodies can and should develop counter-strategies to insulate themselves from corporate influence in all its forms. Marks reviews the norms that regulate public-public interactions (separation of powers) and private-private interactions (antitrust and competition law), and argues for an analogous set of norms to govern public-private interactions. He also offers a novel framework to help public bodies identify the systemic ethical implications of their current or proposed relationships with industry actors. Marks makes a compelling case that the default public-private interaction should be at arm's length: separation, not collaboration. He calls for a new paradigm that avoids the perils of corporate influence and more effectively protects and promotes public health. The Perils of Partnership is essential reading for public health officials and policymakers -- but anyone interested in public health will recognize the urgency of this book.
"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.
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.
Bioterrorism, drug-resistant disease, transmission of disease by global travel . . . there's no shortage of challenges facing America's public health officials. Men and women preparing to enter the field require state-of-the-art training to meet these increasing threats to the public health. But are the programs they rely on provide the high caliber professional training they require? Who Will Keep the Public Healthy? provides an overview of the past, present, and future of public health education, assessing its readiness to provide the training and education needed to prepare men and women to face 21st century challenges. Advocating an ecological approach to public health, the Institute of Medicine examines the role of public health schools and degree-granting programs, medical schools, nursing schools, and government agencies, as well as other institutions that foster public health education and leadership. Specific recommendations address the content of public health education, qualifications for faculty, availability of supervised practice, opportunities for cross-disciplinary research and education, cooperation with government agencies, and government funding for education. Eight areas of critical importance to public health education in the 21st century are examined in depth: informatics, genomics, communication, cultural competence, community-based participatory research, global health, policy and law, and public health ethics. The book also includes a discussion of the policy implications of its ecological framework.
The Future of Nursing explores how nurses' roles, responsibilities, and education should change significantly to meet the increased demand for care that will be created by health care reform and to advance improvements in America's increasingly complex health system. At more than 3 million in number, nurses make up the single largest segment of the health care work force. They also spend the greatest amount of time in delivering patient care as a profession. Nurses therefore have valuable insights and unique abilities to contribute as partners with other health care professionals in improving the quality and safety of care as envisioned in the Affordable Care Act (ACA) enacted this year. Nurses should be fully engaged with other health professionals and assume leadership roles in redesigning care in the United States. To ensure its members are well-prepared, the profession should institute residency training for nurses, increase the percentage of nurses who attain a bachelor's degree to 80 percent by 2020, and double the number who pursue doctorates. Furthermore, regulatory and institutional obstacles-including limits on nurses' scope of practice-should be removed so that the health system can reap the full benefit of nurses' training, skills, and knowledge in patient care. In this book, the Institute of Medicine makes recommendations for an action-oriented blueprint for the future of nursing.
