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.
Early care and education for many children in the United States is in crisis. The period between birth and kindergarten is a critical time for child development, and socioeconomic disparities that begin early in children’s lives contribute to starkly different long-term outcomes for adults. Yet, compared to other advanced economies, high-quality child care and preschool in the United States are scarce and prohibitively expensive for many middle-class and most disadvantaged families. To what extent can early-life interventions provide these children with the opportunities that their affluent peers enjoy and contribute to reduced social inequality in the long term? Cradle to Kindergarten offers a comprehensive, evidence-based strategy that diagnoses the obstacles to accessible early education and charts a path to opportunity for all children. The U.S. government invests less in children under the age of five than do most other developed nations. Most working families must seek private childcare, which means that children from low-income households, who would benefit most from high-quality early education, are the least likely to attend them. Existing policies, such as pre-kindergarten in some states are only partial solutions. To address these deficiencies, the authors propose to overhaul the early care system, beginning with a federal paid parental leave policy that provides both mothers and fathers with time and financial support after the birth of a child. They also advocate increased public benefits, including an expansion of the child care tax credit, and a new child care assurance program that subsidizes the cost of early care for low- and moderate-income families. They also propose that universal, high-quality early education in the states should start by age three, and a reform of the Head Start program that would include more intensive services for families living in areas of concentrated poverty and experiencing multiple adversities from the earliest point in these most disadvantaged children’s lives. They conclude with an implementation plan and contend that these reforms are attainable within a ten-year timeline. Reducing educational and economic inequalities requires that all children have robust opportunities to learn, fully develop their capacities, and have a fair shot at success. Cradle to Kindergarten presents a blueprint for fulfilling this promise by expanding access to educational and financial resources at a critical stage of child development.