Workshop
A particularly valuable opportunity to improve public health arises when an urban area is being redesigned and rebuilt following some type of serious disruption, whether it is caused by a sudden physical event, such as a hurricane or earthquake, or steady economic and social decline that may have occurred over decades. On November 10, 2014, the Institute of Medicine's Roundtable on Environmental Health Sciences, Research, and Medicine held a workshop concerning the ways in which the urban environment, conceived broadly from factors such as air quality and walkability to factors such as access to fresh foods and social support systems, can affect health. Participants explored the various opportunities to reimagine the built environment in a city and to increase the role of health promotion and protection during the process of urban revitalization. Bringing Public Health into Urban Revitalization summarizes the presentations and discussions from this workshop.
98 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-37995-4
ISBN Ebook: 0-309-37996-2
DOI:
https://doi.org/10.17226/21831
National Academies of Sciences, Engineering, and Medicine. 2015. Bringing Public Health into Urban Revitalization: Workshop Summary. Washington, DC: The National Academies Press.
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Workshop
The Institute of Medicine's Roundtable on Population Health Improvement brings together individuals and organizations that represent different sectors in a dialogue about what is needed to improve population health. On September 22, 2014, the roundtable held a workshop to discuss some of the science of health communication, audiences, and messaging, and to explore what it will take to generate widespread awareness, acceptance, and action to improve health, including through the entertainment media, the news media, and social media. This report summarizes the presentations and discussion of the workshop.
96 pages
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ISBN Paperback: 0-309-36867-7
ISBN Ebook: 0-309-36868-5
DOI:
https://doi.org/10.17226/21694
Institute of Medicine. 2015. Communicating to Advance the Public's Health: Workshop Summary. Washington, DC: The National Academies Press.
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The proliferation of consumer-facing technology and personal health information technology has grown steadily over the past decade, and has certainly exploded over the past several years. Many people have embraced smartphones and wearable health-monitoring devices to track their fitness and personal health information. Providers have made it easier for patients and caregivers to access health records and communicate through online patient portals. However, the large volume of health-related information that these devices can generate and input into a health record can also lead to an increased amount of confusion on the part of users and caregivers.
The Institute of Medicine convened a workshop to explore health literate practices in health information technology and then provide and consider the ramifications of this rapidly growing field on the health literacy of users. Health Literacy and Consumer-Facing Technology summarizes the discussions and presentations from this workshop, highlighting the lessons presented, practical strategies, and the needs and opportunities for improving health literacy in consumer-facing technology.
122 pages
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ISBN Paperback: 0-309-37690-4
ISBN Ebook: 0-309-37691-2
DOI:
https://doi.org/10.17226/21781
National Academies of Sciences, Engineering, and Medicine. 2015. Health Literacy and Consumer-Facing Technology: Workshop Summary. Washington, DC: The National Academies Press.
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Research based on decades of experience in the developing world has identified educational status, especially the status of the mother, as a major predictor of health outcomes and that the literature indicates that the gradient in health outcomes by educational attainment has steepened over the last four decades across the United States. Since the 1990s, while the average life expectancy in the United States has been steadily increasing, life expectancy has actually decreased for people without a high school education, especially white women.
To understand the complex relationship between education and health and how this understanding could inform our nation's investments and policies, the Institute of Medicine Roundtable on Population Health Improvement held a public workshop in Washington, DC, on June 5, 2014. This workshop, which featured presentations and extensive discussion periods, also explored how the health and education sectors can work together more effectively to achieve improvements in both health status and educational achievement. This report summarizes the presentations and discussion of the workshop.
126 pages
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6 x 9
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ISBN Paperback: 0-309-31422-4
ISBN Ebook: 0-309-31423-2
DOI:
https://doi.org/10.17226/18979
Institute of Medicine. 2015. Exploring Opportunities for Collaboration Between Health and Education to Improve Population Health: Workshop Summary. Washington, DC: The National Academies Press.
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The U.S. National Climate Assessment identified a number of ways in which climate change is affecting, and is likely to affect, people, infrastructure, natural resources, and ecosystems. Those impacts, in turn, are increasingly having important current and potential future consequences for human health. There is a need to probe more deeply into how climate change impacts on the environment can create environmental stressors that, in turn, are having and/or have the potential to have significant impact on human health in a number of dimensions. In response to this need, the U.S. Global Change Research Program (USGCRP) has initiated an interagency Scientific Assessment on the Impacts of Climate Change on Human Health in the United States. The Assessment is intended to inform public health authorities, other planning and policy entities, and the general public.
Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States evaluates the scientific basis, findings, and key messages of the USGCRP Draft Assessment. This report offers a number of overarching suggestions on how the USGCRP report authors can enhance their identification and assessment of the science and better communicate their conclusions to all of their target audiences. These recommendations this help the Assessment to play a significant role in continued efforts to examine and explore the impacts of climate change on human health.
78 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-37727-7
ISBN Ebook: 0-309-37728-5
DOI:
https://doi.org/10.17226/21787
National Academies of Sciences, Engineering, and Medicine. 2015. Review of the Draft Interagency Report on the Impacts of Climate Change on Human Health in the United States. Washington, DC: The National Academies Press.
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Workshop
In 2004, the Institute of Medicine released Health Literacy: A Prescription to End Confusion, a report on the then-underappreciated challenge of enabling patients to comprehend their condition and treatment, to make the best decisions for their care, and to take the right medications at the right time in the intended dose. That report documented the problems, origins, and consequences of the fact that tens of millions of U.S. adults are unable to read complex texts, including many health-related materials, and it proposed possible solutions to those problems.
To commemorate the anniversary of the release of the 2004 health literacy report, the Institute of Medicine's Roundtable on Health Literacy convened a 1-day public workshop to assess the progress made in the field of health literacy over the past decade, the current state of the field, and the future of health literacy at the local, national, and international levels. Health Literacy: Past, Present, and Future summarizes the presentation and discussion of the workshop.
130 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-37154-6
ISBN Ebook: 0-309-37155-4
DOI:
https://doi.org/10.17226/21714
National Academies of Sciences, Engineering, and Medicine. 2015. Health Literacy: Past, Present, and Future: Workshop Summary. Washington, DC: The National Academies Press.
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Tobacco use by adolescents and young adults poses serious concerns. Nearly all adults who have ever smoked daily first tried a cigarette before 26 years of age. Current cigarette use among adults is highest among persons aged 21 to 25 years. The parts of the brain most responsible for cognitive and psychosocial maturity continue to develop and change through young adulthood, and adolescent brains are uniquely vulnerable to the effects of nicotine.
At the request of the U.S. Food and Drug Administration, Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products considers the likely public health impact of raising the minimum age for purchasing tobacco products. The report reviews the existing literature on tobacco use patterns, developmental biology and psychology, health effects of tobacco use, and the current landscape regarding youth access laws, including minimum age laws and their enforcement. Based on this literature, the report makes conclusions about the likely effect of raising the minimum age to 19, 21, and 25 years on tobacco use initiation. The report also quantifies the accompanying public health outcomes based on findings from two tobacco use simulation models. According to the report, raising the minimum age of legal access to tobacco products, particularly to ages 21 and 25, will lead to substantial reductions in tobacco use, improve the health of Americans across the lifespan, and save lives. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products will be a valuable reference for federal policy makers and state and local health departments and legislators.
398 pages
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6 x 9
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ISBN Paperback: 0-309-31624-3
ISBN Ebook: 0-309-31625-1
DOI:
https://doi.org/10.17226/18997
Institute of Medicine. 2015. Public Health Implications of Raising the Minimum Age of Legal Access to Tobacco Products. Washington, DC: The National Academies Press.
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Tobacco consumption continues to be the leading cause of preventable disease and death in the United States. The Food and Drug Administration (FDA) regulates the manufacture, distribution, and marketing of tobacco products - specifically cigarettes, cigarette tobacco, roll-your-own tobacco, and smokeless tobacco - to protect public health and reduce tobacco use in the United States. Given the strong social component inherent to tobacco use onset, cessation, and relapse, and given the heterogeneity of those social interactions, agent-based models have the potential to be an essential tool in assessing the effects of policies to control tobacco.
Assessing the Use of Agent-Based Models for Tobacco Regulation describes the complex tobacco environment; discusses the usefulness of agent-based models to inform tobacco policy and regulation; presents an evaluation framework for policy-relevant agent-based models; examines the role and type of data needed to develop agent-based models for tobacco regulation; provides an assessment of the agent-based model developed for FDA; and offers strategies for using agent-based models to inform decision making in the future.
290 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-31722-3
ISBN Ebook: 0-309-31723-1
DOI:
https://doi.org/10.17226/19018
Institute of Medicine. 2015. Assessing the Use of Agent-Based Models for Tobacco Regulation. Washington, DC: The National Academies Press.
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Workshop
Business Engagement in Building Healthy Communities is the summary of a workshop convened by the Institute of Medicine's Roundtable on Population Health Improvement in July 2014 to consider the role of business in improving population health beyond the usual worksite wellness and health promotion activities. The workshop followed previous roundtable discussions on the importance of applying a health lens to decision making in non-health sectors and the need for cross-sector collaborations to advance population health. Invited speakers included representatives from several businesses that have taken action to improve the health of their communities and representatives of business coalitions on health. The workshop was designed to discuss why engaging in population health improvement is good for business; explore how businesses can be effective key leaders in improving the health of communities; and discuss ways in which businesses can engage in population health improvement. This report is a record of the presentations and discussion of the event
100 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-31666-9
ISBN Ebook: 0-309-31667-7
DOI:
https://doi.org/10.17226/19003
Institute of Medicine. 2015. Business Engagement in Building Healthy Communities: Workshop Summary. Washington, DC: The National Academies Press.
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Tobacco use has declined because of measures such as high taxes on tobacco products and bans on advertising, but worldwide there are still more than one billion people who regularly use tobacco, including many who purchase products illicitly. By contrast to many other commodities, taxes comprise a substantial portion of the retail price of cigarettes in the United States and most other nations. Large tax differentials between jurisdictions increase incentives for participation in existing illicit tobacco markets. In the United States, the illicit tobacco market consists mostly of bootlegging from low-tax states to high-tax states and is less affected by large-scale smuggling or illegal production as in other countries. In the future, nonprice regulation of cigarettes - such as product design, formulation, and packaging - could in principle, contribute to the development of new types of illicit tobacco markets.
Understanding the U.S. Illicit Tobacco Market reviews the nature of illicit tobacco markets, evidence for policy effects, and variations among different countries with a focus on implications for the United States. This report estimates the portion of the total U.S. tobacco market represented by illicit sales has grown in recent years and is now between 8.5 percent and 21 percent. This represents between 1.24 to 2.91 billion packs of cigarettes annually and between $2.95 billion and $6.92 billion in lost gross state and local tax revenues.
Understanding the U.S. Illicit Tobacco Market describes the complex system associated with illicit tobacco use by exploring some of the key features of that market - the cigarette supply chain, illicit procurement schemes, the major actors in the illicit trade, and the characteristics of users of illicit tobacco. This report draws on domestic and international experiences with the illicit tobacco trade to identify a range of possible policy and enforcement interventions by the U.S. federal government and/or states and localities.
240 pages
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paperback
ISBN Paperback: 0-309-31712-6
ISBN Ebook: 0-309-31713-4
DOI:
https://doi.org/10.17226/19016
National Research Council. 2015. Understanding the U.S. Illicit Tobacco Market: Characteristics, Policy Context, and Lessons from International Experiences. Washington, DC: The National Academies Press.
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Workshop_in_brief
Drawing on the experience of practitioners and stakeholders in health and nonhealth fields, the Institute of Medicine's Roundtable on Population Health Improvement fosters interdisciplinary dialogue about factors and actions needed to improve the nation's health. On February 5, 2015, the roundtable held a workshop in Washington, DC, titled "Opportunities at the Interface of Health Care and Public Health." The event focused on how collaboration can facilitate conversation and action to achieve more meaningful population health solutions. This brief summary of the workshop highlights presentations and discussion sessions.
8 pages
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8.5 x 11
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ISBN Ebook: 0-309-36848-0
DOI:
https://doi.org/10.17226/21687
Institute of Medicine. 2015. Collaboration Between Health Care and Public Health: Workshop in Brief. Washington, DC: The National Academies Press.
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Workshop_in_brief
On December 4, 2014, the Institute of Medicine Roundtable on Population Health Improvement held a workshop focused on the spread, scale, and sustainability of strategies to improve population health in a variety of contexts and sectors. The workshop explored the different meanings of spread and scale; what could be learned about a variety of approaches to the spread and scale of ideas, practices, programs, and policies; how users measure whether their strategies of spread and scale were effective; and how to accelerate a focus on spread and scale strategies in population health. This report summarizes the presentation and discussion of that event.
8 pages
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8.5 x 11
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ISBN Ebook: 0-309-37138-4
DOI:
https://doi.org/10.17226/21711
Institute of Medicine. 2015. Spread, Scale, and Sustainability in Population Health: Workshop in Brief. Washington, DC: The National Academies Press.
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Workshop
Informed consent - the process of communication between a patient or research subject and a physician or researcher that results in the explicit agreement to undergo a specific medical intervention - is an ethical concept based on the principle that all patients and research subjects should understand and agree to the potential consequences of the clinical care they receive. Regulations that govern the attainment of informed consent for treatment and research are crucial to ensuring that medical care and research are conducted in an ethical manner and with the utmost respect for individual preferences and dignity. These regulations, however, often require - or are perceived to require - that informed consent documents and related materials contain language that is beyond the comprehension level of most patients and study participants.
To explore what actions can be taken to help close the gap between what is required in the informed consent process and communicating it in a health-literate and meaningful manner to individuals, the Institute of Medicine's Roundtable on Health Literacy convened a one-day public workshop featuring presentations and discussions that examine the implications of health literacy for informed consent for both research involving human subjects and treatment of patients. Topics covered in this workshop included an overview of the ethical imperative to gain informed consent from patients and research participants, a review of the current state and best practices for informed consent in research and treatment, the connection between poor informed consent processes and minority underrepresentation in research, new approaches to informed consent that reflect principles of health literacy, and the future of informed consent in the treatment and research settings. Informed Consent and Health Literacy is the summary of the presentations and discussion of the workshop.
192 pages
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paperback
ISBN Paperback: 0-309-31727-4
ISBN Ebook: 0-309-31728-2
DOI:
https://doi.org/10.17226/19019
Institute of Medicine. 2015. Informed Consent and Health Literacy: Workshop Summary. Washington, DC: The National Academies Press.
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The Role and Potential of Communities in Population Health Improvement is the summary of a workshop held by the Institute of Medicine Roundtable on Population Health Improvement in April 2014 that featured invited speakers from community groups that have taken steps to improve the health of their communities. Speakers from communities across the United States discussed the potential roles of communities for improving population health. The workshop focused on youth organizing, community organizing or other types of community participation, and partnerships between community and institutional actors. This report explores the roles and potential of the community as leaders, partners, and facilitators in transforming the social and environmental conditions that shape health and well-being at the local level.
86 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-31206-X
ISBN Ebook: 0-309-31207-8
DOI:
https://doi.org/10.17226/18946
Institute of Medicine. 2015. The Role and Potential of Communities in Population Health Improvement: Workshop Summary. Washington, DC: The National Academies Press.
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SMART Vaccines - Strategic Multi-Attribute Ranking Tool for Vaccines - is a prioritization software tool developed by the Institute of Medicine that utilizes decision science and modeling to help inform choices among candidates for new vaccine development. A blueprint for this computer-based guide was presented in the 2012 report Ranking Vaccines: A Prioritization Framework: Phase I. The 2013 Phase II report refined a beta version of the model developed in the Phase I report.
Ranking Vaccines: Applications of a Prioritization Software Tool: Phase III: Use Case Studies and Data Framework extends this project by demonstrating the practical applications of SMART Vaccines through use case scenarios in partnership with the Public Health Agency of Canada, New York State Department of Health, and the Serum Institute of India. This report also explores a novel application of SMART Vaccines in determining new vaccine product profiles, and offers practical strategies for data synthesis and estimation to encourage the broader use of the software.
128 pages
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7 x 10
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paperback
ISBN Paperback: 0-309-30403-2
ISBN Ebook: 0-309-30404-0
DOI:
https://doi.org/10.17226/18763
Institute of Medicine and National Academy of Engineering. 2015. Ranking Vaccines: Applications of a Prioritization Software Tool: Phase III: Use Case Studies and Data Framework. Washington, DC: The National Academies Press.
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Determinants of health - like physical activity levels and living conditions - have traditionally been the concern of public health and have not been linked closely to clinical practice. However, if standardized social and behavioral data can be incorporated into patient electronic health records (EHRs), those data can provide crucial information about factors that influence health and the effectiveness of treatment. Such information is useful for diagnosis, treatment choices, policy, health care system design, and innovations to improve health outcomes and reduce health care costs.
Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 identifies domains and measures that capture the social determinants of health to inform the development of recommendations for the meaningful use of EHRs. This report is the second part of a two-part study. The Phase 1 report identified 17 domains for inclusion in EHRs. This report pinpoints 12 measures related to 11 of the initial domains and considers the implications of incorporating them into all EHRs. This book includes three chapters from the Phase 1 report in addition to the new Phase 2 material.
Standardized use of EHRs that include social and behavioral domains could provide better patient care, improve population health, and enable more informative research. The recommendations of Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2 will provide valuable information on which to base problem identification, clinical diagnoses, patient treatment, outcomes assessment, and population health measurement.
374 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-31242-6
ISBN Ebook: 0-309-31243-4
DOI:
https://doi.org/10.17226/18951
Institute of Medicine. 2014. Capturing Social and Behavioral Domains and Measures in Electronic Health Records: Phase 2. Washington, DC: The National Academies Press.
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Workshop
Despite spending far more on medical care than any other nation and despite having seen a century of unparalleled improvement in population health and longevity, the United States has fallen behind many of its global counterparts and competitors in such health outcomes as overall life expectancy and rates of preventable diseases and injuries. A fundamental but often overlooked driver of the imbalance between spending and outcomes is the nation's inadequate investment in non-clinical strategies that promote health and prevent disease and injury population-wide, strategies that fall under the rubric of "population health." Given that it is unlikely that government funding for governmental public health agencies, whether at the local, state, or federal levels, will see significant and sustained increases, there is interest in finding creative sources of funding for initiatives to improve population health, both through the work of public health agencies and through the contributions of other sectors, including nonhealth entities.
Financing Population Health Improvement is the summary of a workshop convened by the Institute of Medicine Roundtable on Population Health Improvement in February 2014 to explore the range of resources that might be available to provide a secure funding stream for non-clinical actions to enhance health. Presenters and participants discussed the range of potential resources (e.g., financial, human, and community) explored topics related to financial resources. This report discusses return on investment, the value of investing in population-based interventions, and possible sources of funding to improve population health.
84 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-30746-5
ISBN Ebook: 0-309-30747-3
DOI:
https://doi.org/10.17226/18835
Institute of Medicine. 2015. Financing Population Health Improvement: Workshop Summary. Washington, DC: The National Academies Press.
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Supporting a Movement for Health and Health Equity is the summary of a workshop convened in December 2013 by the Institute of Medicine Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities and the Roundtable on Population Health Improvement to explore the lessons that may be gleaned from social movements, both those that are health-related and those that are not primarily focused on health. Participants and presenters focused on elements identified from the history and sociology of social change movements and how such elements can be applied to present-day efforts nationally and across communities to improve the chances for long, healthy lives for all.
The idea of movements and movement building is inextricably linked with the history of public health. Historically, most movements - including, for example, those for safer working conditions, for clean water, and for safe food - have emerged from the sustained efforts of many different groups of individuals, which were often organized in order to protest and advocate for changes in the name of such values as fairness and human rights. The purpose of the workshop was to have a conversation about how to support the fragments of health movements that roundtable members believed they could see occurring in society and in the health field. Recent reports from the National Academies have highlighted evidence that the United States gets poor value on its extraordinary investments in health - in particular, on its investments in health care - as American life expectancy lags behind that of other wealthy nations. As a result, many individuals and organizations, including the Healthy People 2020 initiative, have called for better health and longer lives.
110 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-30331-1
ISBN Ebook: 0-309-30332-X
DOI:
https://doi.org/10.17226/18751
Institute of Medicine. 2014. Supporting a Movement for Health and Health Equity: Lessons from Social Movements: Workshop Summary. Washington, DC: The National Academies Press.
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