Consensus
Sickle cell disease (SCD) is a genetic condition that affects approximately 100,000 people in the United States and millions more globally. Individuals with SCD endure the psychological and physiological toll of repetitive pain as well as side effects from the pain treatments they undergo. Some adults with SCD report reluctance to use health care services, unless as a last resort, due to the racism and discrimination they face in the health care system. Additionally, many aspects of SCD are inadequately studied, understood, and addressed.
Addressing Sickle Cell Disease examines the epidemiology, health outcomes, genetic implications, and societal factors associated with SCD and sickle cell trait (SCT). This report explores the current guidelines and best practices for the care of patients with SCD and recommends priorities for programs, policies, and research. It also discusses limitations and opportunities for developing national SCD patient registries and surveillance systems, barriers in the healthcare sector associated with SCD and SCT, and the role of patient advocacy and community engagement groups.
522 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-66960-X
ISBN Ebook: 0-309-66961-8
DOI:
https://doi.org/10.17226/25632
National Academies of Sciences, Engineering, and Medicine. 2020. Addressing Sickle Cell Disease: A Strategic Plan and Blueprint for Action. Washington, DC: The National Academies Press.
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Workshop_in_brief
On July 29, 2020, the Roundtable on Health Literacy convened a public workshop to explore the challenges resulting from the proliferation of health and medical misinformation and disinformation, particularly as they relate to the COVID-19 pandemic. The workshop explored the role of fact-checking organizations and the technology industry in addressing misinformation and disinformation, the social psychology behind their spread, and health literacy strategies to support this ongoing multidisciplinary work. This publication highlights the presentation and discussion of the workshop.
8 pages
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8.5 x 11
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ISBN Ebook: 0-309-14385-3
DOI:
https://doi.org/10.17226/26021
National Academies of Sciences, Engineering, and Medicine. 2020. Addressing Health Misinformation with Health Literacy Strategies: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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The opioid epidemic, now several decades in the making, continues to cause pain and suffering for millions of Americans. Each year, thousands of individuals die from overdose, and thousands more grieve from these losses. Opioid use disorder (OUD) can lead to a complete interruption of day-to-day activities, including caring for one's family, maintaining a job or career, or keeping track of basic necessities, such as health care and finances.
This report, the first in a series of three, examines four of the Substance Abuse and Mental Health Services Administration (SAMHSA)'s grant programs that help alleviate suffering due to opioids and improve treatment quality and access. It offers recommendations about the existing reporting tools used by these programs and and proposes additional metrics and outcomes that should be considered.
80 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-67528-6
ISBN Ebook: 0-309-67529-4
DOI:
https://doi.org/10.17226/25745
National Academies of Sciences, Engineering, and Medicine. 2020. Measuring Success in Substance Use Grant Programs: Outcomes and Metrics for Improvement. Washington, DC: The National Academies Press.
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Workshop
Young people develop health literacy skills in a variety of environments, facing critical thinking challenges about their health from school, home and family life, peers and social life, and online. To explore the development of health literacy skills in youth, the Roundtable on Health Literacy convened a workshop on November 19, 2019, in Washington, DC. Presenters at the workshop discussed factors relating to health literacy skills and ways to further develop those skills among youth from early childhood to young adulthood. This publication summarizes the presentation and discussion of the workshop.
114 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-68132-4
ISBN Ebook: 0-309-68133-2
DOI:
https://doi.org/10.17226/25888
National Academies of Sciences, Engineering, and Medicine. 2020. Developing Health Literacy Skills in Children and Youth: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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In response to the coronavirus disease 2019 (COVID-19) pandemic and the societal disruption it has brought, national governments and the international community have invested billions of dollars and immense amounts of human resources to develop a safe and effective vaccine in an unprecedented time frame. Vaccination against this novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), offers the possibility of significantly reducing severe morbidity and mortality and transmission when deployed alongside other public health strategies and improved therapies.
Health equity is intertwined with the impact of COVID-19 and there are certain populations that are at increased risk of severe illness or death from COVID-19. In the United States and worldwide, the pandemic is having a disproportionate impact on people who are already disadvantaged by virtue of their race and ethnicity, age, health status, residence, occupation, socioeconomic condition, or other contributing factors.
Framework for Equitable Allocation of COVID-19 Vaccine offers an overarching framework for vaccine allocation to assist policy makers in the domestic and global health communities. Built on widely accepted foundational principles and recognizing the distinctive characteristics of COVID-19, this report's recommendations address the commitments needed to implement equitable allocation policies for COVID-19 vaccine.
272 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-68224-X
ISBN Ebook: 0-309-68225-8
DOI:
https://doi.org/10.17226/25917
National Academies of Sciences, Engineering, and Medicine. 2020. Framework for Equitable Allocation of COVID-19 Vaccine. Washington, DC: The National Academies Press.
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When communities face complex public health emergencies, state local, tribal, and territorial public health agencies must make difficult decisions regarding how to effectively respond. The public health emergency preparedness and response (PHEPR) system, with its multifaceted mission to prevent, protect against, quickly respond to, and recover from public health emergencies, is inherently complex and encompasses policies, organizations, and programs. Since the events of September 11, 2001, the United States has invested billions of dollars and immeasurable amounts of human capital to develop and enhance public health emergency preparedness and infrastructure to respond to a wide range of public health threats, including infectious diseases, natural disasters, and chemical, biological, radiological, and nuclear events. Despite the investments in research and the growing body of empirical literature on a range of preparedness and response capabilities and functions, there has been no national-level, comprehensive review and grading of evidence for public health emergency preparedness and response practices comparable to those utilized in medicine and other public health fields.
Evidence-Based Practice for Public Health Emergency Preparedness and Response reviews the state of the evidence on PHEPR practices and the improvements necessary to move the field forward and to strengthen the PHEPR system. This publication evaluates PHEPR evidence to understand the balance of benefits and harms of PHEPR practices, with a focus on four main areas of PHEPR: engagement with and training of community-based partners to improve the outcomes of at-risk populations after public health emergencies; activation of a public health emergency operations center; communication of public health alerts and guidance to technical audiences during a public health emergency; and implementation of quarantine to reduce the spread of contagious illness.
500 pages
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7 x 10
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paperback
ISBN Paperback: 0-309-67038-1
ISBN Ebook: 0-309-67039-X
DOI:
https://doi.org/10.17226/25650
National Academies of Sciences, Engineering, and Medicine. 2020. Evidence-Based Practice for Public Health Emergency Preparedness and Response. Washington, DC: The National Academies Press.
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More than 3.7 million U.S. service members have participated in operations taking place in the Southwest Asia Theater of Military Operations since 1990. These operations include the 1990-1991 Persian Gulf War, a post-war stabilization period spanning 1992 through September 2001, and the campaigns undertaken in the wake of the September 11, 2001, attacks. Deployment to Iraq, Kuwait, Saudi Arabia, Bahrain, Gulf of Aden, Gulf of Oman, Oman, Qatar, the United Arab Emirates, and Afghanistan exposed service members to a number of airborne hazards, including oil-well fire smoke, emissions from open burn pits, dust and sand suspended in the air, and exhaust from diesel vehicles. The effects of these were compounded by stressors like excessive heat and noise that are inevitable attributes of service in a combat environment.
Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations reviews the scientific evidence regarding respiratory health outcomes in veterans of the Southwest Asia conflicts and identifies research that could feasibly be conducted to address outstanding questions and generate answers, newly emerging technologies that could aid in these efforts, and organizations that the Veterans Administration might partner with to accomplish this work.
270 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-67910-9
ISBN Ebook: 0-309-67911-7
DOI:
https://doi.org/10.17226/25837
National Academies of Sciences, Engineering, and Medicine. 2020. Respiratory Health Effects of Airborne Hazards Exposures in the Southwest Asia Theater of Military Operations. Washington, DC: The National Academies Press.
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Workshop
California and other wildfire-prone western states have experienced a substantial increase in the number and intensity of wildfires in recent years. Wildlands and climate experts expect these trends to continue and quite likely to worsen in coming years. Wildfires and other disasters can be particularly devastating for vulnerable communities. Members of these communities tend to experience worse health outcomes from disasters, have fewer resources for responding and rebuilding, and receive less assistance from state, local, and federal agencies. Because burning wood releases particulate matter and other toxicants, the health effects of wildfires extend well beyond burns. In addition, deposition of toxicants in soil and water can result in chronic as well as acute exposures.
On June 4-5, 2019, four different entities within the National Academies of Sciences, Engineering, and Medicine held a workshop titled Implications of the California Wildfires for Health, Communities, and Preparedness at the Betty Irene Moore School of Nursing at the University of California, Davis. The workshop explored the population health, environmental health, emergency preparedness, and health equity consequences of increasingly strong and numerous wildfires, particularly in California. This publication is a summary of the presentations and discussion of the workshop.
160 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-49987-9
ISBN Ebook: 0-309-49988-7
DOI:
https://doi.org/10.17226/25622
National Academies of Sciences, Engineering, and Medicine. 2020. Implications of the California Wildfires for Health, Communities, and Preparedness: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Because of the individualized nature of drug and therapeutic treatments, clinical trials require participants who represent the diversity of the patient base. If early trials do not have a broad patient base, it can be difficult to know who may or may not benefit from or respond to a treatment later. In addition to diversity in recruitment, informed consent during participation is also crucial. If participants do not fully understand what they are signing up for, they may become confused, mistrustful, or drop out of a trial altogether, confusing investigators and possibly affecting the generalizability of a study.
To explore the incorporation of health literacy practices into clinical trials, the Roundtable on Health Literacy convened a workshop titled Clinical Trials: Practice and Impact on April 11, 2019, in Washington, DC. The workshop presentations and discussion centered around issues related to the challenges or barriers for diverse populations' participation in clinical trials, best practices for clinical trial sites and researchers incorporating health literacy practices, and effective health literacy strategies for clear communication with participants. This publication summarizes the presentation and discussion of the workshop.
120 pages
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paperback
ISBN Paperback: 0-309-49969-0
ISBN Ebook: 0-309-49970-4
DOI:
https://doi.org/10.17226/25616
National Academies of Sciences, Engineering, and Medicine. 2020. Health Literacy in Clinical Research: Practice and Impact: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Workshop_in_brief
On December 3, 2018, the National Academies of Sciences, Engineering, and Medicine's Roundtable on Population Health Improvement held a workshop on Reorienting Health Care and Business Sector Investment Priorities Toward Health and Well-Being in New York City at NYU Langone Health. The workshop focused on changing concepts of value and investment in health care. This publication highlights the presentation and discussion of the workshop.
10 pages
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8.5 x 11
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ISBN Ebook: 0-309-49353-6
DOI:
https://doi.org/10.17226/25469
National Academies of Sciences, Engineering, and Medicine. 2020. Reorienting Health Care and Business Sector Investment Priorities Toward Health and Well-Being: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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Workshop
Brain health affects Americans across all ages, genders, races, and ethnicities. Enriching the body of scientific knowledge around brain health and cognitive ability has the potential to improve quality of life and longevity for many millions of Americans and their families. The Centers for Disease Control and Prevention estimate that as many as 5 million Americans were living with Alzheimer's disease in 2014. That same year, more than 800,000 children were treated for concussion or traumatic brain injuries in U.S. emergency departments. Each year, more than 795,000 people in the United States have a stroke. Developing more effective treatment strategies for brain injuries and illnesses is essential, but brain health is not focused exclusively on disease, disorders, and vulnerability. It is equally important to better understand the ways our brains grow, learn, adapt, and heal. Addressing all of these domains to optimize brain health will require consideration about how to define brain health and resilience and about how to identify key elements to measure those concepts. Understanding the interactions between the brain, the body, and socioenvironmental forces is also fundamental to improving brain health.
To explore issues related to brain health throughout the life span, from birth through old age, a public workshop titled Brain Health Across the Life Span was convened on September 24 and 25, 2019, by the Board on Population Health and Public Health Practice in the Health and Medicine Division of the National Academies. This publication summarizes the presentation and discussion of the workshop.
180 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-67261-9
ISBN Ebook: 0-309-67262-7
DOI:
https://doi.org/10.17226/25703
National Academies of Sciences, Engineering, and Medicine. 2020. Brain Health Across the Life Span: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Opioid use and infectious diseases are intertwined epidemics. Despite the fact that the United States is more than two decades into the opioid crisis - the cause of tens of thousands of deaths every year on its own - the health system has not sufficiently addressed the morbidity and mortality of drug use coupled with infectious diseases. This is at least in part due to traditional models of substance use disorder care wherein substance use disorder treatment is delivered independently of other medical care, thereby inhibiting the delivery of comprehensive care. As a result, the United States is experiencing a drastic increase in infectious diseases that spread with drug use.
Opportunities to Improve Opioid Use Disorder and Infectious Disease Services examines current efforts to integrate care and describes barriers, such as inadequate workforce and training; lack of data integration and sharing; and stigma among people who use drugs and have also been diagnosed with an infectious disease. The conclusions and recommendations of this report will help to promote patient-centered, integrated programs to address this dual epidemic.
216 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-65449-1
ISBN Ebook: 0-309-65450-5
DOI:
https://doi.org/10.17226/25626
National Academies of Sciences, Engineering, and Medicine. 2020. Opportunities to Improve Opioid Use Disorder and Infectious Disease Services: Integrating Responses to a Dual Epidemic. Washington, DC: The National Academies Press.
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Among the many who serve in the United States Armed Forces and who are deployed to distant locations around the world, myriad health threats are encountered. In addition to those associated with the disruption of their home life and potential for combat, they may face distinctive disease threats that are specific to the locations to which they are deployed. U.S. forces have been deployed many times over the years to areas in which malaria is endemic, including in parts of Afghanistan and Iraq. Department of Defense (DoD) policy requires that antimalarial drugs be issued and regimens adhered to for deployments to malaria-endemic areas. Policies directing which should be used as first and as second-line agents have evolved over time based on new data regarding adverse events or precautions for specific underlying health conditions, areas of deployment, and other operational factors
At the request of the Veterans Administration, Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis assesses the scientific evidence regarding the potential for long-term health effects resulting from the use of antimalarial drugs that were approved by FDA or used by U.S. service members for malaria prophylaxis, with a focus on mefloquine, tafenoquine, and other antimalarial drugs that have been used by DoD in the past 25 years. This report offers conclusions based on available evidence regarding associations of persistent or latent adverse events.
426 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-67210-4
ISBN Ebook: 0-309-67211-2
DOI:
https://doi.org/10.17226/25688
National Academies of Sciences, Engineering, and Medicine. 2020. Assessment of Long-Term Health Effects of Antimalarial Drugs When Used for Prophylaxis. Washington, DC: The National Academies Press.
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The high rate of incarceration in the United States contributes significantly to the nation's health inequities, extending beyond those who are imprisoned to families, communities, and the entire society. Since the 1970s, there has been a seven-fold increase in incarceration. This increase and the effects of the post-incarceration reentry disproportionately affect low-income families and communities of color. It is critical to examine the criminal justice system through a new lens and explore opportunities for meaningful improvements that will promote health equity in the United States.
The National Academies convened a workshop on June 6, 2018 to investigate the connection between incarceration and health inequities to better understand the distributive impact of incarceration on low-income families and communities of color. Topics of discussion focused on the experience of incarceration and reentry, mass incarceration as a public health issue, women's health in jails and prisons, the effects of reentry on the individual and the community, and promising practices and models for reentry. The programs and models that are described in this publication are all Philadelphia-based because Philadelphia has one of the highest rates of incarceration of any major American city. This publication summarizes the presentations and discussions of the workshop.
88 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-49366-8
ISBN Ebook: 0-309-49367-6
DOI:
https://doi.org/10.17226/25471
National Academies of Sciences, Engineering, and Medicine. 2020. The Effects of Incarceration and Reentry on Community Health and Well-Being: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Beginning in 1979 and in each subsequent decades, the U.S. Department of Health and Human Services (HHS) has overseen the Healthy People initiative to set national goals and objectives for health promotion and disease prevention. At the request of HHS, this study presents a slate of Leading Health Indicators (LHIs) that will serve as options for the Healthy People Federal Interagency Workgroup to consider as they develop the final criteria and set of LHIs for Healthy People 2030.
172 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-67187-6
ISBN Ebook: 0-309-67188-4
DOI:
https://doi.org/10.17226/25682
National Academies of Sciences, Engineering, and Medicine. 2020. Leading Health Indicators 2030: Advancing Health, Equity, and Well-Being. Washington, DC: The National Academies Press.
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Legionnaires' disease, a pneumonia caused by the Legionella bacterium, is the leading cause of reported waterborne disease outbreaks in the United States. Legionella occur naturally in water from many different environmental sources, but grow rapidly in the warm, stagnant conditions that can be found in engineered water systems such as cooling towers, building plumbing, and hot tubs. Humans are primarily exposed to Legionella through inhalation of contaminated aerosols into the respiratory system. Legionnaires' disease can be fatal, with between 3 and 33 percent of Legionella infections leading to death, and studies show the incidence of Legionnaires' disease in the United States increased five-fold from 2000 to 2017.
Management of Legionella in Water Systems reviews the state of science on Legionella contamination of water systems, specifically the ecology and diagnosis. This report explores the process of transmission via water systems, quantification, prevention and control, and policy and training issues that affect the incidence of Legionnaires' disease. It also analyzes existing knowledge gaps and recommends research priorities moving forward.
290 pages
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7 x 10
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hardcover
ISBN Ebook: 0-309-49383-8
DOI:
https://doi.org/10.17226/25474
National Academies of Sciences, Engineering, and Medicine. 2020. Management of Legionella in Water Systems. Washington, DC: The National Academies Press.
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Workshop_in_brief
Experts from the health measurement and population health fields gathered on May 28, 2019, in Washington, DC, at a workshop organized by the National Academies of Sciences, Engineering, and Medicine for the Committee on Informing the Selection of Leading Health Indicators for Healthy People 2030. The workshop presentations and discussion aimed to help inform the committee's task, which is to advise on the criteria for selecting Healthy People 2030's Leading Health Indicators (LHIs) and to propose a slate of LHIs for the Healthy People Federal Interagency Workgroup to consider in finalizing the Healthy People 2030 plan. This publication summarizes the presentation and discussion of the workshop.
10 pages
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8.5 x 11
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ISBN Ebook: 0-309-67060-8
DOI:
https://doi.org/10.17226/25654
National Academies of Sciences, Engineering, and Medicine. 2020. Informing the Selection of Leading Health Indicators for Healthy People 2030: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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Every ten years, the Department of Health and Human Service's Healthy People Initiative develops a new set of science-based, national objectives with the goal of improving the health of all Americans. Defining balanced and comprehensive criteria for healthy people enables the public, programs, and policymakers to gauge our progress and reevaluate efforts towards a healthier society. Criteria for Selecting the Leading Health Indicators for Healthy People 2030 makes recommendations for the development of Leading Health Indicators for the initiative's Healthy People 2030 framework. The authoring committee's assessments inform their recommendations for the Healthy People Federal Interagency Workgroup in their endeavor to develop the latest Leading Health Indicators. The finalized Leading Health Indicators will establish the criteria for healthy Americans and help update policies that will guide decision-marking throughout the next decade. This report also reviews and reflects upon current and past Healthy People materials to identify gaps and new objectives.
70 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-49594-6
ISBN Ebook: 0-309-49595-4
DOI:
https://doi.org/10.17226/25531
National Academies of Sciences, Engineering, and Medicine. 2019. Criteria for Selecting the Leading Health Indicators for Healthy People 2030. Washington, DC: The National Academies Press.
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