Workshop_in_brief
On December 8, 2016, the Roundtable on Population Health Improvement held a 1-day public workshop in Oakland, California. At this workshop, participants explored multisector community health partnerships that aim to address inequities and improve the health and well-being of communities. Individual participants discussed different strategies used by community partnerships to engage residents in community health initiatives. This publication highlights topics that individual speakers identified as opportunities and challenges to engaging a range of residents and other stakeholders in community-driven social change.
8 pages
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8.5 x 11
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ISBN Ebook: 0-309-45969-9
DOI:
https://doi.org/10.17226/24784
National Academies of Sciences, Engineering, and Medicine. 2017. Multisector Community Health Partnerships: Potential Opportunities and Challenges: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver.
Accounting For Social Risk Factors in Medicare Payment is the fifth and final report in a series of brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report aims to put the entire series in context and offers additional thoughts about how to best consider the various methods for accounting for social risk factors, as well as next steps.
580 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-44920-0
ISBN Ebook: 0-309-44921-9
DOI:
https://doi.org/10.17226/23635
National Academies of Sciences, Engineering, and Medicine. 2017. Accounting for Social Risk Factors in Medicare Payment. Washington, DC: The National Academies Press.
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Workshop_in_brief
On November 17, 2016, the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine convened a workshop on communicating clearly about medicines. The workshop focused on the clarity of written information given to patients and consumers as printed or digital materials. Participants explored the design of health-literate written materials and examples that illustrated implementation of research into the development of these materials. This publication summarizes the presentations and discussions from the workshop.
7 pages
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8.5 x 11
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ISBN Ebook: 0-309-45970-2
DOI:
https://doi.org/10.17226/24785
National Academies of Sciences, Engineering, and Medicine. 2017. Communicating Clearly About Medicines: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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Significant changes have taken place in the policy landscape surrounding cannabis legalization, production, and use. During the past 20 years, 25 states and the District of Columbia have legalized cannabis and/or cannabidiol (a component of cannabis) for medical conditions or retail sales at the state level and 4 states have legalized both the medical and recreational use of cannabis. These landmark changes in policy have impacted cannabis use patterns and perceived levels of risk.
However, despite this changing landscape, evidence regarding the short- and long-term health effects of cannabis use remains elusive. While a myriad of studies have examined cannabis use in all its various forms, often these research conclusions are not appropriately synthesized, translated for, or communicated to policy makers, health care providers, state health officials, or other stakeholders who have been charged with influencing and enacting policies, procedures, and laws related to cannabis use. Unlike other controlled substances such as alcohol or tobacco, no accepted standards for safe use or appropriate dose are available to help guide individuals as they make choices regarding the issues of if, when, where, and how to use cannabis safely and, in regard to therapeutic uses, effectively.
Shifting public sentiment, conflicting and impeded scientific research, and legislative battles have fueled the debate about what, if any, harms or benefits can be attributed to the use of cannabis or its derivatives, and this lack of aggregated knowledge has broad public health implications. The Health Effects of Cannabis and Cannabinoids provides a comprehensive review of scientific evidence related to the health effects and potential therapeutic benefits of cannabis. This report provides a research agenda—outlining gaps in current knowledge and opportunities for providing additional insight into these issues—that summarizes and prioritizes pressing research needs.
486 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-45304-6
ISBN Ebook: 0-309-45305-4
DOI:
https://doi.org/10.17226/24625
National Academies of Sciences, Engineering, and Medicine. 2017. The Health Effects of Cannabis and Cannabinoids: The Current State of Evidence and Recommendations for Research. Washington, DC: The National Academies Press.
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Military operations produce a great deal of trash in an environment where standard waste management practices may be subordinated to more pressing concerns. As a result, ground forces have long relied on incineration in open-air pits as a means of getting rid of refuse. Concerns over possible adverse effects of exposure to smoke from trash burning in the theater were first expressed in the wake of the 1990–1991 Gulf War and stimulated a series of studies that indicated that exposures to smoke from oil-well fires and from other combustion sources, including waste burning, were stressors for troops. In January 2013, Congress directed the Department of Veterans Affairs (VA) to establish and maintain a registry for service members who may have been exposed to toxic airborne chemicals and fumes generated by open burn pits.
Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry analyzes the initial months of data collected by the registry and offers recommendations on ways to improve the instrument and best use the information it collects. This report assesses the effectiveness of the VA's information gathering efforts and provides recommendations for addressing the future medical needs of the affected groups, and provides recommendations on collecting, maintaining, and monitoring information collected by the VA's Airborne Hazards and Open Burn Pit Registry.
252 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-45117-5
ISBN Ebook: 0-309-45118-3
DOI:
https://doi.org/10.17226/23677
National Academies of Sciences, Engineering, and Medicine. 2017. Assessment of the Department of Veterans Affairs Airborne Hazards and Open Burn Pit Registry. Washington, DC: The National Academies Press.
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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.
582 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-45296-1
ISBN Ebook: 0-309-45297-X
DOI:
https://doi.org/10.17226/24624
National Academies of Sciences, Engineering, and Medicine. 2017. Communities in Action: Pathways to Health Equity. Washington, DC: The National Academies Press.
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Since the passage of the Patient Protection and Affordable Care Act (ACA), health care reform has created major changes in the U.S. health care system. The ACA has brought millions of people into the system who had no previous access, and many of these newly enrolled individuals have had limited experience navigating the complex and complicated U.S. health system.
In July 2016 the National Academies of Sciences, Engineering, and Medicine convened a public workshop to examine health insurance through the lens of health literacy, focusing on literacy related barriers to information and coverage as well as on possible solutions. Participants discussed the role of health literacy in accessing health care and remaining in treatment; delivery and financing system reforms that affect organizational health literacy; and quality and equity considerations. This publication summarizes the presentations and discussions from the workshop.
128 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-45473-5
ISBN Ebook: 0-309-45474-3
DOI:
https://doi.org/10.17226/24664
National Academies of Sciences, Engineering, and Medicine. 2017. Health Insurance and Insights from Health Literacy: Helping Consumers Understand: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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Cardiac arrest often strikes seemingly healthy individuals without warning and without regard to age, gender, race, or health status. Representing the third leading cause of death in the United States, cardiac arrest is defined as "a severe malfunction or cessation of the electrical and mechanical activity of the heart ... [which] results in almost instantaneous loss of consciousness and collapse". Although the exact number of cardiac arrests is unknown, conservative estimates suggest that approximately 600,000 individuals experience a cardiac arrest in the United States each year.
In June 2015, the Institute of Medicine (IOM) released its consensus report Strategies to Improve Cardiac Arrest Survival: A Time to Act, which evaluated the factors affecting resuscitation research and outcomes in the United States. Following the release of this report, the National Academies of Sciences, Engineering, and Medicine was asked to hold a workshop to explore the barriers and opportunities for advancing the IOM recommendations. This publication summarizes the presentations and discussions from the workshop.
136 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-45191-4
ISBN Ebook: 0-309-45192-2
DOI:
https://doi.org/10.17226/23695
National Academies of Sciences, Engineering, and Medicine. 2017. Exploring Strategies to Improve Cardiac Arrest Survival: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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In times of rapid change and constrained resources, measures that are important, focused, and reliable are vital. However there is an overabundance of measures available for evaluating various aspects of population health and previous efforts to simplify existing sets to meet the needs of all decision makers have been unsuccessful. The National Academies of Sciences, Engineering, and Medicine convened a workshop to explore the status and uses of measures and measurement in the work of improving population health. Participants explored existing and emerging population health metric sets and characteristics of metrics necessary for stakeholder action across multiple sectors. This report summarizes the presentations and discussions from the workshop.
140 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-39153-9
ISBN Ebook: 0-309-39154-7
DOI:
https://doi.org/10.17226/21899
National Academies of Sciences, Engineering, and Medicine. 2016. Metrics That Matter for Population Health Action: Workshop Summary. Washington, DC: The National Academies Press.
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The ability to see deeply affects how human beings perceive and interpret the world around them. For most people, eyesight is part of everyday communication, social activities, educational and professional pursuits, the care of others, and the maintenance of personal health, independence, and mobility. Functioning eyes and vision system can reduce an adult's risk of chronic health conditions, death, falls and injuries, social isolation, depression, and other psychological problems. In children, properly maintained eye and vision health contributes to a child's social development, academic achievement, and better health across the lifespan.
The public generally recognizes its reliance on sight and fears its loss, but emphasis on eye and vision health, in general, has not been integrated into daily life to the same extent as other health promotion activities, such as teeth brushing; hand washing; physical and mental exercise; and various injury prevention behaviors. A larger population health approach is needed to engage a wide range of stakeholders in coordinated efforts that can sustain the scope of behavior change. The shaping of socioeconomic environments can eventually lead to new social norms that promote eye and vision health.
Making Eye Health a Population Health Imperative: Vision for Tomorrow proposes a new population-centered framework to guide action and coordination among various, and sometimes competing, stakeholders in pursuit of improved eye and vision health and health equity in the United States. Building on the momentum of previous public health efforts, this report also introduces a model for action that highlights different levels of prevention activities across a range of stakeholders and provides specific examples of how population health strategies can be translated into cohesive areas for action at federal, state, and local levels.
586 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-43998-1
ISBN Ebook: 0-309-43999-X
DOI:
https://doi.org/10.17226/23471
National Academies of Sciences, Engineering, and Medicine. 2016. Making Eye Health a Population Health Imperative: Vision for Tomorrow. Washington, DC: The National Academies Press.
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On July 21, 2016, the Roundtable on Health Literacy of the National Academies of Sciences, Engineering, and Medicine convened a workshop on health literacy and health insurance literacy in the context of health reform in the United States. Since 2010, the year the Patient Protection and Affordable Care Act (ACA) became law, the roundtable has convened two workshops related to this topic as well as commissioned two papers, and several members have prepared individually written perspectives. The roundtable's attention to the topic of health insurance is appropriate because health reform has created major changes in the health care system in this country. It has brought millions of people into the system that previously did not have access. In addition, many of these individuals have limited experience with health care and health insurance and are from populations that traditionally have high rates of low health literacy. The workshop focused on the challenges and opportunities in helping consumers obtain, understand, and use health insurance.
6 pages
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8.5 x 11
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ISBN Ebook: 0-309-45236-8
DOI:
https://doi.org/10.17226/24613
National Academies of Sciences, Engineering, and Medicine. 2016. Health Insurance and Insights from Health Literacy: Helping Consumers Understand: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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Evidence from the public health sector demonstrates that health care is only one of the determinants of health, which also include genes, behavior, social factors, and the built environment. These contextual elements are key to understanding why health care organizations are motivated to focus beyond their walls and to consider and respond in unprecedented ways to the social needs of patients, including transportation needs. In June 2016 the National Academies of Sciences, Engineering, and Medicine held a joint workshop to explore partnerships, data, and measurement at the intersection of the health care and transportation sectors. This publication summarizes the presentations and discussions from the workshop.
268 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-44935-9
ISBN Ebook: 0-309-44936-7
DOI:
https://doi.org/10.17226/23638
National Academies of Sciences, Engineering, and Medicine. 2016. Exploring Data and Metrics of Value at the Intersection of Health Care and Transportation: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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On January 20, 2015, President Obama announced the Precision Medicine Initiative (PMI) in his State of the Union address. The PMI, by developing new approaches for detecting, measuring, and analyzing a wide range of biomedical information including molecular, genomic, cellular, clinical, behavioral, physiological, and environmental parameters, is intended to enable a new era of medicine in which researchers, providers, and patients work together to develop individualized care. Part of this effort included the creation of a national, large-scale research participant group, or cohort. The PMI Cohort Program is aimed at extending precision medicine to many diseases, including both rare and common diseases such as diabetes, heart disease, Alzheimer's disease, obesity, and mental illnesses such as depression, bipolar disorder, and schizophrenia, by building a national research cohort of 1 million or more U.S. participants.
An important challenge to assembling the PMI Cohort will be to reach individuals who are socioeconomically disadvantaged. Individuals who are socioeconomically disadvantaged have lower health literacy; often belong to racial, ethnic, and minority communities; and are often less likely to participate in research studies and biorepositories. To explore possible strategies and messaging designs, the Roundtable on Health Literacy formed an ad hoc committee charged with planning and conducting a 1-day public workshop on the intersection of health literacy and precision medicine. The workshop participants discussed a variety of topics including an overview of precision medicine and its potential, the relevance of health literacy to the success of precision medicine efforts, and perspectives and understanding of different groups, such as health care providers, consumers, and insurers. This publication summarizes the presentations and discussions from the workshop.
124 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-44732-1
ISBN Ebook: 0-309-44733-X
DOI:
https://doi.org/10.17226/23592
National Academies of Sciences, Engineering, and Medicine. 2016. Relevance of Health Literacy to Precision Medicine: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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In June 2016 the National Academies of Sciences, Engineering, and Medicine held a workshop on public health approaches to reducing and preventing community violence. Participants discussed the effects of trauma and violence on communities and explored approaches that communities and multi-sector partners are using to build safe, resilient, and healthy communities. They also explored community- and hospital-based anti-violence programs, community policing, blight reduction, and the community's participation in initiatives, including the youth and adults at risk or responsible for much of the violence in communities. This publication summarizes the presentations and discussions from the workshop.
8 pages
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8.5 x 11
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ISBN Ebook: 0-309-45073-X
DOI:
https://doi.org/10.17226/23668
National Academies of Sciences, Engineering, and Medicine. 2016. Community Violence as a Population Health Issue: Proceedings of a Workshop—in Brief. Washington, DC: The National Academies Press.
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Recent health care payment reforms aim to improve the alignment of Medicare payment strategies with goals to improve the quality of care provided, patient experiences with health care, and health outcomes, while also controlling costs. These efforts move Medicare away from the volume-based payment of traditional fee-for-service models and toward value-based purchasing, in which cost control is an explicit goal in addition to clinical and quality goals. Specific payment strategies include pay-for-performance and other quality incentive programs that tie financial rewards and sanctions to the quality and efficiency of care provided and accountable care organizations in which health care providers are held accountable for both the quality and cost of the care they deliver.
Accounting For Social Risk Factors in Medicare Payment: Data is the fourth in a series of five brief reports that aim to inform ASPE analyses that account for social risk factors in Medicare payment programs mandated through the IMPACT Act. This report provides guidance on data sources for and strategies to collect data on indicators of social risk factors that could be accounted for Medicare quality measurement and payment programs.
82 pages
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8.5 x 11
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paperback
ISBN Paperback: 0-309-44801-8
ISBN Ebook: 0-309-44802-6
DOI:
https://doi.org/10.17226/23605
National Academies of Sciences, Engineering, and Medicine. 2016. Accounting for Social Risk Factors in Medicare Payment: Data. Washington, DC: The National Academies Press.
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In February 2016, the National Academies of Sciences, Engineering, and Medicine held a workshop in which speakers shared strategies for individuals, organizations, and communities to advance racial and health equity. Participants discussed increasing awareness about the role of historical contexts and dominant narratives in interpreting data and information about different racial and ethnic groups, framing messages for different social and political outcomes, and readying people to institutionalize practices, policies, and partnerships that advance racial and health equity. This publication serves as a factual summary of the presentations and discussions from the workshop.
86 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-44573-6
ISBN Ebook: 0-309-44574-4
DOI:
https://doi.org/10.17226/23576
National Academies of Sciences, Engineering, and Medicine. 2016. Framing the Dialogue on Race and Ethnicity to Advance Health Equity: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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The U.S. Environmental Protection Agency (EPA) defines PM as a mixture of extremely small particles and liquid droplets comprising a number of components, including "acids (such as nitrates and sulfates), organic chemicals, metals, soil or dust particles, and allergens (such as fragments of pollen and mold spores)". The health effects of outdoor exposure to particulate matter (PM) are the subject of both research attention and regulatory action. Although much less studied to date, indoor exposure to PM is gaining attention as a potential source of adverse health effects. Indoor PM can originate from outdoor particles and also from various indoor sources, including heating, cooking, and smoking. Levels of indoor PM have the potential to exceed outdoor PM levels.
Understanding the major features and subtleties of indoor exposures to particles of outdoor origin can improve our understanding of the exposure–response relationship on which ambient air pollutant standards are based. The EPA's Indoor Environments Division commissioned the National Academies of Sciences, Engineering, and Medicine to hold a workshop examining the issue of indoor exposure to PM more comprehensively and considering both the health risks and possible intervention strategies. Participants discussed the ailments that are most affected by particulate matter and the attributes of the exposures that are of greatest concern, exposure modifiers, vulnerable populations, exposure assessment, risk management, and gaps in the science. This report summarizes the presentations and discussions from the workshop.
158 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-44362-8
ISBN Ebook: 0-309-44363-6
DOI:
https://doi.org/10.17226/23531
National Academies of Sciences, Engineering, and Medicine. 2016. Health Risks of Indoor Exposure to Particulate Matter: Workshop Summary. Washington, DC: The National Academies Press.
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A critical component of the nation's economic vitality is ensuring that all Americans can contribute and prosper. Such contributions presuppose an intentional focus on achieving the highest levels of health possible, which requires that conditions in communities, schools workplaces, and other settings promote health and address the social determinants of health for all community members. Many organizations, in both the private and public sectors, have been establishing partnerships to further healthy workplaces and health equity in general. Many are taking the lead in producing economic growth that is inclusive and responsive to the nation's diverse needs and populations. Increasingly, private–public partnerships are emerging as ways of doing business. Additionally, a variety of new developments in health, health care, and community benefits obligations that are part of the Affordable Care Act have contributed to this interest in economic growth and health and in the creation of new partnerships.
To examine past successes and future opportunities, the National Academies of Sciences, Engineering, and Medicine held a workshop in November 2015. The workshop focused on the potential of the private sector to produce a triple bottom line: economic opportunity (including workforce development) and growth, healthy work and community environments, and improved employee health. At the same time, participants looked beyond the private sector to public–private partnerships and to public-sector actions that combine opportunities for economic growth and good health for all. This publication summarizes the presentations and discussions from the workshop.
82 pages
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6 x 9
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paperback
ISBN Paperback: 0-309-44352-0
ISBN Ebook: 0-309-44353-9
DOI:
https://doi.org/10.17226/23529
National Academies of Sciences, Engineering, and Medicine. 2016. The Private Sector as a Catalyst for Health Equity and a Vibrant Economy: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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