Manuel Pastor, Paul Speer, Jyoti Gupta, Hahrie Han, Jennifer Ito
The last few decades have seen an upsurge in research linking health outcomes to the “conditions in the environments in which people are born, live, learn, work, play, worship, and age,” commonly referred to as the social determinants of health (Cash-Gibson et al., 2018). These conditions include “economic stability, education, social and community context, health and health care, and neighborhood and built environment” (Offi ce of Disease Prevention and Health Promotion, 2014). More recently, many in the public health fi eld are recognizing the need to analyze (and transform) the structural determinants of health that are at the root of inequities (Baum et al., 2018). Such structures include government rules and regulations, institutional policies and priorities, cultural norms and values (for example, racism, sexism, xenophobia, homophobia, and ableism), and disparities in the power and infl uence of diff erent communities to change those structures. This consideration of “community power” has acquired special salience in the wake of the widespread and devastating impacts of the COVID-19 pandemic in 2020–2021. The pandemic brought to broad public attention what communities of color and low-income communities have long known: that underlying inequities by race, income, and geography put their communities at higher risk of contracting the virus and with lower levels of access to vaccines (Ollove and Vestal, 2020). Simultaneously, protests swept the nation and the world in response to the tragic deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery, continuing to highlight the role of deep-rooted racial diff erences in treatment by the police and other social institutions. Together, these crises have accelerated long-overdue conversations across the country about how racism is a public health issue (Vestal, 2020). This three-part series highlights learnings from Lead Local: Community-Driven Change and the Power of Collective Action, a collaborative eff ort funded by the Robert Wood Johnson Foundation that convened well-respected local organizations and leaders in the fi elds of community organizing, advocacy, and research to examine the relationship between health and power building. Building on the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Community Power in Population Health Improvement workshop in January 2021, priority areas for action are shared to make progress toward, and further an understanding of, community power building for health and racial equity.
{"title":"Community Power and Health Equity: Closing the Gap between Scholarship and Practice.","authors":"Manuel Pastor, Paul Speer, Jyoti Gupta, Hahrie Han, Jennifer Ito","doi":"10.31478/202206c","DOIUrl":"https://doi.org/10.31478/202206c","url":null,"abstract":"The last few decades have seen an upsurge in research linking health outcomes to the “conditions in the environments in which people are born, live, learn, work, play, worship, and age,” commonly referred to as the social determinants of health (Cash-Gibson et al., 2018). These conditions include “economic stability, education, social and community context, health and health care, and neighborhood and built environment” (Offi ce of Disease Prevention and Health Promotion, 2014). More recently, many in the public health fi eld are recognizing the need to analyze (and transform) the structural determinants of health that are at the root of inequities (Baum et al., 2018). Such structures include government rules and regulations, institutional policies and priorities, cultural norms and values (for example, racism, sexism, xenophobia, homophobia, and ableism), and disparities in the power and infl uence of diff erent communities to change those structures. This consideration of “community power” has acquired special salience in the wake of the widespread and devastating impacts of the COVID-19 pandemic in 2020–2021. The pandemic brought to broad public attention what communities of color and low-income communities have long known: that underlying inequities by race, income, and geography put their communities at higher risk of contracting the virus and with lower levels of access to vaccines (Ollove and Vestal, 2020). Simultaneously, protests swept the nation and the world in response to the tragic deaths of George Floyd, Breonna Taylor, and Ahmaud Arbery, continuing to highlight the role of deep-rooted racial diff erences in treatment by the police and other social institutions. Together, these crises have accelerated long-overdue conversations across the country about how racism is a public health issue (Vestal, 2020). This three-part series highlights learnings from Lead Local: Community-Driven Change and the Power of Collective Action, a collaborative eff ort funded by the Robert Wood Johnson Foundation that convened well-respected local organizations and leaders in the fi elds of community organizing, advocacy, and research to examine the relationship between health and power building. Building on the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Community Power in Population Health Improvement workshop in January 2021, priority areas for action are shared to make progress toward, and further an understanding of, community power building for health and racial equity.","PeriodicalId":74236,"journal":{"name":"NAM perspectives","volume":"2022 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499379/pdf/nampsp-2022-202206c.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9286746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anaeze C Offodile, Jason B Gibbons, Samantha Murrell, Donna Kinzer, Joshua M Sharfstein
{"title":"A Global Equity Model (GEM) for the Advancement of Community Health and Health Equity.","authors":"Anaeze C Offodile, Jason B Gibbons, Samantha Murrell, Donna Kinzer, Joshua M Sharfstein","doi":"10.31478/202211b","DOIUrl":"https://doi.org/10.31478/202211b","url":null,"abstract":"","PeriodicalId":74236,"journal":{"name":"NAM perspectives","volume":"2022 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9875856/pdf/nampsp-2022-202211b.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10585944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obesity presents a formidable challenge to health care financing systems. According to the 2017-2018 National Health and Nutrition Survey (NHANES), rates of obesity among U.S. adults have now climbed to 42.8% (Hales et al., 2020). The problem of this high prevalence of obesity has been particularly highlighted during the COVID-19 pandemic, when individuals with obesity were shown to have increased risk for adverse outcomes of COVID-19, including hospitalization, admission to the intensive care unit, mechanical ventilation, or death (Kompaniyets et al., 2021). In addition, the increase in obesity rates has also led to an increase in the burden of other obesity-driven chronic diseases, such as heart disease, cancer, chronic lung disease, stroke, diabetes, Alzheimer’s disease, and chronic kidney disease. According to the Centers for Disease Control and Prevention (CDC), six in ten American adults have at least one chronic disease and four in ten have two or more (NCCDPHP, 2022). Given this connection between obesity and chronic disease, the impact of obesity on medical care costs is alarming. According to a recent study, aggregate medical costs in 2016 due to obesity among U.S. adults were $260.6 billion (Cawley et al., 2021). Adults with obesity (BMI >30 kg/m2) incurred $2,505 more in annual medical costs, double the medical expenditures of those with BMI between 18.5 and 25 kg/m2 (Cawley et al., 2021). Patients with obesity had higher costs in every category of care, including inpatient and outpatient expenses, as well as prescription drug expenses. Further, costs were shown to increase significantly with class of obesity, with class 1 (BMI 30<35 kg/m2), class 2 (BMI 35<40 kg/m2), and class 3 (BMI >40 kg/m2) categories demonstrating ascending costs. For those whose insurance was funded by public programs, annual medical expenditures were more ($2,868) as compared to those with privately funded health insurance ($2,058) (Cawley et al., 2021). Obesity also has economic implications beyond direct health care costs, including productivity costs (absenteeism, presenteeism, disability, premature mortality), transportation costs, and human capital costs (Hammond and Levine, 2010). This commentary explores a case study of one large employer, H-E-B, LP, that developed and implemented an employer-provided benefits program as an attempt to tackle the clinical and economic impacts of obesity among their workforce.
{"title":"An Innovative Approach to Employer-Provided Benefits for Obesity Care: A Case Report on H-E-B's Healthier Lifestyle Choices Program.","authors":"Abigail Ammerman, Donna H Ryan","doi":"10.31478/202209a","DOIUrl":"https://doi.org/10.31478/202209a","url":null,"abstract":"Obesity presents a formidable challenge to health care financing systems. According to the 2017-2018 National Health and Nutrition Survey (NHANES), rates of obesity among U.S. adults have now climbed to 42.8% (Hales et al., 2020). The problem of this high prevalence of obesity has been particularly highlighted during the COVID-19 pandemic, when individuals with obesity were shown to have increased risk for adverse outcomes of COVID-19, including hospitalization, admission to the intensive care unit, mechanical ventilation, or death (Kompaniyets et al., 2021). In addition, the increase in obesity rates has also led to an increase in the burden of other obesity-driven chronic diseases, such as heart disease, cancer, chronic lung disease, stroke, diabetes, Alzheimer’s disease, and chronic kidney disease. According to the Centers for Disease Control and Prevention (CDC), six in ten American adults have at least one chronic disease and four in ten have two or more (NCCDPHP, 2022). Given this connection between obesity and chronic disease, the impact of obesity on medical care costs is alarming. According to a recent study, aggregate medical costs in 2016 due to obesity among U.S. adults were $260.6 billion (Cawley et al., 2021). Adults with obesity (BMI >30 kg/m2) incurred $2,505 more in annual medical costs, double the medical expenditures of those with BMI between 18.5 and 25 kg/m2 (Cawley et al., 2021). Patients with obesity had higher costs in every category of care, including inpatient and outpatient expenses, as well as prescription drug expenses. Further, costs were shown to increase significantly with class of obesity, with class 1 (BMI 30<35 kg/m2), class 2 (BMI 35<40 kg/m2), and class 3 (BMI >40 kg/m2) categories demonstrating ascending costs. For those whose insurance was funded by public programs, annual medical expenditures were more ($2,868) as compared to those with privately funded health insurance ($2,058) (Cawley et al., 2021). Obesity also has economic implications beyond direct health care costs, including productivity costs (absenteeism, presenteeism, disability, premature mortality), transportation costs, and human capital costs (Hammond and Levine, 2010). This commentary explores a case study of one large employer, H-E-B, LP, that developed and implemented an employer-provided benefits program as an attempt to tackle the clinical and economic impacts of obesity among their workforce.","PeriodicalId":74236,"journal":{"name":"NAM perspectives","volume":"2022 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9875854/pdf/nampsp-2022-202209a.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10590511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health researchers, leaders in health care and public health, and funders have long valued the concept of community engagement, when residents authentically connect on issues or amplify their voices to drive policy decisions affecting the health and well-being of their community and neighbors. The Robert Wood Johnson Foundation (RWJF) has funded past work at the National Academies to assess meaningful community engagement in health and health care programs (Organizing Committee, 2022). Until recently, leaders in health and health care, including RWJF, have been less familiar and less comfortable with the concept of community power and the fundamental role it plays in advancing racial and health equity and dismantling structures that perpetuate inequity. Powerlessness is a structural barrier, like racism and sexism, to advancing health equity. Power imbalances are at the root of the structural issues that produce an unfair and unequal distribution of the social, economic, and environmental benefits that influence health. Behind any crisis—whether democratic or related to housing, climate, or health—there is an imbalance in who holds and wields power. Different from community engagement, at the root of community power building are strategies to organize people most impacted by a problem. Evidence now shows that putting more power in the hands of more people, including those most impacted by structural inequities, results in systemic changes in the ways people make decisions that benefit all (Pastor et al., 2020). The authors of this manuscript know from our own work with mobilizing domestic workers, caregivers, and voters, and through work supported by RWJF, that community engagement is distinct from community power in multiple ways. First, campaigns to expand Medicaid and place moratoriums on evictions are examples of efforts that activate communities most impacted by structural inequiThis three-part series highlights learnings from Lead Local: Community-Driven Change and the Power of Collective Action, a collaborative effort funded by the Robert Wood Johnson Foundation that convened well-respected local organizations and leaders in the fields of community organizing, advocacy, and research to examine the relationship between health and power building. Building on the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Community Power in Population Health Improvement workshop in January 2021, priority areas for action are shared to make progress toward, and further an understanding of, community power building for health and racial equity.
{"title":"Why Community Power Is Fundamental to Advancing Racial and Health Equity.","authors":"Aditi Vaidya, Ai-Jen Poo, LaTosha Brown","doi":"10.31478/202206b","DOIUrl":"https://doi.org/10.31478/202206b","url":null,"abstract":"Health researchers, leaders in health care and public health, and funders have long valued the concept of community engagement, when residents authentically connect on issues or amplify their voices to drive policy decisions affecting the health and well-being of their community and neighbors. The Robert Wood Johnson Foundation (RWJF) has funded past work at the National Academies to assess meaningful community engagement in health and health care programs (Organizing Committee, 2022). Until recently, leaders in health and health care, including RWJF, have been less familiar and less comfortable with the concept of community power and the fundamental role it plays in advancing racial and health equity and dismantling structures that perpetuate inequity. Powerlessness is a structural barrier, like racism and sexism, to advancing health equity. Power imbalances are at the root of the structural issues that produce an unfair and unequal distribution of the social, economic, and environmental benefits that influence health. Behind any crisis—whether democratic or related to housing, climate, or health—there is an imbalance in who holds and wields power. Different from community engagement, at the root of community power building are strategies to organize people most impacted by a problem. Evidence now shows that putting more power in the hands of more people, including those most impacted by structural inequities, results in systemic changes in the ways people make decisions that benefit all (Pastor et al., 2020). The authors of this manuscript know from our own work with mobilizing domestic workers, caregivers, and voters, and through work supported by RWJF, that community engagement is distinct from community power in multiple ways. First, campaigns to expand Medicaid and place moratoriums on evictions are examples of efforts that activate communities most impacted by structural inequiThis three-part series highlights learnings from Lead Local: Community-Driven Change and the Power of Collective Action, a collaborative effort funded by the Robert Wood Johnson Foundation that convened well-respected local organizations and leaders in the fields of community organizing, advocacy, and research to examine the relationship between health and power building. Building on the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Community Power in Population Health Improvement workshop in January 2021, priority areas for action are shared to make progress toward, and further an understanding of, community power building for health and racial equity.","PeriodicalId":74236,"journal":{"name":"NAM perspectives","volume":"2022 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499376/pdf/nampsp-2022-202206b.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9291730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Leaders and practitioners across industries—including public health, health care, and clinical settings; local, state, and federal government agencies; and academic institutions—are asking hard questions about what it will take to achieve health equity. The COVID-19 pandemic, the 2020 uprisings for Black liberation, the January 6 insurrection, and increasing state and local restrictions on voting illuminate how high the stakes are for Black, Indigenous, and other People of Color (BIPOC). Previously quiet conversations about “advancing health equity” and “moving upstream” are evolving into more public debates about the need to center racial equity in institutional efforts to achieve health equity. As of October 2021, the American Public Health Association tracked more than 220 jurisdictions that had named racism a public health crisis, and organizations across various sectors are making visible commitments to transform their practices, programs, and policies to achieve racial equity (American Public Health Association, n.d.). What should go hand-in-hand with efforts to achieve racial and health equity are efforts to share and shift power with communities affected by health and structural inequities. For example, more health institutions and funders, such as the Robert Wood Johnson Foundation, National Association for County and City Health Officials, and The California Endowment, are making this commitment—looking for opportunities to help build community power, as an outcome in and of itself, in their sphere of influence. In this commentary, the authors discuss why this emerging emphasis on building community power is essential to achieving health and racial equity and highlight a set of values and principles to guide practitioners, researchers, and leaders in transforming how they work with communities to build their power. This three-part series highlights learnings from Lead Local: Community-Driven Change and the Power of Collective Action, a collaborative effort funded by the Robert Wood Johnson Foundation that convened well-respected local organizations and leaders in the fields of community organizing, advocacy, and research to examine the relationship between health and power building. Building on the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Community Power in Population Health Improvement workshop in January 2021, priority areas for action are shared to make progress toward, and further an understanding of, community power building for health and racial equity.
{"title":"Building Community Power to Achieve Health and Racial Equity: Principles to Guide Transformative Partnerships with Local Communities.","authors":"Lili Farhang, Xavier Morales","doi":"10.31478/202206d","DOIUrl":"https://doi.org/10.31478/202206d","url":null,"abstract":"Leaders and practitioners across industries—including public health, health care, and clinical settings; local, state, and federal government agencies; and academic institutions—are asking hard questions about what it will take to achieve health equity. The COVID-19 pandemic, the 2020 uprisings for Black liberation, the January 6 insurrection, and increasing state and local restrictions on voting illuminate how high the stakes are for Black, Indigenous, and other People of Color (BIPOC). Previously quiet conversations about “advancing health equity” and “moving upstream” are evolving into more public debates about the need to center racial equity in institutional efforts to achieve health equity. As of October 2021, the American Public Health Association tracked more than 220 jurisdictions that had named racism a public health crisis, and organizations across various sectors are making visible commitments to transform their practices, programs, and policies to achieve racial equity (American Public Health Association, n.d.). What should go hand-in-hand with efforts to achieve racial and health equity are efforts to share and shift power with communities affected by health and structural inequities. For example, more health institutions and funders, such as the Robert Wood Johnson Foundation, National Association for County and City Health Officials, and The California Endowment, are making this commitment—looking for opportunities to help build community power, as an outcome in and of itself, in their sphere of influence. In this commentary, the authors discuss why this emerging emphasis on building community power is essential to achieving health and racial equity and highlight a set of values and principles to guide practitioners, researchers, and leaders in transforming how they work with communities to build their power. This three-part series highlights learnings from Lead Local: Community-Driven Change and the Power of Collective Action, a collaborative effort funded by the Robert Wood Johnson Foundation that convened well-respected local organizations and leaders in the fields of community organizing, advocacy, and research to examine the relationship between health and power building. Building on the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Community Power in Population Health Improvement workshop in January 2021, priority areas for action are shared to make progress toward, and further an understanding of, community power building for health and racial equity.","PeriodicalId":74236,"journal":{"name":"NAM perspectives","volume":"2022 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499374/pdf/nampsp-2022-202206d.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9286744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inclusion, Diversity, Equity, and Anti-Racism in Health and Science Professions: A Call to Action for Membership and Leadership Organizations.","authors":"Elena Fuentes-Afflick, Victor J Dzau","doi":"10.31478/202205b","DOIUrl":"https://doi.org/10.31478/202205b","url":null,"abstract":"","PeriodicalId":74236,"journal":{"name":"NAM perspectives","volume":"2022 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9499380/pdf/nampsp-2022-202205b.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9291731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Animals have been used as scientific research subjects since at least the 4th century BCE (Guerrini, 2003). Since then, there has been both support for and objections to that use. Some similarity between nonhuman animals and humans powers the arguments of both research advocates (who see animals as relevant models for human disease) and animal protectionists (who see animals as victimized, nonconsenting individuals). Taking into account both science and health care concerns, as well as to human and animal welfare, the authors of this commentary encourage the biomedical research community to ask at least three questions about the use of animals in research: • Has animal-based research helped advance the understanding of basic physiological and pathophysiological processes, reliably identified toxic substances, and advanced human and animal health care? • Has unchallenged reliance on animal-based research diverted resources from developing what might have and could become other methods of scientific investigation (nonanimal methods or new approach methods [alternatives]) that predict positive or negative health care outcomes with equal or greater effectiveness? • Lastly, who or what groups of people can most effectively champion the utility of nonanimal methods and their potential to replace or significantly reduce animal use after a controversy lasting more than two millenia?
{"title":"Alternative Thinking About Animals in Research.","authors":"Lisa Hara Levin, Louis J Muglia","doi":"10.31478/202211a","DOIUrl":"https://doi.org/10.31478/202211a","url":null,"abstract":"Animals have been used as scientific research subjects since at least the 4th century BCE (Guerrini, 2003). Since then, there has been both support for and objections to that use. Some similarity between nonhuman animals and humans powers the arguments of both research advocates (who see animals as relevant models for human disease) and animal protectionists (who see animals as victimized, nonconsenting individuals). Taking into account both science and health care concerns, as well as to human and animal welfare, the authors of this commentary encourage the biomedical research community to ask at least three questions about the use of animals in research: • Has animal-based research helped advance the understanding of basic physiological and pathophysiological processes, reliably identified toxic substances, and advanced human and animal health care? • Has unchallenged reliance on animal-based research diverted resources from developing what might have and could become other methods of scientific investigation (nonanimal methods or new approach methods [alternatives]) that predict positive or negative health care outcomes with equal or greater effectiveness? • Lastly, who or what groups of people can most effectively champion the utility of nonanimal methods and their potential to replace or significantly reduce animal use after a controversy lasting more than two millenia?","PeriodicalId":74236,"journal":{"name":"NAM perspectives","volume":"2022 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9875849/pdf/nampsp-2022-202211a.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10585939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-29eCollection Date: 2021-01-01DOI: 10.31478/202111c
Frederick Isasi, Mary D Naylor, David Skorton, David C Grabowski, Sandra Hernández, Valerie Montgomery Rice
About the NAM series on Emerging Stronger After COVID-19: Priorities for Health System Transformation This discussion paper is part of the National Academy of Medicine’s Emerging Stronger After COVID-19: Priorities for Health System Transformation initiative, which commissioned papers from experts on how 9 key sectors of the health, health care, and biomedical science fi elds responded to and can be transformed in the wake of the COVID-19 pandemic. The views presented in this discussion paper and others in the series are those of the authors and do not represent formal consensus positions of the NAM, the National Academies of Sciences, Engineering, and Medicine, or the authors’ organizations. Learn more: nam.edu/TransformingHealth
{"title":"Patients, Families, and Communities COVID-19 Impact Assessment: Lessons Learned and Compelling Needs.","authors":"Frederick Isasi, Mary D Naylor, David Skorton, David C Grabowski, Sandra Hernández, Valerie Montgomery Rice","doi":"10.31478/202111c","DOIUrl":"10.31478/202111c","url":null,"abstract":"About the NAM series on Emerging Stronger After COVID-19: Priorities for Health System Transformation This discussion paper is part of the National Academy of Medicine’s Emerging Stronger After COVID-19: Priorities for Health System Transformation initiative, which commissioned papers from experts on how 9 key sectors of the health, health care, and biomedical science fi elds responded to and can be transformed in the wake of the COVID-19 pandemic. The views presented in this discussion paper and others in the series are those of the authors and do not represent formal consensus positions of the NAM, the National Academies of Sciences, Engineering, and Medicine, or the authors’ organizations. Learn more: nam.edu/TransformingHealth","PeriodicalId":74236,"journal":{"name":"NAM perspectives","volume":"2021 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8803391/pdf/nampsp-2021-202111c.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39887910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-11-22eCollection Date: 2021-01-01DOI: 10.31478/202111b
Jonathan Rushton, Barry J McMahon, Mary E Wilson, Jonna A K Mazet, Bhavani Shankar
Every dollar spent on food in the United States produces two dollars of negative impact on public health and the environment. Today’s food system feeds people but harms the environment and the health of humans, animals, and plants globally (The Rockefeller Foundation, 2021). The authors of this commentary explore how food systems have arrived at this unsustainable state and what can be done to address this crisis. Driven by a narrow focus on economic efficiency, modern food systems have evolved to deliver cheap food at any cost. These food systems are typically guided by Ministries of Agriculture that often work in a narrow and siloed manner, function independently of Ministries of Health and Environment, are reactive to emergencies, and fail to respond proactively to the mining of natural resources and poor food-related public health outcomes (Scott and Gong, 2021). The authors of this commentary present a case for an urgent change of mindset toward systems thinking and proactive policies to curb these negative externalities (i.e., unintended negative impacts not adequately accounting for economic costs). This mindset change centers One Health, an approach that addresses the health of people, animals, plants and the environment through intersectoral and transdisciplinary methods, at the core of global food system policies (Rushton et al., 2018). If you are 50 or older and grew up in a rural town or provincial village in a wealthy country, there is a good chance that your family was involved in agriculture. You might have gone to school with children from farms who perhaps smelled of livestock or had to take time from school to help with crop planting or harvest. You might have been aware of food shortages, the importance of water availability, the seasonality of many fruits and vegetables, and how some meats were highly prized and saved for special occasions. You might understand how food would go bad, turning rancid or becoming moldy. You may have participated in preserving your own family’s homegrown or other locally grown produce. Agriculture might have surrounded you in your younger days. You might have known farm-
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