In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.

The understanding of how to reduce risk factors for mental disorders has expanded remarkably as a result of recent scientific advances. This study, mandated by Congress, reviews those advances in the context of current research and provides a targeted definition of prevention and a conceptual framework that emphasizes risk reduction. Highlighting opportunities for and barriers to interventions, the book draws on successful models for the prevention of cardiovascular disease, injuries, and smoking. In addition, it reviews the risk factors associated with Alzheimer's disease, schizophrenia, alcohol abuse and dependence, depressive disorders, and conduct disorders and evaluates current illustrative prevention programs. The models and examination provide a framework for the design, application, and evaluation of interventions intended to prevent mental disorders and the transfer of knowledge about prevention from research to clinical practice. The book presents a focused research agenda, with recommendations on how to develop effective intervention programs, create a cadre of prevention researchers, and improve coordination among federal agencies.

This report considers the biological and behavioral mechanisms that may underlie the pathogenicity of tobacco smoke. Many Surgeon General's reports have considered research findings on mechanisms in assessing the biological plausibility of associations observed in epidemiologic studies. Mechanisms of disease are important because they may provide plausibility, which is one of the guideline criteria for assessing evidence on causation. This report specifically reviews the evidence on the potential mechanisms by which smoking causes diseases and considers whether a mechanism is likely to be operative in the production of human disease by tobacco smoke. This evidence is relevant to understanding how smoking causes disease, to identifying those who may be particularly susceptible, and to assessing the potential risks of tobacco products.

Decades of research have demonstrated that the parent-child dyad and the environment of the familyâ€"which includes all primary caregiversâ€"are at the foundation of children's well- being and healthy development. From birth, children are learning and rely on parents and the other caregivers in their lives to protect and care for them. The impact of parents may never be greater than during the earliest years of life, when a child's brain is rapidly developing and when nearly all of her or his experiences are created and shaped by parents and the family environment. Parents help children build and refine their knowledge and skills, charting a trajectory for their health and well-being during childhood and beyond. The experience of parenting also impacts parents themselves. For instance, parenting can enrich and give focus to parents' lives; generate stress or calm; and create any number of emotions, including feelings of happiness, sadness, fulfillment, and anger. Parenting of young children today takes place in the context of significant ongoing developments. These include: a rapidly growing body of science on early childhood, increases in funding for programs and services for families, changing demographics of the U.S. population, and greater diversity of family structure. Additionally, parenting is increasingly being shaped by technology and increased access to information about parenting. Parenting Matters identifies parenting knowledge, attitudes, and practices associated with positive developmental outcomes in children ages 0-8; universal/preventive and targeted strategies used in a variety of settings that have been effective with parents of young children and that support the identified knowledge, attitudes, and practices; and barriers to and facilitators for parents' use of practices that lead to healthy child outcomes as well as their participation in effective programs and services. This report makes recommendations directed at an array of stakeholders, for promoting the wide-scale adoption of effective programs and services for parents and on areas that warrant further research to inform policy and practice. It is meant to serve as a roadmap for the future of parenting policy, research, and practice in the United States.

Here is a major new volume for practitioners, researchers, and those concerned with future policies to promote the welfare of children and families. The patterns of support and the ability of family members to care for each other have changed along with the problems for the health and functioning of families. In Families as Nurturing Systems, respected scholars examine the new and emerging directions in the design and implementation of family resources and support programs. They describe and analyze a wide range of program models in the areas of prevention, social support, family resource, and empowerment that have been implemented in schools, the Afro-American church, early intervention programs, the workplace, and the public policy arena, reflecting the needs of families at different stages in the family life cycle.

The Exposome: A Primer is the first book dedicated to exposomics, detailing the purpose and scope of this emerging field of study, its practical applications and how it complements a broad range of disciplines. Genetic causes account for up to a third of all complex diseases. (As genomic approaches improve, this is likely to rise.) Environmental factors also influence human disease but, unlike with genetics, there is no standard or systematic way to measure the influence of environmental exposures. The exposome is an emerging concept that hopes to address this, measuring the effects of life-long environmental exposures on health and how these exposures can influence disease. This systematic introduction considers topics of managing and integrating exposome data (including maps, models, computation, and systems biology), "-omics"-based technologies, and more. Both students and scientists in disciplines including toxicology, environmental health, epidemiology, and public health will benefit from this rigorous yet readable overview.

In the Handbook of Injury and Violence Prevention, over fifty experts present the current landscape of intervention methods - from risk reduction to rethinking social norms - as they address some of the most prevalent forms of accidental and violent injury. - Overview chapters examine the social and economic scope of unintentional and violent injury today - Extensive literature review of specific intervention programs to prevent violence and injury - Special chapters on childhood injuries, alcohol-related accidents, and disasters - "Interventions in the Field" section offers solid guidelines for implementing and improving existing programs - Critical analysis of issues involved in delivering programs to wider audiences - Helpful appendices list relevant agencies and professional resources This dual focus on intervention and application makes the Handbook a bedrock text for professionals involved in delivering or managing prevention programs. Its what-works-now approach gives it particular utility in the graduate classroom, and researchers will benefit from the critical attention paid to knowledge gaps in the field. It is a major resource for any reader committed to reducing the number of incidents just waiting to happen.

Traumatic brain injury (TBI) remains a significant source of death and permanent disability, contributing to nearly one-third of all injury related deaths in the United States and exacting a profound personal and economic toll. Despite the increased resources that have recently been brought to bear to improve our understanding of TBI, the developme