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.

Sixth edition of the hugely successful, internationally recognised textbook on global public health and epidemiology, with 3 volumes comprehensively covering the scope, methods, and practice of the discipline

Unequal Lives focuses on the connections between people's unequal health and people's unequal lives, and between health and socioeconomic inequalities

This book shows the important links between social conditions and health and begins to describe the processes through which these health inequalities may be generated. It reviews a range of methodologies that could be used by health researchers in this field and proposes innovative future research directions.

'Punchily written ... He leaves the reader with a sense of the gross injustice of a world where health outcomes are so unevenly distributed' Times Literary Supplement 'Splendid and necessary' Henry Marsh, author of Do No Harm, New Statesman There are dramatic differences in health between countries and within countries. But this is not a simple matter of rich and poor. A poor man in Glasgow is rich compared to the average Indian, but the Glaswegian's life expectancy is 8 years shorter. The Indian is dying of infectious disease linked to his poverty; the Glaswegian of violent death, suicide, heart disease linked to a rich country's version of disadvantage. In all countries, people at relative social disadvantage suffer health disadvantage, dramatically so. Within countries, the higher the social status of individuals the better is their health. These health inequalities defy usual explanations. Conventional approaches to improving health have emphasised access to technical solutions – improved medical care, sanitation, and control of disease vectors; or behaviours – smoking, drinking – obesity, linked to diabetes, heart disease and cancer. These approaches only go so far. Creating the conditions for people to lead flourishing lives, and thus empowering individuals and communities, is key to reduction of health inequalities. In addition to the scale of material success, your position in the social hierarchy also directly affects your health, the higher you are on the social scale, the longer you will live and the better your health will be. As people change rank, so their health risk changes. What makes these health inequalities unjust is that evidence from round the world shows we know what to do to make them smaller. This new evidence is compelling. It has the potential to change radically the way we think about health, and indeed society.

New Horizons in Health discusses how the National Institutes of Health (NIH) can integrate research in the social, behavioral, and biomedical sciences to better understand the causes of disease as well as interventions that promote health. It outlines a set of research priorities for consideration by the Office of Behavioral and Social Sciences Research (OBSSR), with particular attention to research that can support and complement the work of the National Institutes of Health. By addressing the range of interactions among social settings, behavioral patterns, and important health concerns, it highlights areas of scientific opportunity where significant investment is most likely to improve nationalâ€"and globalâ€"health outcomes. These opportunities will apply the knowledge and methods of the behavioral and social sciences to contemporary health needs, and give attention to the chief health concerns of the general public.

Social scientists have repeatedly uncovered a disturbing feature of economic inequality: people with larger incomes and better education tend to lead longer, healthier lives. This pattern holds across all ages and for virtually all measures of health, apparently indicating a biological dimension of inequality. But scholars have only begun to understand the complex mechanisms that drive this disparity. How exactly do financial well-being and human physiology interact? The Biological Consequences of Socioeconomic Inequalities incorporates insights from the social and biological sciences to quantify the biology of disadvantage and to assess how poverty gets under the skin to impact health. Drawing from unusually rich datasets of biomarkers, brain scans, and socioeconomic measures, Biological Consequences of Socioeconomic Inequalities illustrates exciting new paths to understanding social inequalities in health. Barbara Wolfe, William N. Evans and Nancy Adler begin the volume with a critical evaluation of the literature on income and health, providing a lucid review of the difficulties of establishing clear causal pathways between the two variables. In their chapter, Arun S. Karlamangla, Tara L. Gruenewald, and Teresa E. Seeman outline the potential of biomarkers—such as cholesterol, heart pressure, and C-reactive protein—to assess and indicate the factors underlying health. Edith Chen, Hannah M. C. Schreier, and Meanne Chan reveal the empirical power of biomarkers by examining asthma, a condition steeply correlated with socioeconomic status. Their analysis shows how stress at the individual, family, and neighborhood levels can increase the incidence of asthma. The volume then turns to cognitive neuroscience, using biomarkers in a new way to examine the impact of poverty on brain development. Jamie Hanson, Nicole Hair, Amitabh Chandra, Ed Moss, Jay Bhattacharya, Seth D. Pollack, and Barbara Wolfe use a longitudinal Magnetic Resonance Imaging (MRI) study of children between the ages of four and eighteen to study the link between poverty and limited cognition among children. Michelle C. Carlson, Christopher L. Seplaki, and Teresa E. Seeman also focus on brain development to examine the role of socioeconomic status in cognitive decline among older adults. Featuring insights from the biological and social sciences, Biological Consequences of Socioeconomic Inequalities will be an essential resource for scholars interested in socioeconomic disparities and the biological imprint that material deprivation leaves on the human body.

During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages-cancer and cardiovascular disease-available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which-unlike randomized controlled trials-are subject to many biases.

Good health is a key component of people's well-being. It is a value in itself but - through its influence on social, education and labour market outcomes - being in good or bad health has also wider implications on people's chances of leading a fulfilling and productive life. Yet, even in the OECD countries, health inequality persists with severe consequences on the goal of promoting inclusive growth. This report documents a comprehensive range of inequalities in health and health systems to the detriment of disadvantaged population groups in a large set of OECD and EU countries. It assesses the gaps in health outcomes and risk factors between different socio-economic groups. When it comes to health systems, the report measures inequalities in health care utilisation, unmet needs and the affordability of health care services. For each of these different domains, the report identifies groups of countries that display higher, intermediate, and low levels of inequality. The report makes a strong case for addressing health-related inequalities as a key component of a policy strategy to promote inclusive growth and reduce social inequalities. It also provides a framework for more in-depth analyses on how to address these inequalities at country level.