The obesity crisis in the United States disproportionately affects some demographic groups more than others. Contextual influences on obesity are complex and include an individual's weight-related behaviors and outcomes, the intermediate variables that influence these behaviors and outcomes, and broader, upstream historical, social, economic, physical, and policy contexts. The National Academies convened a workshop on April 1, 2019 to explore the history of health equity issues in demographic groups that have above-average obesity risk and to consider principles and approaches to address these issues as part of obesity prevention and treatment efforts. This publication summarizes the presentations and discussions from the workshop.

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 obesity crisis in the United States disproportionately affects some demographic groups more than others. Contextual influences on obesity are complex and include an individual's weight-related behaviors and outcomes, the intermediate variables that influence these behaviors and outcomes, and broader, upstream historical, social, economic, physical, and policy contexts. The National Academies convened a workshop on April 1, 2019 to explore the history of health equity issues in demographic groups that have above-average obesity risk and to consider principles and approaches to address these issues as part of obesity prevention and treatment efforts. This publication summarizes the presentations and discussions from the workshop"--Publisher's description

"Supporting a Movement for Health and Health Equity" is the summary of a workshop convened in December 2013 by the Institute of Medicine Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities and the Roundtable on Population Health Improvement to explore the lessons that may be gleaned from social movements, both those that are health-related and those that are not primarily focused on health. Participants and presenters focused on elements identified from the history and sociology of social change movements and how such elements can be applied to present-day efforts nationally and across communities to improve the chances for long, healthy lives for all. The idea of movements and movement building is inextricably linked with the history of public health. Historically, most movements - including, for example, those for safer working conditions, for clean water, and for safe food - have emerged from the sustained efforts of many different groups of individuals, which were often organized in order to protest and advocate for changes in the name of such values as fairness and human rights. The purpose of the workshop was to have a conversation about how to support the fragments of health movements that roundtable members believed they could see occurring in society and in the health field. Recent reports from the National Academies have highlighted evidence that the United States gets poor value on its extraordinary investments in health - in particular, on its investments in health care - as American life expectancy lags behind that of other wealthy nations. As a result, many individuals and organizations, including the Healthy People 2020 initiative, have called for better health and longer lives.

Children are the foundation of the United States, and supporting them is a key component of building a successful future. However, millions of children face health inequities that compromise their development, well-being, and long-term outcomes, despite substantial scientific evidence about how those adversities contribute to poor health. Advancements in neurobiological and socio-behavioral science show that critical biological systems develop in the prenatal through early childhood periods, and neurobiological development is extremely responsive to environmental influences during these stages. Consequently, social, economic, cultural, and environmental factors significantly affect a child's health ecosystem and ability to thrive throughout adulthood. Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity builds upon and updates research from Communities in Action: Pathways to Health Equity (2017) and From Neurons to Neighborhoods: The Science of Early Childhood Development (2000). This report provides a brief overview of stressors that affect childhood development and health, a framework for applying current brain and development science to the real world, a roadmap for implementing tailored interventions, and recommendations about improving systems to better align with our understanding of the significant impact of health equity.

As the public health threat of childhood obesity has become clear, the issue has become the focus of local, state, and national initiatives. Many of these efforts are centered on the community environment in recognition of the role of environmental factors in individual behaviors related to food and physical activity. In many communities, for example, fresh produce is not available or affordable, streets and parks are not amenable to exercise, and policies and economic choices make fast food cheaper and more convenient than healthier alternatives. Community efforts to combat obesity vary in scope and scale; overall, however, they remain fragmented, and little is known about their effectiveness. At the local level, communities are struggling to determine which obesity prevention programs to initiate and how to evaluate their impact. In this context, the Institute of Medicine held two workshops to inform current work on obesity prevention in children through input from individuals who are actively engaged in community- and policy-based obesity prevention programs. Community perspectives were elicited on the challenges involved in undertaking policy and programmatic interventions aimed at preventing childhood obesity, and on approaches to program implementation and evaluation that have shown promise. Highlights of the workshop presentations and discussions are presented in this volume.

Social justice is a matter of life and death. It affects the way people live, their consequent chance of illness, and their risk of premature death. We watch in wonder as life expectancy and good health continue to increase in parts of the world and in alarm as they fail to improve in others.

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

The increasing prevalence and burden of obesity transcends borders, straining populations worldwide. Data shows that 50 million girls, 74 million boys, 390 million women, and 281 million men were estimated to have obesity in 2016 (NCD-RisC, 2017). The National Academies of Sciences, Engineering, and Medicine convened a workshop on October 9, 2018 to address the status of the global obesity pandemic and discuss diverse approaches to manage this problem. Speakers examined the collective prevalence, costs, and drivers of obesity around the world using cross-cultural comparisons. Panels and group discussions emphasized the need to reduce disparities in prevention and treatment efforts and to generate new policy and system initiatives related to nutrition and physical activity worldwide. This publication summarizes the presentations and discussions from the workshop.

Reading this book is like sitting down with Dr. David Satcher to hear stories of leadership and lessons learned from his lifetime commitment to health equity. Dr. David Satcher is one of the most widely known and well-regarded physicians of our time. A former four-star admiral in the US Public Health Service Commissioned Corps, he served as the assistant secretary for health, the surgeon general of the United States, and the director of the Centers for Disease Control and Prevention before founding the eponymous Satcher Health Leadership Institute at Morehouse School of Medicine. At the core of his impact on public health, he is also a lifelong leader for civil rights and health equity. Born black and poor in the deep South, Dr. Satcher was a victim of an unjust health care system: he almost died of whooping cough at the age of two because Jim Crow laws meant that his black doctor could not admit him to a hospital. That experience was the first of many that shaped him as a leader and a healer deeply attuned to social inequity—someone who was determined to make a positive difference. In My Quest for Health Equity, Dr. Satcher takes an inspiring and instructive look inside his fifty-year career to shed light on the challenge and burden of leadership. Explaining that he has thought of each leadership role—whether in academia, community, or government—as an opportunity to move the needle toward health equity, he shares the hard-won lessons he has learned over a lifetime in the medical field. Drawing on his early memories, medical school days, experience in the civil rights movement, and professional highs and lows, Dr. Satcher touches on a number of topics, including • the essential qualities of leadership • leading from science to policy to practice • the importance of clear communication and continual learning • the need for workplace discipline • confronting failure • specific health issues, including the obesity epidemic, reproductive health, and mental health stigma • team approaches to leadership • and much more In this book, readers will discover a template for using leadership roles of all types to eliminate health disparities. My Quest for Health Equity is a vital resource for current and rising leaders.