TY - BOOK AU - Institute of Medicine A2 - Heather M. Colvin A2 - Abigail E. Mitchell TI - Hepatitis and Liver Cancer: A National Strategy for Prevention and Control of Hepatitis B and C SN - DO - 10.17226/12793 PY - 2010 UR - https://nap.nationalacademies.org/catalog/12793/hepatitis-and-liver-cancer-a-national-strategy-for-prevention-and PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The global epidemic of hepatitis B and C is a serious public health problem. Hepatitis B and C are the major causes of chronic liver disease and liver cancer in the world. In the next 10 years, 150,000 people in the United States will die from liver disease or liver cancer associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infections. Today, between 800,000 and 1.4 million people in the United States have chronic hepatitis B and between 2.7 and 3.9 million have chronic hepatitis C. People most at risk for hepatitis B and C often are the least likely to have access to medical services. Reducing the rates of illness and death associated with these diseases will require greater awareness and knowledge among health care workers, improved identification of at-risk people, and improved access to medical care. Hepatitis B is a vaccine-preventable disease. Although federal public health officials recommend that all newborns, children, and at-risk adults receive the vaccine, about 46,000 new acute cases of the HBV infection emerge each year, including 1,000 in infants who acquire the infection during birth from their HBV-positive mothers. Unfortunately, there is no vaccine for hepatitis C, which is transmitted by direct exposure to infectious blood. Hepatitis and Liver Cancer identifies missed opportunities related to the prevention and control of HBV and HCV infections. The book presents ways to reduce the numbers of new HBV and HCV infections and the morbidity and mortality related to chronic viral hepatitis. It identifies priorities for research, policy, and action geared toward federal, state, and local public health officials, stakeholder, and advocacy groups and professional organizations. ER - TY - BOOK AU - Institute of Medicine TI - Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research SN - DO - 10.17226/13172 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13172/relieving-pain-in-america-a-blueprint-for-transforming-prevention-care PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Chronic pain costs the nation up to $635 billion each year in medical treatment and lost productivity. The 2010 Patient Protection and Affordable Care Act required the Department of Health and Human Services (HHS) to enlist the Institute of Medicine (IOM) in examining pain as a public health problem. In this report, the IOM offers a blueprint for action in transforming prevention, care, education, and research, with the goal of providing relief for people with pain in America. To reach the vast multitude of people with various types of pain, the nation must adopt a population-level prevention and management strategy. The IOM recommends that HHS develop a comprehensive plan with specific goals, actions, and timeframes. Better data are needed to help shape efforts, especially on the groups of people currently underdiagnosed and undertreated, and the IOM encourages federal and state agencies and private organizations to accelerate the collection of data on pain incidence, prevalence, and treatments. Because pain varies from patient to patient, healthcare providers should increasingly aim at tailoring pain care to each person's experience, and self-management of pain should be promoted. In addition, because there are major gaps in knowledge about pain across health care and society alike, the IOM recommends that federal agencies and other stakeholders redesign education programs to bridge these gaps. Pain is a major driver for visits to physicians, a major reason for taking medications, a major cause of disability, and a key factor in quality of life and productivity. Given the burden of pain in human lives, dollars, and social consequences, relieving pain should be a national priority. ER - TY - BOOK AU - National Research Council AU - Institute of Medicine TI - Depression in Parents, Parenting, and Children: Opportunities to Improve Identification, Treatment, and Prevention SN - DO - 10.17226/12565 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12565/depression-in-parents-parenting-and-children-opportunities-to-improve-identification PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Behavioral and Social Sciences AB - Depression is a widespread condition affecting approximately 7.5 million parents in the U.S. each year and may be putting at least 15 million children at risk for adverse health outcomes. Based on evidentiary studies, major depression in either parent can interfere with parenting quality and increase the risk of children developing mental, behavioral and social problems. Depression in Parents, Parenting, and Children highlights disparities in the prevalence, identification, treatment, and prevention of parental depression among different sociodemographic populations. It also outlines strategies for effective intervention and identifies the need for a more interdisciplinary approach that takes biological, psychological, behavioral, interpersonal, and social contexts into consideration. A major challenge to the effective management of parental depression is developing a treatment and prevention strategy that can be introduced within a two-generation framework, conducive for parents and their children. Thus far, both the federal and state response to the problem has been fragmented, poorly funded, and lacking proper oversight. This study examines options for widespread implementation of best practices as well as strategies that can be effective in diverse service settings for diverse populations of children and their families. The delivery of adequate screening and successful detection and treatment of a depressive illness and prevention of its effects on parenting and the health of children is a formidable challenge to modern health care systems. This study offers seven solid recommendations designed to increase awareness about and remove barriers to care for both the depressed adult and prevention of effects in the child. The report will be of particular interest to federal health officers, mental and behavioral health providers in diverse parts of health care delivery systems, health policy staff, state legislators, and the general public. ER - TY - BOOK AU - Institute of Medicine A2 - Monica S. Ruiz A2 - Alicia R. Gable A2 - Edward H. Kaplan A2 - Michael A. Stoto A2 - Harvey V. Fineberg A2 - James Trussell TI - No Time to Lose: Getting More from HIV Prevention SN - DO - 10.17226/9964 PY - 2001 UR - https://nap.nationalacademies.org/catalog/9964/no-time-to-lose-getting-more-from-hiv-prevention PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The United States has spent two productive decades implementing a variety of prevention programs. While these efforts have slowed the rate of infection, challenges remain. The United States must refocus its efforts to contain the spread of HIV and AIDS in a way that would prevent as many new HIV infections as possible. No Time to Lose presents the Institute of Medicine’s framework for a national prevention strategy. ER - TY - BOOK TI - PY - UR - PB - The National Academies Press CY - Washington, DC LA - English ER - TY - BOOK AU - Institute of Medicine A2 - Steve Olson TI - Cross-Sector Responses to Obesity: Models for Change: Workshop Summary SN - DO - 10.17226/21706 PY - 2015 UR - https://nap.nationalacademies.org/catalog/21706/cross-sector-responses-to-obesity-models-for-change-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Food and Nutrition KW - Health and Medicine AB - Obesity affects 17 percent of children and adolescents and almost 36 percent of adults in the United States. Conservative estimates suggest that obesity now accounts for almost 20 percent of national health care spending. Until the obesity epidemic is reversed, obesity will continue to drive rates of chronic diseases such as heart disease, stroke, type 2 diabetes, and certain types of cancer. Cross-Sector Responses to Obesity is a summary of a workshop convened by the Institute of Medicine Roundtable on Obesity Solutions in September 2014 to explore models of cross-sector work that may reduce the prevalence and consequences of obesity. This report identifies case studies of cross-sector initiatives that engage partners from diverse fields, and lessons learned from and barriers to established cross-sector initiatives. ER - TY - BOOK AU - Institute of Medicine A2 - Steve Olson A2 - Leslie Sim A2 - Sarah Ziegenhorn TI - Cross-Sector Responses to Obesity: Models for Change: Workshop in Brief DO - 10.17226/21686 PY - 2014 UR - https://nap.nationalacademies.org/catalog/21686/cross-sector-responses-to-obesity-models-for-change-workshop-in PB - The National Academies Press CY - Washington, DC LA - English KW - Food and Nutrition AB - On September 30, 2014, the Institute of Medicine's Roundtable on Obesity Solutions held a 1-day workshop titled "Cross-Sector Work on Obesity Prevention, Treatment, and Weight Maintenance: Models for Change." The workshop was designed to explore models of cross-sector work that may reduce the prevalence and consequences of obesity, discuss lessons learned from case studies of cross-sector initiatives, and spur future cross-sector collaboration. This brief summary of the workshop highlights the salient points that emerged from the presentations and discussions at the workshop. ER - TY - BOOK AU - Institute of Medicine A2 - Thomas R. Eng A2 - William T. Butler TI - The Hidden Epidemic: Confronting Sexually Transmitted Diseases SN - DO - 10.17226/5284 PY - 1997 UR - https://nap.nationalacademies.org/catalog/5284/the-hidden-epidemic-confronting-sexually-transmitted-diseases PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The United States has the dubious distinction of leading the industrialized world in overall rates of sexually transmitted diseases (STDs), with 12 million new cases annually. About 3 million teenagers contract an STD each year, and many will have long-term health problems as a result. Women and adolescents are particularly vulnerable to these diseases and their health consequences. In addition, STDs increase the risk of HIV transmission. The Hidden Epidemic examines the scope of sexually transmitted infections in the United States and provides a critical assessment of the nation's response to this public health crisis. The book identifies the components of an effective national STD prevention and control strategy and provides direction for an appropriate response to the epidemic. Recommendations for improving public awareness and education, reaching women and adolescents, integrating public health programs, training health care professionals, modifying messages from the mass media, and supporting future research are included. The book documents the epidemiological dimensions and the economic and social costs of STDs, describing them as "a secret epidemic" with tremendous consequences. The committee frankly discusses the confusing and often hypocritical nature of how Americans deal with issues regarding sexuality—the conflicting messages conveyed in the mass media, the reluctance to promote condom use, the controversy over sex education for teenagers, and the issue of personal blame. The Hidden Epidemic identifies key elements of effective, culturally appropriate programs to promote healthy behavior by adolescents and adults. It examines the problem of fragmentation in STD services and provides examples of communities that have formed partnerships between stakeholders to develop integrated approaches. The committee's recommendations provide a practical foundation on which to build an integrated national program to help young people and adults develop habits of healthy sexuality. The Hidden Epidemic was written for both health care professionals and people without a medical background and will be indispensable to anyone concerned about preventing and controlling STDs. ER - TY - BOOK AU - Institute of Medicine AU - National Academies of Sciences, Engineering, and Medicine A2 - Erin Rusch TI - Bringing Public Health into Urban Revitalization: Workshop in Brief DO - 10.17226/21847 PY - 2015 UR - https://nap.nationalacademies.org/catalog/21847/bringing-public-health-into-urban-revitalization-workshop-in-brief PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - On November 10, 2014, the Roundtable on Environmental Health Sciences, Research, and Medicine held a 1-day workshop titled "Bringing Public Health into Urban Revitalization." The purpose of the workshop was to explore public health issues related to the redesign of major U.S. cities, focusing on recent examples from Detroit, Michigan; New York City; and Washington, DC. Workshop speakers showed how rebuilding efforts provide an opportunity to reimagine the built environment, increase a sense of community, increase the role of public health departments and health systems, and increase the use of green technologies. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Darla Thompson TI - Community Violence as a Population Health Issue: Proceedings of a Workshop—in Brief DO - 10.17226/23668 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23668/community-violence-as-a-population-health-issue-proceedings-of-a PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - 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. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Steve Olson TI - Driving Action and Progress on Obesity Prevention and Treatment: Proceedings of a Workshop—in Brief DO - 10.17226/24642 PY - 2017 UR - https://nap.nationalacademies.org/catalog/24642/driving-action-and-progress-on-obesity-prevention-and-treatment-proceedings PB - The National Academies Press CY - Washington, DC LA - English KW - Food and Nutrition AB - The Roundtable on Obesity Solutions of the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, on September 27, 2016, titled "Driving Action and Progress on Obesity Prevention and Treatment." The workshop was designed to (1) review the progress that has been made in obesity prevention and treatment; (2) identify some of the levers that can drive significant future progress; and (3) discuss how gaps in the field can be filled. This Proceedings of a Workshop-in Brief highlights key points made during the presentations and discussions and is not intended to provide a comprehensive summary of information shared during the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Joe Alper A2 - Rose Marie Martinez A2 - Dara Rosenberg TI - Integrating Firearm Injury Prevention into Health Care: Proceedings of a Joint Workshop of the National Academies of Sciences, Engineering, and Medicine; Northwell Health; and PEACE Initiative SN - DO - 10.17226/26707 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26707/integrating-firearm-injury-prevention-into-health-care-proceedings-of-a PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The staggering number of deaths and emergency department visits caused by firearm injuries has only grown with time. Costs associated with firearm related injuries amount to over a billion dollars annually in the United States alone, not including physician charges and postdischarge costs. To address this epidemic, in April of 2022, the National Academies of Sciences, Engineering, and Medicine's Board on Population Health and Public Health Practice, in collaboration with Northwell Heath and the PEACE Initiative, brought together firearm injury prevention thought leaders to explore how health systems can integrate interventions for firearm injury prevention into routine care for the purpose of improving the health of patients and communities. The workshop speakers discussed strategies for firearm injury and mortality prevention and its integration into routine care. Speakers also explored facilitators and barriers to implementation strategies, and how health systems might work to overcome those barriers. ER - TY - BOOK AU - Institute of Medicine A2 - Maria Oria A2 - Kristin Sawyer TI - Joint U.S.-Mexico Workshop on Preventing Obesity in Children and Youth of Mexican Origin: Summary SN - DO - 10.17226/11813 PY - 2007 UR - https://nap.nationalacademies.org/catalog/11813/joint-us-mexico-workshop-on-preventing-obesity-in-children-and-youth-of-mexican-origin PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Joint U.S.-Mexico Workshop on Preventing Obesity in Children and Youth of Mexican Origin was initiated by a desire to share experiences regarding the problem of obesity in children and youth of Mexican origin on both sides of the border, with a particular focus on potential solutions. U.S and Mexican researchers, public health officials, industry leaders, and policy-makers engaged in valuable dialogue to share perspectives, challenges, and opportunities. Commonalities and differences in the United States and Mexico regarding risk factors, potential interventions and programs, and need for all sectors to collaborate and make progress toward solving this serious public health problem were also discussed. This dialogue served as a basis to explore a bi-national agenda for addressing this epidemic, which was the ultimate goal of the workshop. ER - TY - BOOK AU - Institute of Medicine TI - Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation SN - DO - 10.17226/13275 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13275/accelerating-progress-in-obesity-prevention-solving-the-weight-of-the PB - The National Academies Press CY - Washington, DC LA - English KW - Food and Nutrition KW - Health and Medicine AB - One-third of adults are now obese, and children's obesity rates have climbed from 5 to 17 percent in the past 30 years. The causes of the nation's obesity epidemic are multi-factorial, having much more to do with the absence of sidewalks and the limited availability of healthy and affordable foods than a lack of personal responsibility. The broad societal changes that are needed to prevent obesity will inevitably affect activity and eating environments and settings for all ages. Many aspects of the obesity problem have been identified and discussed; however, there has not been complete agreement on what needs to be done to accelerate progress. Accelerating Progress in Obesity Prevention reviews previous studies and their recommendations and presents five key recommendations to accelerate meaningful change on a societal level during the next decade. The report suggests recommendations and strategies that, independently, can accelerate progress, but urges a systems approach of many strategies working in concert to maximize progress in accelerating obesity prevention. The recommendations in Accelerating Progress in Obesity Prevention include major reforms in access to and opportunities for physical activity; widespread reductions in the availability of unhealthy foods and beverages and increases in access to healthier options at affordable, competitive prices; an overhaul of the messages that surround Americans through marketing and education with respect to physical activity and food consumption; expansion of the obesity prevention support structure provided by health care providers, insurers, and employers; and schools as a major national focal point for obesity prevention. The report calls on all individuals, organizations, agencies, and sectors that do or can influence physical activity and nutrition environments to assess and begin to act on their potential roles as leaders in obesity prevention. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Jens-Uwe Kuhn A2 - Nizam Arain A2 - Justin Bell A2 - Brianna Davis A2 - Helen Kaiser A2 - Devin Madden A2 - Guilene Prepetit A2 - Kaaren Williamsen TI - Strategies for Developing, Implementing, and Sustaining Sexual Harassment Bystander Intervention Programs for Faculty, Staff, and Graduate Students DO - 10.17226/27266 PY - 2023 UR - https://nap.nationalacademies.org/catalog/27266/strategies-for-developing-implementing-and-sustaining-sexual-harassment-bystander-intervention-programs-for-faculty-staff-and-graduate-students PB - The National Academies Press CY - Washington, DC LA - English KW - Education AB - To address the persistent problem of sexual harassment within higher education, research suggests that environments need to convey that sexual harassment is not a norm and actively discourage it when it does occur. One approach that researchers have identified as helping to create such environments is bystander intervention programs, which prepare and equip individuals to interrupt and intervene when harassing behavior occurs. This paper explores bystander intervention training approaches that are designed for the complex work environments within higher education, and considers how to apply the principles of bystander intervention to the experiences and environments of faculty, staff, and graduate students., Institutions within the Action Collaborative were asked a standard set of questions to learn about their experiences with commitment and buy-in from leadership, details on how the trainings were developed and what audience it was targeted to, and how the training programs were evaluated. The paper summarizes responses from seven of these institutions and ends with a call for additional research and action. This individually-authored issue paper was created by members of the Prevention Working Group of the Action Collaborative on Preventing Sexual Harassment in Higher Education to understand how institutions are addressing the gap in bystander intervention training for faculty, staff, and graduate students. The Action Collaborative on Preventing Sexual Harassment in Higher Education of the National Academies of Sciences, Engineering, and Medicine brings together academic and research institutions and key stakeholders to work toward targeted, collective action on addressing and preventing sexual harassment across all disciplines and among all people in higher education. The Action Collaborative includes four working groups (Prevention, Response, Remediation, and Evaluation) that identify topics in need of research, gather information, and publish resources for the higher education community. ER - TY - BOOK AU - Institute of Medicine TI - Primary Care and Public Health: Exploring Integration to Improve Population Health SN - DO - 10.17226/13381 PY - 2012 UR - https://nap.nationalacademies.org/catalog/13381/primary-care-and-public-health-exploring-integration-to-improve-population PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health. Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention. This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health. ER - TY - BOOK AU - Institute of Medicine A2 - Barbara S. Lynch A2 - Richard J. Bonnie TI - Growing Up Tobacco Free: Preventing Nicotine Addiction in Children and Youths SN - DO - 10.17226/4757 PY - 1994 UR - https://nap.nationalacademies.org/catalog/4757/growing-up-tobacco-free-preventing-nicotine-addiction-in-children-and PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Tobacco use kills more people than any other addiction and we know that addiction starts in childhood and youth. We all agree that youths should not smoke, but how can this be accomplished? What prevention messages will they find compelling? What effect does tobacco advertising—more than $10 million worth every day—have on youths? Can we responsibly and effectively restrict their access to tobacco products? These questions and more are addressed in Growing Up Tobacco Free, prepared by the Institute of Medicine to help everyone understand the troubling issues surrounding youths and tobacco use. Growing Up Tobacco Free provides a readable explanation of nicotine's effects and the process of addiction, and documents the search for an effective approach to preventing the use of cigarettes, chewing and spitting tobacco, and snuff by children and youths. It covers the results of recent initiatives to limit young people's access to tobacco and discusses approaches to controls or bans on tobacco sales, price sensitivity among adolescents, and arguments for and against taxation as a prevention strategy for tobacco use. The controversial area of tobacco advertising is thoroughly examined. With clear guidelines for public action, everyone can benefit by reading and acting on the messages in this comprehensive and compelling book. ER - TY - BOOK AU - Institute of Medicine A2 - Joe Alper TI - Population Health Implications of the Affordable Care Act: Workshop Summary SN - DO - 10.17226/18546 PY - 2014 UR - https://nap.nationalacademies.org/catalog/18546/population-health-implications-of-the-affordable-care-act-workshop-summary PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Population Health Implications of the Affordable Care Act is the summary of a workshop convened in June 2013 by the Institute of Medicine Roundtable on Population Health Improvement to explore the likely impact on population health improvement of various provisions within the Affordable Care Act (ACA). This public workshop featured presentations and discussion of the impact of various provisions in the ACA on population health improvement. Several provisions of the ACA offer an unprecedented opportunity to shift the focus of health experts, policy makers, and the public beyond health care delivery to the broader array of factors that play a role in shaping health outcomes. The shift includes a growing recognition that the health care delivery system is responsible for only a modest proportion of what makes and keeps Americans healthy and that health care providers and organizations could accept and embrace a richer role in communities, working in partnership with public health agencies, community-based organizations, schools, businesses, and many others to identify and solve the thorny problems that contribute to poor health. Population Health Implications of the Affordable Care Act looks beyond narrow interpretations of population as the group of patients covered by a health plan to consider a more expansive understanding of population, one focused on the distribution of health outcomes across all individuals living within a certain set of geopolitical boundaries. In establishing the National Prevention, Health Promotion, and Public Health Council, creating a fund for prevention and public health, and requiring nonprofit hospitals to transform their concept of community benefit, the ACA has expanded the arena for interventions to improve health beyond the "doctor's" office. Improving the health of the population - whether in a community or in the nation as a whole - requires acting to transform the places where people live, work, study, and play. This report examines the population health-oriented efforts of and interactions among public health agencies (state and local), communities, and health care delivery organizations that are beginning to facilitate such action. ER - TY - BOOK AU - Institute of Medicine A2 - Jacques Normand A2 - David Vlahov A2 - Lincoln E. Moses TI - Preventing HIV Transmission: The Role of Sterile Needles and Bleach SN - DO - 10.17226/4975 PY - 1995 UR - https://nap.nationalacademies.org/catalog/4975/preventing-hiv-transmission-the-role-of-sterile-needles-and-bleach PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - This volume addresses the interface of two major national problems: the epidemic of HIV-AIDS and the widespread use of illegal injection drugs. Should communities have the option of giving drug users sterile needles or bleach for cleaning needs in order to reduce the spread of HIV? Does needle distribution worsen the drug problem, as opponents of such programs argue? Do they reduce the spread of other serious diseases, such as hepatitis? Do they result in more used needles being carelessly discarded in the community? The panel takes a critical look at the available data on needle exchange and bleach distribution programs, reaches conclusions about their efficacy, and offers concrete recommendations for public policy to reduce the spread of HIV/AIDS. The book includes current knowledge about the epidemiologies of HIV/AIDS and injection drug use; characteristics of needle exchange and bleach distribution programs and views on those programs from diverse community groups; and a discussion of laws designed to control possession of needles, their impact on needle sharing among injection drug users, and their implications for needle exchange programs. ER - TY - BOOK AU - Institute of Medicine A2 - David Blumenthal A2 - Elizabeth Malphrus A2 - J. Michael McGinnis TI - Vital Signs: Core Metrics for Health and Health Care Progress SN - DO - 10.17226/19402 PY - 2015 UR - https://nap.nationalacademies.org/catalog/19402/vital-signs-core-metrics-for-health-and-health-care-progress PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their usefulness in either gauging or guiding performance improvement in health and health care is seriously limited by their sheer number, as well as their lack of consistency, compatibility, reliability, focus, and organization. To achieve better health at lower cost, all stakeholders - including health professionals, payers, policy makers, and members of the public - must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans? Vital Signs explores the most important issues - healthier people, better quality care, affordable care, and engaged individuals and communities - and specifies a streamlined set of 15 core measures. These measures, if standardized and applied at national, state, local, and institutional levels across the country, will transform the effectiveness, efficiency, and burden of health measurement and help accelerate focus and progress on our highest health priorities. Vital Signs also describes the leadership and activities necessary to refine, apply, maintain, and revise the measures over time, as well as how they can improve the focus and utility of measures outside the core set. If health care is to become more effective and more efficient, sharper attention is required on the elements most important to health and health care. Vital Signs lays the groundwork for the adoption of core measures that, if systematically applied, will yield better health at a lower cost for all Americans. ER -