TY - BOOK AU - Institute of Medicine AU - National Research Council TI - Improving Access to Oral Health Care for Vulnerable and Underserved Populations SN - DO - 10.17226/13116 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13116/improving-access-to-oral-health-care-for-vulnerable-and-underserved-populations PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Access to oral health care is essential to promoting and maintaining overall health and well-being, yet only half of the population visits a dentist each year. Poor and minority children are less likely to have access to oral health care than are their nonpoor and nonminority peers. Older adults, people who live in rural areas, and disabled individuals, uniformly confront access barriers, regardless of their financial resources. The consequences of these disparities in access to oral health care can lead to a number of conditions including malnutrition, childhood speech problems, infections, diabetes, heart disease, and premature births. Improving Access to Oral Health Care for Vulnerable and Underserved Populations examines the scope and consequences of inadequate access to oral health services in the United States and recommends ways to combat the economic, structural, geographic, and cultural factors that prevent access to regular, quality care. The report suggests changing funding and reimbursement for dental care; expanding the oral health work force by training doctors, nurses, and other nondental professionals to recognize risk for oral diseases; and revamping regulatory, educational, and administrative practices. It also recommends changes to incorporate oral health care into overall health care. These recommendations support the creation of a diverse workforce that is competent, compensated, and authorized to serve vulnerable and underserved populations across the life cycle. The recommendations provided in Improving Access to Oral Health Care for Vulnerable and Underserved Populations will help direct the efforts of federal, state, and local government agencies; policy makers; health professionals in all fields; private and public health organizations; licensing and accreditation bodies; educational institutions; health care researchers; and philanthropic and advocacy organizations. ER - TY - BOOK AU - Transportation Research Board AU - National Academies of Sciences, Engineering, and Medicine TI - Practical Approaches for Involving Traditionally Underserved Populations in Transportation Decisionmaking DO - 10.17226/22813 PY - 2012 UR - https://nap.nationalacademies.org/catalog/22813/practical-approaches-for-involving-traditionally-underserved-populations-in-transportation-decisionmaking PB - The National Academies Press CY - Washington, DC LA - English KW - Transportation and Infrastructure AB - TRB’s National Cooperative Highway Research Program (NCHRP) Report 710: Practical Approaches for Involving Traditionally Underserved Populations in Transportation Decisionmaking highlights tools, techniques, and approaches for identifying and connecting with populations that have traditionally been underserved and underrepresented in transportation decisionmaking. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Forum on Drug Discovery, Development, and Translation: 2022 Annual Review DO - 10.17226/26954 PY - 2023 UR - https://nap.nationalacademies.org/catalog/26954/forum-on-drug-discovery-development-and-translation-2022-annual-review PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Last year the Forum on Drug Discovery, Development, and Translation, helped to envision a transformed clinical trials enterprise for 2030–one that is more efficient, effective, and person-centered. In 2022, the Forum championed the inclusion of under-represented and underserved populations in clinical trials, drug research and development for adults across the older age span, and innovation in drug research and development for patients with chronic diseases. Learn more in this 2022 Annual Report. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Erin Hammers Forstag TI - Supporting Children with Disabilities: Lessons from the Pandemic: Proceedings of a Workshop SN - DO - 10.17226/26702 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26702/supporting-children-with-disabilities-lessons-from-the-pandemic-proceedings-of PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - An estimated 10 percent of children in the United States are living with disabilities, including a disproportionate number of children living in poverty and children of marginalized racial and ethnic groups. During the pandemic, children with disabilities suffered disproportionately compared to their peers without disabilities. To learn more about what policies and practices might be sustained or implemented beyond the pandemic to support children with disabilities and their families, the Board on Children, Youth, and Families hosted a workshop on June 13-15, 2022. Workshop presenters included service providers, researchers, government leaders, youth with disabilities, and caregivers of children and youth with disabilities. In this workshop, practices were identified that could improve the system of care for children with disabilities as well as improve access to services for underserved and marginalized populations. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Erin Balogh A2 - Sarah Domnitz A2 - Margie Patlak A2 - Sharyl J. Nass TI - Advancing Progress in the Development and Implementation of Effective, High-Quality Cancer Screening: Proceedings of a Workshop SN - DO - 10.17226/26019 PY - 2021 UR - https://nap.nationalacademies.org/catalog/26019/advancing-progress-in-the-development-and-implementation-of-effective-high-quality-cancer-screening PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - New technologies and improved understanding of the genesis and progression of various cancers have added to the enthusiasm for potential new strategies to improve screening and early detection of cancer. Research is also under way to evaluate refinements in current screening approaches, including determining optimal screening intervals, the ages at which screening should begin and end, as well as more specific estimates of the potential risks and benefits of screening for certain populations, such as racial and ethnic minority populations and people who have elevated risk for specific cancers. However, there remain significant challenges to developing, validating, and effectively implementing new cancer screening approaches. Guidelines for screening issued by different organizations vary considerably with no clear way of deciding which guidelines are most trustworthy. There is also a need to improve access to high-quality cancer screening and follow-up care, particularly in low-resource communities and among populations who are underserved or have numerous barriers to receiving care. To examine the challenges and opportunities related to improving current approaches to cancer screening, as well as the evidence base for novel cancer screening methods, the National Cancer Policy Forum held a workshop, Advancing Progress in the Development and Implementation of Effective, High-Quality Cancer Screening, on March 2-3, 2020, in Washington, DC. This workshop convened a broad range of experts, including clinicians, researchers, statisticians, and patient advocates, as well as representatives of health care organizations, academic medical centers, insurers, and federal agencies. This publication summarizes the presentations and discussions of the workshop and highlights suggestions from individual participants regarding how to improve cancer screening. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Karen M. Anderson A2 - Steve Olson TI - The Promises and Perils of Digital Strategies in Achieving Health Equity: Workshop Summary SN - DO - 10.17226/23439 PY - 2016 UR - https://nap.nationalacademies.org/catalog/23439/the-promises-and-perils-of-digital-strategies-in-achieving-health-equity PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Computers and Information Technology AB - Health care is in the midst of a dramatic transformation in the United States. Spurred by technological advances, economic imperatives, and governmental policies, information technologies are rapidly being applied to health care in an effort to improve access, enhance quality, and decrease costs. At the same time, the use of technologies by the consumers of health care is changing how people interact with the health care system and with health information. These changes in health care have the potential both to exacerbate and to diminish the stark disparities in health and well-being that exist among population groups in the United States. If the benefits of technology flow disproportionately to those who already enjoy better coverage, use, and outcomes than disadvantaged groups, heath disparities could increase. But if technologies can be developed and implemented in such a way to improve access and enhance quality for the members of all groups, the ongoing transformation of health care could reduce the gaps among groups while improving health care for all. To explore the potential for further insights into, and opportunities to address, disparities in underserved populations the National Academies of Sciences, Engineering, and Medicine held a workshop in October 2014. The workshop focused on (1) how communities are using digital health technologies to improve health outcomes for racial and ethnic minority populations, (2) how community engagement can improve access to high-quality health information for members of these groups, and (3) on models of successful technology-based strategies to reduce health disparities. This report summarizes the presentations and discussions at the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Joe Alper TI - Health Literacy and Older Adults: Reshaping the Landscape: Proceedings of a Workshop SN - DO - 10.17226/25188 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25188/health-literacy-and-older-adults-reshaping-the-landscape-proceedings-of PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Adults age 65 and older make up the fastest-growing segment of the U.S. population. At the same time, the complexity of health care delivery continues to grow, creating challenges that are magnified for older adults, given that age is one of the highest correlates of low health literacy. This creates a shared obligation between health care and the health care team to use the principles, tools, and practices of health literacy so that patients and families of older adults can more easily navigate discussions related to chronic disease, polypharmacy, long-term care, palliative care, insurance complexities, the social determinants of health, and other factors that create challenges for older adults, particularly among underserved populations nationwide. To gain a better understanding of the health communication challenges among older adults and their professional and family caregivers and how those challenges affect the care older adults receive, the National Academies of Sciences, Engineering, and Medicine’s Roundtable on Health Literacy convened a 1-day public workshop featuring presentations and discussions that examined the effect of low health literacy on the health of older adults. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Social Isolation and Loneliness in Older Adults: Opportunities for the Health Care System SN - DO - 10.17226/25663 PY - 2020 UR - https://nap.nationalacademies.org/catalog/25663/social-isolation-and-loneliness-in-older-adults-opportunities-for-the PB - The National Academies Press CY - Washington, DC LA - English KW - Behavioral and Social Sciences KW - Health and Medicine AB - Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish. ER - TY - BOOK AU - Institute of Medicine TI - Advancing Oral Health in America SN - DO - 10.17226/13086 PY - 2011 UR - https://nap.nationalacademies.org/catalog/13086/advancing-oral-health-in-america PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Though it is highly preventable, tooth decay is a common chronic disease both in the United States and worldwide. Evidence shows that decay and other oral diseases may be associated with adverse pregnancy outcomes, respiratory disease, cardiovascular disease, and diabetes. However, individuals and many health care professionals remain unaware of the risk factors and preventive approaches for many oral diseases. They do not fully appreciate how oral health affects overall health and well-being. In Advancing Oral Health in America, the Institute of Medicine (IOM) highlights the vital role that the Department of Health and Human Services (HHS) can play in improving oral health and oral health care in the United States. The IOM recommends that HHS design an oral health initiative which has clearly articulated goals, is coordinated effectively, adequately funded and has high-level accountability. In addition, the IOM stresses three key areas needed for successfully maintaining oral health as a priority issue: strong leadership, sustained interest, and the involvement of multiple stakeholders from both the public and private sectors. Advancing Oral Health in America provides practical recommendations that the Department of Health and Human Services can use to improve oral health care in America. The report will serve as a vital resource for federal health agencies, health care professionals, policy makers, researchers, and public and private health organizations. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Cato T. Laurencin TI - An American Crisis: The Growing Absence of Black Men in Medicine and Science: Proceedings of a Joint Workshop SN - DO - 10.17226/25130 PY - 2018 UR - https://nap.nationalacademies.org/catalog/25130/an-american-crisis-the-growing-absence-of-black-men-in PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Black men are increasingly underrepresented in medical schools and in the medical profession. A diverse workforce is a key attribute of quality healthcare and research suggests that a diverse workforce may help to advance cultural competency and increase access to high-quality health care, especially for underserved populations. Conversely, lack of diversity in the health workforce threatens health care quality and access and contributes to health disparities. In this way, the growing absence of Black men in medicine is especially troubling, because their absence in medicine may have adverse consequences for health care access, quality, and outcomes among Black Americans and Americans overall. To better understand the factors that contribute to the low participation of Black men in the medical profession, facilitate discussion of current strategies used to increase their participation in medical education, and explore new strategies along the educational and professional pipeline that may have potential to increase participation in medicine, the National Academies of Sciences, Engineering, and Medicine and the Cobb Institute jointly convened a 2-day workshop in November 2017, in Washington, DC. This publication summarizes the presentations and discussions from the workshop. ER - TY - BOOK AU - Institute of Medicine A2 - Tracy A. Harris TI - The U.S. Oral Health Workforce in the Coming Decade: Workshop Summary SN - DO - 10.17226/12669 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12669/the-us-oral-health-workforce-in-the-coming-decade-workshop PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Access to oral health services is a problem for all segments of the U.S. population, and especially problematic for vulnerable populations, such as rural and underserved populations. The many challenges to improving access to oral health services include the lack of coordination and integration among the oral health, public health, and medical health care systems; misaligned payment and education systems that focus on the treatment of dental disease rather than prevention; the lack of a robust evidence base for many dental procedures and workforce models; and regulatory barriers that prevent the exploration of alternative models of care. This volume, the summary of a three-day workshop, evaluates the sufficiency of the U.S. oral health workforce to consider three key questions: What is the current status of access to oral health services for the U.S. population? What workforce strategies hold promise to improve access to oral health services? How can policy makers, state and federal governments, and oral health care providers and practitioners improve the regulations and structure of the oral health care system to improve access to oral health services? ER - TY - BOOK TI - PY - UR - PB - The National Academies Press CY - Washington, DC LA - English ER - TY - BOOK AU - Institute of Medicine AU - National Academies of Sciences, Engineering, and Medicine TI - A Framework for Educating Health Professionals to Address the Social Determinants of Health SN - DO - 10.17226/21923 PY - 2016 UR - https://nap.nationalacademies.org/catalog/21923/a-framework-for-educating-health-professionals-to-address-the-social-determinants-of-health PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine KW - Education AB - The World Health Organization defines the social determinants of health as "the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life." These forces and systems include economic policies, development agendas, cultural and social norms, social policies, and political systems. In an era of pronounced human migration, changing demographics, and growing financial gaps between rich and poor, a fundamental understanding of how the conditions and circumstances in which individuals and populations exist affect mental and physical health is imperative. Educating health professionals about the social determinants of health generates awareness among those professionals about the potential root causes of ill health and the importance of addressing them in and with communities, contributing to more effective strategies for improving health and health care for underserved individuals, communities, and populations. Recently, the National Academies of Sciences, Engineering, and Medicine convened a workshop to develop a high-level framework for such health professional education. A Framework for Educating Health Professionals to Address the Social Determinants of Health also puts forth a conceptual model for the framework's use with the goal of helping stakeholder groups envision ways in which organizations, education, and communities can come together to address health inequalities. ER - TY - BOOK AU - Institute of Medicine A2 - M. Alfred Haynes A2 - Brian D. Smedley TI - The Unequal Burden of Cancer: An Assessment of NIH Research and Programs for Ethnic Minorities and the Medically Underserved SN - DO - 10.17226/6377 PY - 1999 UR - https://nap.nationalacademies.org/catalog/6377/the-unequal-burden-of-cancer-an-assessment-of-nih-research PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - We know more about cancer prevention, detection, and treatment than ever before—yet not all segments of the U.S. population have benefited to the fullest extent possible from these advances. Some ethnic minorities experience more cancer than the majority population, and poor people—no matter what their ethnicity—often lack access to adequate cancer care. This book provides an authoritative view of cancer as it is experienced by ethnic minorities and the medically underserved. It offers conclusions and recommendations in these areas: Defining and understanding special populations, and improving the collection of cancer-related data. Setting appropriate priorities for and increasing the effectiveness of specific National Institutes of Health (NIH) research programs, to ensure that special populations are represented in clinical trials. Disseminating research results to health professionals serving these populations, with sensitivity to the issues of cancer survivorship. The book provides background data on the nation's struggle against cancer, activities and expenditures of the NIH, and other relevant topics. ER - TY - BOOK AU - Institute of Medicine TI - Nursing and Nursing Education: Public Policies and Private Actions SN - DO - 10.17226/1120 PY - 1983 UR - https://nap.nationalacademies.org/catalog/1120/nursing-and-nursing-education-public-policies-and-private-actions PB - The National Academies Press CY - Washington, DC LA - English KW - Education KW - Health and Medicine ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Andrew March A2 - Amanda Wagner Gee A2 - Robert Pool A2 - Carolyn Shore TI - Innovation in Drug Research and Development for Prevalent Chronic Diseases: Proceedings of a Workshop SN - DO - 10.17226/26291 PY - 2021 UR - https://nap.nationalacademies.org/catalog/26291/innovation-in-drug-research-and-development-for-prevalent-chronic-diseases PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - Investment and innovation in drug research and development (R&D) for highly prevalent chronic diseases has stalled in recent decades, despite half of all Americans living with at least one chronic disease. As a result, prevalent chronic diseases are producing immense health care costs as well as preventable suffering and death. On February 22, March 2, and March 8, 2021, the National Academies of Sciences, Engineering, and Medicine, convened a workshop to discuss barriers to innovation in this space and examine strategies and incentives to support equitable, person-centered drug R&D for prevalent chronic diseases. ER - TY - BOOK AU - National Research Council AU - Institute of Medicine TI - The Health Hazard Evaluation Program at NIOSH: Reviews of Research Programs of the National Institute for Occupational Safety and Health SN - DO - 10.17226/12475 PY - 2009 UR - https://nap.nationalacademies.org/catalog/12475/the-health-hazard-evaluation-program-at-niosh-reviews-of-research PB - The National Academies Press CY - Washington, DC LA - English KW - Industry and Labor KW - Health and Medicine AB - It is the unique mission of the Health Hazard Evaluation Program within the National Institute for Occupational Safety and Health (NIOSH) to respond to requests to investigate potential occupational health hazards. In contrast to other NIOSH programs, the Health Hazard Evaluation Program is not primarily a research program. Rather, it investigates and provides advice to workplaces in response to requests from employers, employees and their representatives, and federal agencies. The National Research Council was charged with evaluating the NIOSH Health Hazard Evaluation Program and determining whether program activities resulted in improvements in workplace practices and decreases in hazardous exposures that cause occupational illnesses. The program was found to play a key role in addressing existing widespread or emerging occupational health issues. This book makes several recommendations that could improve a very strong program including more systematic use of surveillance data to facilitate priority setting, and greater interaction with a broader array of workers, industries, and other government agencies. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine A2 - Jennifer Lalitha Flaubert A2 - Ruth Cooper A2 - Megan Snair A2 - Sharyl Nass TI - Achieving Excellence in Cancer Diagnosis: Proceedings of a Workshop—in Brief DO - 10.17226/26505 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26505/achieving-excellence-in-cancer-diagnosis-proceedings-of-a-workshop-in PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The Board on Health Care Services of the National Academies of Sciences, Engineering, and Medicine hosted a virtual workshop to examine the current science and research opportunities for improving the diagnosis of cancer within the U.S. health care system. The workshop, held on October 6, 2021, highlighted the patient experience, the diagnostic process, cancer epidemiology, approaches to mitigate disparities and promote equity in diagnosis, novel diagnostic strategies and tools, and strategies to improve the overall system of cancer diagnosis. This workshop was the third in a series on diagnostic excellence funded by the Gordon and Betty Moore Foundation. This Proceedings of a Workshop-in Brief highlights the presentations and discussions that occurred at the workshop. ER - TY - BOOK AU - Transportation Research Board AU - National Academies of Sciences, Engineering, and Medicine A2 - Karen J. Alexander A2 - Catherine Heady A2 - Martin Balcazar A2 - Ryan Walsh TI - Inclusive Virtual Public Involvement for Public Transit DO - 10.17226/27106 PY - 2023 UR - https://nap.nationalacademies.org/catalog/27106/inclusive-virtual-public-involvement-for-public-transit PB - The National Academies Press CY - Washington, DC LA - English KW - Transportation and Infrastructure AB - Virtual public engagement can be a more inclusive and equitable way to engage with communities, but it is important to consider the digital divide and use a variety of approaches and tools to reach all community members. Prior to the COVID-19 pandemic, transit agencies had limited virtual communication tools. However, the pandemic encouraged agencies to adopt new virtual strategies and practices.TCRP Research Report 241: Inclusive Virtual Public Involvement for Public Transit, from TRB's Transit Cooperative Research Program, is designed to assist public transit agencies to enhance public engagement by more effectively using virtual tools and strategies. ER - TY - BOOK AU - National Academies of Sciences, Engineering, and Medicine TI - Rapid Expert Consultation on Critical Federal Capabilities Needed to Evaluate Real-World Safety, Effectiveness, and Equitable Distribution and Use of Medical Countermeasures During a Public Health Emergency DO - 10.17226/26574 PY - 2022 UR - https://nap.nationalacademies.org/catalog/26574/rapid-expert-consultation-on-critical-federal-capabilities-needed-to-evaluate-real-world-safety-effectiveness-and-equitable-distribution-and-use-of-medical-countermeasures-during-a-public-health-emergency PB - The National Academies Press CY - Washington, DC LA - English KW - Health and Medicine AB - The COVID-19 pandemic has highlighted the importance of having access to real-world data and evidence to monitor and assess medical countermeasure (MCM) use and performance so policy makers can make more effective and rapid public health decisions, protect population health, and save lives. During public health emergencies, the use of MCMs, such as therapeutics, vaccines, and diagnostics, can be made available to the public under a range of regulatory access mechanisms. This Rapid Expert Consultation was produced by individual members of the Standing Committee for CDC Center for Preparedness and Response. Its aim is to review and propose modifications to an initial draft list of critical federal capabilities presented by the Centers for Disease Control and Prevention and the U.S. Food and Drug Administration that are needed to evaluate real-world safety, effectiveness, equitable distribution, access, and use of MCMs during a public health emergency. This effort draws from expert input, published literature, and lessons learned from previous public health emergencies, as well as the ongoing COVID-19 pandemic. ER -