More than 2 million Americans below age 24 self-identify as being of American Indian or Alaska Native descent. Many of the serious behavioral, emotional, and physical health concerns facing young people today are especially prevalent with Native youth (e.g., depression, violence, and substance abuse). Adolescent Native Americans have death rates two to five times the rate of whites in the same age group because of higher levels of suicide and a variety of risky behaviors (e.g., drug and alcohol use, inconsistent school attendance). Violence, including intentional injuries, homicide, and suicide, accounts for three-quarters of deaths for Native American youth ages 12 to 20. Suicide is the second leading cause of death?and 2.5 times the national rate?for Native youth ages 15 to 24. Arrayed against these health problems are vital cultural strengths on which Native Americans can draw. At a workshop held in 2012, by the National Academies of Sciences, Engineering, and Medicine, presenters described many of these strengths, including community traditions and beliefs, social support networks, close-knit families, and individual resilience. In May 2014, the Academies held a follow-up workshop titled Advancing Health Equity for Native American Youth. Participants discussed issues related to (1) the visibility of racial and ethnic disparities in health and health care as a national problem, (2) the development of programs and strategies by and for Native and Indigenous communities to reduce disparities and build resilience, and (3) the emergence of supporting Native expertise and leadership. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Themes of the Workshop 2 Voices of Native Youth 3 Contributors to Resilience 4 Health and Well-Being 5 Addressing Health Disparities Through Education 6 Concluding Comments References Appendix A: Workshop Agenda Appendix B: Speaker Biographies Appendix C: Resources

Since 1965 the foreign-born population of the United States has swelled from 9.6 million or 5 percent of the population to 45 million or 14 percent in 2015. Today, about one-quarter of the U.S. population consists of immigrants or the children of immigrants. Given the sizable representation of immigrants in the U.S. population, their health is a major influence on the health of the population as a whole. On average, immigrants are healthier than native-born Americans. Yet, immigrants also are subject to the systematic marginalization and discrimination that often lead to the creation of health disparities. To explore the link between immigration and health disparities, the Roundtable on the Promotion of Health Equity held a workshop in Oakland, California, on November 28, 2017. This summary of that workshop highlights the presentations and discussions of the workshop. Table of Contents Front Matter 1 Introduction 2 The Past and Present of U.S. Immigration Policy 3 Immigration and the Social Determinants of Health 4 The Voices of Immigrants 5 Reflections on the Workshop References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches Appendix C: World Caf Organizations Appendix D: Statement of Task

Even as the U.S. population becomes steadily more diverse, minorities and women remain underrepresented in clinical trials to develop new drugs and medical devices. Although progress in increasing minority participation in clinical trials has occurred, participation rates do not fully represent the overall population of minorities in the United States. This underrepresentation threatens the health of both these populations and the general population, since greater minority representation could reveal factors that affect health in all populations. Federal legislation has sought to increase the representation of minorities and women in clinical trials, but legislation by itself has not been sufficient to overcome the many barriers to greater participation. Only much broader changes will bring about the meaningful participation of all population groups in the clinical research needed to improve health. To examine the barriers to participation in clinical trials and ways of overcoming those barriers, the National Academies of Sciences, Engineering, and Medicine held a workshop in April 2015. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Highlights of the Workshop 2 Historical Perspectives and Context 3 Scientific Issues: Clinically Meaningful Inclusion 4 Recruitment and Retention Issues: Patient, Provider, Institutional, and System Barriers 5 Potential Best Practices and Policy Options References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches Appendix C: Statement of Task

A critical component of the nation's economic vitality is ensuring that all Americans can contribute and prosper. Such contributions presuppose an intentional focus on achieving the highest levels of health possible, which requires that conditions in communities, schools workplaces, and other settings promote health and address the social determinants of health for all community members. Many organizations, in both the private and public sectors, have been establishing partnerships to further healthy workplaces and health equity in general. Many are taking the lead in producing economic growth that is inclusive and responsive to the nation's diverse needs and populations. Increasingly, private?public partnerships are emerging as ways of doing business. Additionally, a variety of new developments in health, health care, and community benefits obligations that are part of the Affordable Care Act have contributed to this interest in economic growth and health and in the creation of new partnerships. To examine past successes and future opportunities, the National Academies of Sciences, Engineering, and Medicine held a workshop in November 2015. The workshop focused on the potential of the private sector to produce a triple bottom line: economic opportunity (including workforce development) and growth, healthy work and community environments, and improved employee health. At the same time, participants looked beyond the private sector to public?private partnerships and to public-sector actions that combine opportunities for economic growth and good health for all. This publication summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Organization of the Workshop 2 Paying Attention to Disparities 3 Workforce Development Initiatives in the Chicago Area 4 Health Care Opportunities 5 Community-Based Initiatives 6 Major Topics of the Workshop Appendix A: World Caf Models Appendix B: Workshop Agenda Appendix C: Speaker Biographical Sketches Appendix D: Statement of Task

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. Table of Contents Front Matter 1 Introduction of the Workshop 2 Technology and Health Disparities 3 Engaging Providers and Racial/Ethnic Minority Patients in Digital Strategies 4 Examples of Engaging Racial/Ethnic Minority Communities in Digital Health Strategies 5 Policy and Technology Perspectives 6 Synthesis of Workshop Messages References Appendix A: Examples of eHealth Solutions Featured at the Workshop Appendix B: Workshop Agenda Appendix C: Speaker Biographical Sketches

The Handbook of West European Pension Politics provides scholars, policy-makers and students with a complete overview of the political and policy issues involved in pension policy, and well as case studies of contemporary pension politics (1980 to present) in 16 countries: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden, Switzerland, and the UK. The handbook is suitable as a text for courses in comparative politics, European Studies, social policy, comparative public policy and public administration. Each chapter is written by an expert on pension politics and is presented in a standardized format with standardized tables and figures that describe: political institutions; government coalitions, parliamentary and electoral majorities; the party system; the pension system; proposed and enacted pension reforms.

Since its creation by the Institute of Medicine (IOM) in 2007, the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities has been fostering dialogue on racial and ethnic disparities in health and health care, examining the development of programs and strategies to reduce disparities, and encouraging the emergence of new leadership focused on health equity. For the past several years, a prominent topic of discussion within the roundtable has been the Patient Protection and Affordable Care Act (ACA). The ACA has multiple provisions specific to race, ethnicity, and language and other provisions with significant implications for racially and ethnically diverse populations. In April 2013, the roundtable held a workshop to address many issues surrounding the ACA, including expansion of coverage, delivery systems, and access points, service delivery and payment reform, public-private partnerships, and challenges to the safety net. This report summarizes the presentations and discussions from the workshop. Table of Contents Front Matter 1 Introduction and Themes of the Workshop 2 The Potential of the ACA to Reduce Health Disparities 3 The ACA and Health Equity 4 The Patient-Centered Medical Home 5 The Safety Net and Beyond 6 Consumer Engagement References Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches

The IOM held a workshop on July 28, 2008, to examine strategies for discussing health disparities in ways that engage the public and motivate change. Speakers focused on health disparities in California, which continues to see dramatic demographic shifts.

The high rate of incarceration in the United States contributes significantly to the nation's health inequities, extending beyond those who are imprisoned to families, communities, and the entire society. Since the 1970s, there has been a seven-fold increase in incarceration. This increase and the effects of the post-incarceration reentry disproportionately affect low-income families and communities of color. It is critical to examine the criminal justice system through a new lens and explore opportunities for meaningful improvements that will promote health equity in the United States. The National Academies convened a workshop on June 6, 2018 to investigate the connection between incarceration and health inequities to better understand the distributive impact of incarceration on low-income families and communities of color. Topics of discussion focused on the experience of incarceration and reentry, mass incarceration as a public health issue, women's health in jails and prisons, the effects of reentry on the individual and the community, and promising practices and models for reentry. The programs and models that are described in this publication are all Philadelphia-based because Philadelphia has one of the highest rates of incarceration of any major American city. This publication summarizes the presentations and discussions of the workshop. Table of Contents Front Matter 1 Introduction 2 The Experience of Incarceration and Reentry 3 Mass Incarceration as a Public Health Issue 4 Women's Health in Jails and Prisons 5 Reentry: Effects on the Individual and the Community 6 Promising Practices and Models for Reentry 7 The Perspective from the District Attorney's Office 8 Wrap-Up Session Appendix A: References Appendix B: Workshop Agenda Appendix C: Speaker Biographical Sketches Appendix D: Statement of Task

Social policy has become an increasingly prominent component of the European Union's policy-making responsibilities. Today, for example, a highly developed body of law regulates equal treatment in social security and co-ordinates national security schemes; national health services have opened up to patients and service providers from other states; and rules govern the translation of educational and vocational certificates across member states. This state of affairs is all the more remarkable given the relatively limited resources at the EU's disposal and the initial intentions of its founders. During negotiations for the Treaty of Rome in the 1950s, social policy was viewed as the exclusive provenance of the member states. There were to be provisions to facilitate labour mobility within the common market, but until the 1970s social policy making at the EU-level was modest. However, plans for the internal market moved social policy on the EU's decision-making agenda. The Social Chapter was adopted in 1989, and the Single European Act expanded EU competencies in social policy. The Treaties of Maastricht, Amsterdam and Nice all expanded competencies further, so that by the time the heads of government met in Lisbon in 2007 to sign the EU's latest treaty, the extent of supranational control over important aspects of social policy making was quite impressive. This important book provides a full account of the evolution of social policy in the EU and of its current reach. It examines the reasons for the increased role of the EU in the area, in spite of formidable obstacles, and details its effects in member states, where social provision is often the biggest item in government budgets and a crucial issue in national elections. Drawing on research done on welfare states around the world and on European integration, this book provides a distinctive and sophisticated account of social policy in Europe, showing how it must now be understood in the context of multi-level governance in which EU institutions play a pivotal role.

At the turn of the 21st century, several important reports and events designed to raise awareness of health disparities and to describe initial efforts to reduce health disparities took place. The Surgeon General's office released several reports that showed dramatic disparities in tobacco use and access to mental health services by race and ethnicity. The first real legislation focused on reducing health disparities was signed into law, creating the National Center for Minority Health and Health Disparities within the NIH. In 2001, the IOM released its landmark report, Crossing the Quality Chasm: A New Health System for the 21st Century, highlighting the importance of a focus on health care quality rather than a focus on only access and cost issues. Building upon these reports and events, the IOM held a workshop on April 8, 2010, that discussed progress to address health disparities and focused on the success of various federal initiatives to reduce health disparities. How Far Have We Come in Reducing Health Disparities? summarizes the workshop and explains the progress in the field since 2000. Table of Contents Front Matter 1 Introduction 2 What Progress in Reducing Health Disparities Has Been Made?: A Historical Perspective 3 Healthy People 2010: How Far Have We Come in Reducing Health Disparities? 4 Federal Perspectives on Reducing Health Disparities 5 Promising Practices in Addressing Social Determinants: Obesity Prevention 6 What Do We Still Need to Learn About Reducing Health Disparities? 7 Legislative Actions to Reduce Health Disparities Appendix A: Workshop Agenda Appendix B: Speaker Biographical Sketches

Socioeconomic conditions are known to be major determinants of health at all stages of life, from pregnancy through childhood and adulthood. "Life-course epidemiology" has added a further dimension to the understanding of the social determinants of health by showing an association between early-life socioeconomic conditions and adult health-related behaviors, morbidity, and mortality. Sensitive and critical periods of development, such as the prenatal period and early childhood, present significant opportunities to influence lifelong health. Yet simply intervening in the health system is insufficient to influence health early in the life course. Community-level approaches to affect key determinants of health are also critical. Many of these issues were raised in the 1995 National Academies book, Children's Health, the Nation's Wealth. The present volume builds upon this earlier book with presentations and examples from the field. Focusing on Children's Health describes the evidence linking early childhood life conditions and adult health; discusses the contribution of the early life course to observed racial and ethnic disparities in health; and highlights successful models that engage both community factors and health care to affect life course development. Table of Contents Front Matter 1 Introduction 2 Disparities in Children's Health: Major Challenges and Opportunities 3 Investing in Children's Health 4 From Policy to Practice: How Policy Changes Can Affect Children's Lives 5 Community Development Approaches: Overcoming Challenges, Striving for Change 6 Do Businesses Have a Role Improving Communities or Improving Children's Lives? 7 Closing Comments Appendix A: Workshop Agenda Appendix B: Biosketches of Presenters and Authors Appendix C: Resources Appendix D: Special Presentation: Unnatural Causes Appendix E: Clinical Health Care Practice and Community Building: Addressing Racial Disparities in Healthy Child Development

Health Politics in Europe: A Handbook is a major new reference work, which provides historical background and up-to-date information and analysis on health politics and health systems throughout Europe. In particular, it captures developments that have taken place since the end of the Cold War, a turning point for many European health systems, with most post-communist transition countries privatizing their state-run health systems, and many Western European health systems experimenting with new public management and other market-oriented health reforms. Following three introductory, stage-setting chapters, the handbook offers country cases divided into seven regional sections, each of which begins with a short regional outlook chapter that highlights the region's common characteristics and divergent paths taken by the separate countries, including comparative data on health system financing, healthcare access, and the political salience of health. Each regional section contains at least one detailed main case, followed by shorter treatments of the other countries in the region. Country chapters feature a historical overview focusing on the country's progression through a series of political regimes and the consequences of this history for the health system; an overview of the institutions and functioning of the contemporary health system; and a political narrative tracing the politics of health policy since 1989. This political narrative, the core of each country case, examines key health reforms in order to understand the political motivations and dynamics behind them and their impact on public opinion and political legitimacy. The handbook's systematic structure makes it useful for country-specific, cross-national, and topical research and analysis.

Leveraging Culture to Address Health Inequalities: Examples from Native Communities is the summary of a workshop convened in November 2012 by the Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities of the Institute of Medicine. The workshop brought together more than 100 health care providers, policy makers, program administrators, researchers, and Native advocates to discuss the sizable health inequities affecting Native American, Alaska Native, First Nation, and Pacific Islander populations and the potential role of culture in helping to reduce those inequities. This report summarizes the presentations and discussion of the workshop and includes case studies that examine programs aimed at diabetes prevention and management and cancer prevention and treatment programs. In Native American tradition, the medicine wheel encompasses four different components of health: physical, emotional, mental, and spiritual. Health and well-being require balance within and among all four components. Thus, whether someone remains healthy depends as much on what happens around that person as on what happens within. Leveraging Culture to Address Health Inequalities addresses the broad role of culture in contributing to and ameliorating health inequities. Table of Contents Front Matter 1 Introduction and Themes of the Workshop 2 Culture as a Social Determinant of Health 3 Why Culture Matters in Addressing Health Inequities 4 Cultural Sensitivity in Health Care Delivery and Research 5 Diabetes Prevention in Native Communities 6 Cancer Prevention and Treatment in Native Communities 7 Reflections on the Workshop References Appendix A: Culture as a Social Determinant of Health Appendix B: Agenda Appendix C: Speaker Biographies (in order of appearance)

The Handbook of West European Pension Politics provides scholars, policy-makers and students with a complete overview of the political and policy issues involved in pension policy, and well as case studies of contemporary pension politics (1980 to present) in 16 countries: Austria, Belgium, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, the Netherlands, Portugal, Spain, Sweden, Switzerland, and the UK. The book is suitable as a text for courses in comparative politics, European Studies, social policy, comparative public policy and public administration. Each chapter is written by an expert on pension politics and is presented in a standardized format with standardized tables and figures that describe: political institutions; government coalitions, parliamentary and electoral majorities; the party system; the pension system; proposed and enacted pension reforms.