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Sodium Intake in Populations: Assessment of Evidence
Sodium Intake in Populations: Assessment of Evidence
Source: Institute of Medicine
From press release:
Recent studies that examine links between sodium consumption and health outcomes support recommendations to lower sodium intake from the very high levels some Americans consume now, but evidence from these studies does not support reduction in sodium intake to below 2,300 mg per day, says a new report from the Institute of Medicine.
Despite efforts over the past several decades to reduce dietary intake of sodium, a main component of table salt, the average American adult still consumes 3,400 mg or more of sodium a day – equivalent to about 1 ½ teaspoons of salt. The current Dietary Guidelines for Americans urge most people ages 14 to 50 to limit their sodium intake to 2,300 mg daily. People ages 51 or older, African Americans, and people with hypertension, diabetes, or chronic kidney disease – groups that together make up more than 50 percent of the U.S. population – are advised to follow an even stricter limit of 1,500 mg per day. These recommendations are based largely on a body of research that links higher sodium intakes to certain “surrogate markers” such as high blood pressure, an established risk factor for heart disease.
The expert committee that wrote the new report reviewed recent studies that in contrast examined how sodium consumption affects direct health outcomes like heart disease and death. “These new studies support previous findings that reducing sodium from very high intake levels to moderate levels improves health,” said committee chair Brian Strom, George S. Pepper Professor of Public Health and Preventive Medicine at the University of Pennsylvania Perelman School of Medicine. “But they also suggest that lowering sodium intake too much may actually increase a person’s risk of some health problems.”
Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy
Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy
Source: Institute of Medicine
For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families.
In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA’s Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments.
Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.
Challenges and Opportunities for Change in Food Marketing to Children and Youth: Workshop Summary
Challenges and Opportunities for Change in Food Marketing to Children and Youth: Workshop Summary
Source: Institute of Medicine
The childhood obesity epidemic is an urgent public health problem. The most recent data available show that nearly 19 percent of boys and about 15 percent of girls aged 2-19 are obese, and almost a third of U.S. children and adolescents are overweight or obese (Ogden et al., 2012). The obesity epidemic will continue to take a substantial toll on the health of Americans. In the midst of this epidemic, children are exposed to an enormous amount of commercial advertising and marketing for food. In 2009, children aged 2-11 saw an average of more than 10 television food ads per day (Powell et al., 2011). Children see and hear advertising and marketing messages for food through many other channels as well, including radio, movies, billboards, and print media. Most notably, many new digital media venues and vehicles for food marketing have emerged in recent years, including Internet-based advergames, couponing on cell phones, and marketing on social networks, and much of this advertising is invisible to parents.
The marketing of high-calorie, low-nutrient foods and beverages is linked to overweight and obesity. A major 2006 report from the Institute of Medicine (IOM) documents evidence that television advertising influences the food and beverage preferences, requests, and short-term consumption of children aged 2-11 (IOM, 2006). Challenges and Opportunities for Change in Food Marketing to Children and Youth also documents a body of evidence showing an association of television advertising with the adiposity of children and adolescents aged 2-18. The report notes the prevailing pattern that food and beverage products marketed to children and youth are often high in calories, fat, sugar, and sodium; are of low nutritional value; and tend to be from food groups Americans are already overconsuming. Furthermore, marketing messages that promote nutrition, healthful foods, or physical activity are scarce (IOM, 2006). To review progress and explore opportunities for action on food and beverage marketing that targets children and youth, the IOM’s Standing Committee on Childhood Obesity Prevention held a workshop in Washington, DC, on November 5, 2012, titled "New Challenges and Opportunities in Food Marketing to Children and Youth."
Environmental Decisions in the Face of Uncertainty
Environmental Decisions in the Face of Uncertainty
Source: Institute of Medicine
The U.S. Environmental Protection Agency (EPA) is one of several federal agencies responsible for protecting Americans against significant risks to human health and the environment. EPA estimates the nature, magnitude, and likelihood of risks to human health and the environment; identifies the potential regulatory actions that will mitigate those risks and protect public health and the environment; and uses that information to decide on appropriate regulatory action. Uncertainties in the data and analyses on which these decisions are based enter into the process at each step. As a result, the informed identification and understanding of the uncertainties inherent in the process is an essential feature of environmental decision making.
The EPA asked the IOM to provide guidance to its decision makers and their partners in states and localities on approaches to managing risk in different contexts when uncertainty is present. It also sought guidance on how information on uncertainty should be presented to help risk managers make sound decisions and to increase transparency in its communications with the public about those decisions.
Countering the Problem of Falsified and Substandard Drugs
Countering the Problem of Falsified and Substandard Drugs
Source: Institute of Medicine
Falsified and substandard medicines provide little protection from disease and, worse, can expose consumers to major harm. Bad drugs pose potential threats around the world, but the nature of the risk varies by country, with higher risk in countries with minimal or non-existent regulatory oversight. While developed countries are not immune, – negligent production at a Massachusetts compounding pharmacy killed 44 people from September 2012 to January 2013 – the vast majority of problems occur in developing countries where underpowered and unsafe medicines affect millions.
It is difficult to measure the public health burden of falsified and substandard drugs, the number of deaths they cause, or the amount of time and money wasted using them. The FDA asked the IOM to assess the global public health implications of falsified, substandard, and counterfeit pharmaceuticals to help jumpstart international discourse about this problem. At the international level, productive discussion relies on cooperation and mutual trust. This report lays out a plan to invest in quality to improve public health.
Oral Health Literacy – Workshop Summary
Oral Health Literacy – Workshop Summary
Source: Institute of Medicine
Oral health and oral health literacy are of national interest as demonstrated in the recommendations of two recent IOM reports – Advancing Oral Health in America and Improving Access to Oral Health Care for Vulnerable and Underserved Populations – as well as in the objectives of the HHS Healthy People 2020. Limited oral health literacy is associated with inaccurate knowledge about preventive measures such as water fluoridation, dental care visits, and oral health-related quality of life. The public and health care providers are largely unaware of the basic risk factors and preventive regimens for many oral diseases. Oral disease is expensive in terms of teeth, time, and money and results in pain, disfigurement, loss of school and work days, and even death when left untreated.
The IOM Roundtable on Health Literacy was interested in exploring findings from oral health literacy research and how such findings are being translated into oral health practice as well as the intersection between oral health literacy and health literacy. The roundtable held a workshop on March 29, 2012, to examine the field of oral health literacy. This document summarizes the workshop.
IOM — Evaluation of PEPFAR
Source: Institute of Medicine
Through the President’s Emergency Plan for AIDS Relief (PEPFAR), the United States has provided an unprecedented level of health and development assistance and health diplomacy around the world. PEPFAR has saved and improved the lives of millions of people; supported HIV prevention, care, and treatment; strengthened systems; and engaged with partner countries to facilitate HIV policy and planning for sustainable responses to their epidemic.
The IOM evaluation drew upon a variety of data sources, including quantitative data, extensive document review, and primary qualitative data collection through more than 400 interviews, including some site visits, with diverse stakeholders in 13 PEPFAR partner countries, at PEPFAR’s headquarters, and at other institutions and agencies involved in the global HIV response.
PEPFAR has been globally transformative. Across partner countries, PEPFAR was described as a lifeline, and people credit PEPFAR for restoring hope. The initiative’s future contributions will be informed by its past achievements and lessons learned from challenges it has faced. PEPFAR will continue a new direction as it supports partner countries in taking on more central roles in accountability and setting strategic priorities for investment in their HIV response.
Contagion of Violence: Workshop Summary
Contagion of Violence: Workshop Summary
Source: Institute of Medicine
The past 25 years have seen a major paradigm shift in the field of violence prevention, from the assumption that violence is inevitable to the recognition that violence is preventable. Part of this shift has occurred in thinking about why violence occurs, and where intervention points might lie. In exploring the occurrence of violence, researchers have recognized the tendency for violent acts to cluster, to spread from place to place, and to mutate from one type to another. Furthermore, violent acts are often preceded or followed by other violent acts.
In the field of public health, such a process has also been seen in the infectious disease model, in which an agent or vector initiates a specific biological pathway leading to symptoms of disease and infectivity. The agent transmits from individual to individual, and levels of the disease in the population above the baseline constitute an epidemic. Although violence does not have a readily observable biological agent as an initiator, it can follow similar epidemiological pathways.
On April 30-May 1, 2012, the Institute of Medicine (IOM) Forum on Global Violence Prevention convened a workshop to explore the contagious nature of violence. Part of the Forum’s mandate is to engage in multisectoral, multidirectional dialogue that explores crosscutting, evidence-based approaches to violence prevention, and the Forum has convened four workshops to this point exploring various elements of violence prevention. The workshops are designed to examine such approaches from multiple perspectives and at multiple levels of society. In particular, the workshop on the contagion of violence focused on exploring the epidemiology of the contagion, describing possible processes and mechanisms by which violence is transmitted, examining how contextual factors mitigate or exacerbate the issue. Contagion of Violence: Workshop Summary covers the major topics that arose during the 2-day workshop. It is organized by important elements of the infectious disease model so as to present the contagion of violence in a larger context and in a more compelling and comprehensive way.
Environmental Decisions in the Face of Uncertainty
Environmental Decisions in the Face of Uncertainty
Source: Institute of Medicine
The U.S. Environmental Protection Agency (EPA) is one of several federal agencies responsible for protecting Americans against significant risks to human health and the environment. As part of that mission, EPA estimates the nature, magnitude, and likelihood of risks to human health and the environment; identifies the potential regulatory actions that will mitigate those risks and protect public health and the environment; and uses that information to decide on appropriate regulatory action. Uncertainties, both qualitative and quantitative, in the data and analyses on which these decisions are based enter into the process at each step. As a result, the informed identification and use of the uncertainties inherent in the process is an essential feature of environmental decision making.
EPA requested that the Institute of Medicine (IOM) convene a committee to provide guidance to its decision makers and their partners in states and localities on approaches to managing risk in different contexts when uncertainty is present. It also sought guidance on how information on uncertainty should be presented to help risk managers make sound decisions and to increase transparency in its communications with the public about those decisions. Given that its charge is not limited to human health risk assessment and includes broad questions about managing risks and decision making, in this report the committee examines the analysis of uncertainty in those other areas in addition to human health risks. Environmental Decisions in the Face of Uncertainty explains the statement of task and summarizes the findings of the committee.
Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy
Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy
Source: Institute of Medicine
For many Americans who live at or below the poverty threshold, access to healthy foods at a reasonable price is a challenge that often places a strain on already limited resources and may compel them to make food choices that are contrary to current nutritional guidance. To help alleviate this problem, the U.S. Department of Agriculture (USDA) administers a number of nutrition assistance programs designed to improve access to healthy foods for low-income individuals and households. The largest of these programs is the Supplemental Nutrition Assistance Program (SNAP), formerly called the Food Stamp Program, which today serves more than 46 million Americans with a program cost in excess of $75 billion annually. The goals of SNAP include raising the level of nutrition among low-income households and maintaining adequate levels of nutrition by increasing the food purchasing power of low-income families.
In response to questions about whether there are different ways to define the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, USDA’s Food and Nutrition Service (FNS) asked the Institute of Medicine (IOM) to conduct a study to examine the feasibility of defining the adequacy of SNAP allotments, specifically: the feasibility of establishing an objective, evidence-based, science-driven definition of the adequacy of SNAP allotments consistent with the program goals of improving food security and access to a healthy diet, as well as other relevant dimensions of adequacy; and data and analyses needed to support an evidence-based assessment of the adequacy of SNAP allotments.
Supplemental Nutrition Assistance Program: Examining the Evidence to Define Benefit Adequacy reviews the current evidence, including the peer-reviewed published literature and peer-reviewed government reports. Although not given equal weight with peer-reviewed publications, some non-peer-reviewed publications from nongovernmental organizations and stakeholder groups also were considered because they provided additional insight into the behavioral aspects of participation in nutrition assistance programs. In addition to its evidence review, the committee held a data gathering workshop that tapped a range of expertise relevant to its task.
Collecting Sexual Orientation and Gender Identity Data in Electronic Health Records – Workshop Summary
Source: Institute of Medicine
In 2011, the IOM released the report The Health of Lesbian, Gay, Bisexual, and Transgender People: Building a Foundation for Better Understanding, the first comprehensive compilation of what is known about the health of each of these groups at different stages of life. One of the recommendations in this report was that information on patients’ sexual orientation and gender identity should be collected in electronic health records, just as information on race and ethnicity is routinely collected. These data are essential because demographics provide the foundation for understanding any population’s status and needs.
As the next step in exploring this recommendation, the IOM held a workshop on October 12, 2012, on collecting sexual orientation and gender identity data in electronic health records. This document summarizes the workshop.
U.S. Health in International Perspective: Shorter Lives, Poorer Health
U.S. Health in International Perspective: Shorter Lives, Poorer Health
Source: Institute of Medicine
The United States is among the wealthiest nations in the world, but it is far from the healthiest. For many years, Americans have been dying at younger ages than people in almost all other high-income countries. This health disadvantage prevails even though the U.S. spends far more per person on health care than any other nation. To gain a better understanding of this problem, the NIH asked the National Research Council and the IOM to investigate potential reasons for the U.S. health disadvantage and to assess its larger implications.
No single factor can fully explain the U.S. health disadvantage. It likely has multiple causes and involves some combination of inadequate health care, unhealthy behaviors, adverse economic and social conditions, and environmental factors, as well as public policies and social values that shape those conditions. Without action to reverse current trends, the health of Americans will probably continue to fall behind that of people in other high-income countries. The tragedy is not that the U.S. is losing a contest with other countries, but that Americans are dying and suffering from illness and injury at rates that are demonstrably unnecessary.
Future Uses of the Department of Defense Joint Pathology Center Biorepository
Future Uses of the Department of Defense Joint Pathology Center Biorepository
Source: Institute of Medicine
Founded during the Civil War as the Army Medical Museum, the Armed Forces Institute of Pathology (AFIP) amassed the world’s largest collection of human pathologic specimens and was considered a premier consultation, education, and research facility by the end of the 20th century. Samples from the AFIP were instrumental in helping to solve public health mysteries, such as the sequence of the genome of the 1918 influenza virus that killed more than 40 million people worldwide.
In 2005, the federal Base Realignment and Closure Commission recommended that the AFIP be closed, and its biorepository was transferred to the newly created Joint Pathology Center. During the transition, the Department of Defense asked the IOM to provide advice on operating the biorepository, managing its collection, and determining appropriate future use of specimens for consultation, education, and research.
In this report, the IOM proposes a series of protocols, standards, safeguards, and guidelines that could help to ensure that this national treasure continues to be available to researchers in the years to come, while protecting the privacy of the people who provided the materials and maintaining the security of their personal information.
Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care
Medical Care Economic Risk: Measuring Financial Vulnerability from Spending on Medical Care
Source: National Research Council/Institute of Medicine
The United States has seen major advances in medical care during the past decades, but access to care at an affordable cost is not universal. Many Americans lack health care insurance of any kind, and many others with insurance are nonetheless exposed to financial risk because of high premiums, deductibles, co-pays, limits on insurance payments, and uncovered services. One might expect that the U.S. poverty measure would capture these financial effects and trends in them over time. Yet the current official poverty measure developed in the early 1960s does not take into account significant increases and variations in medical care costs, insurance coverage, out-of-pocket spending, and the financial burden imposed on families and individuals. Although medical costs consume a growing share of family and national income and studies regularly document high rates of medical financial stress and debt, the current poverty measure does not capture the consequences for families’ economic security or their income available for other basic needs.
In 1995, a panel of the National Research Council (NRC) recommended a new poverty measure, which compares families’ disposable income to poverty thresholds based on current spending for food, clothing, shelter, utilities, and a little more. The panel’s recommendations stimulated extensive collaborative research involving several government agencies on experimental poverty measures that led to a new research Supplemental Poverty Measure (SPM), which the U.S. Census Bureau first published in November 2011 and will update annually. Analyses of the effects of including and excluding certain factors from the new SPM showed that, were it not for the cost that families incurred for premiums and other medical expenses not covered by health insurance, 10 million fewer people would have been poor according to the SPM.
The implementation of the patient Protection and Affordable Care Act (ACA) provides a strong impetus to think rigorously about ways to measure medical care economic burden and risk, which is the basis for Medical Care Economic Risk. As new policies – whether part of the ACA or other policies – are implemented that seek to expand and improve health insurance coverage and to protect against the high costs of medical care relative to income, such measures will be important to assess the effects of policy changes in both the short and long term on the extent of financial burden and risk for the population, which are explained in this report.
Substance Use Disorders in the U.S. Armed Forces
Substance Use Disorders in the U.S. Armed Forces
Source: Institute of Medicine
From press release:
Outdated approaches to preventing and treating substance abuse, barriers to care, and other problems hinder the U.S. Defense Department’s ability to curb substance use disorders among military service members and their families, says a new report from the Institute of Medicine. Service members’ rising rate of prescription drug addiction and their difficulty in accessing adequate treatment for alcohol and drug-related disorders were among the concerns that prompted members of Congress to request this review.
…
About 20 percent of active duty personnel reported having engaged in heavy drinking in 2008, the latest year for which data are available, and binge drinking increased from 35 percent in 1998 to 47 percent in 2008. While rates of both illicit and prescription drug abuse are low, the rate of medication misuse is rising. Just 2 percent of active duty personnel reported misusing prescription drugs in 2002 compared with 11 percent in 2008. The armed forces’ programs and policies have not evolved to effectively address medication misuse and abuse, the committee noted.To tackle these disorders better, DOD needs to lead from the top to ensure that all service branches take excess drinking and other substance use as seriously as they should, and that they consistently adhere to evidence-based strategies for prevention, screening, and treatment, the report says. Inconsistent use of evidence-based diagnostic and treatment strategies contributes to lower quality care. The department’s own Clinical Practice Guideline for Management of Substance Use Disorders is an excellent resource on effective approaches that is not being consistently followed, the committee said.
Best Care at Lower Cost: The Path to Continuously Learning Health Care in America
Best Care at Lower Cost: The Path to Continuously Learning Health Care in America
Source: Institute of Medicine
America’s health care system has become far too complex and costly to continue business as usual. Pervasive inefficiencies, an inability to manage a rapidly deepening clinical knowledge base, and a reward system poorly focused on key patient needs, all hinder improvements in the safety and quality of care and threaten the nation’s economic stability and global competitiveness. Achieving higher quality care at lower cost will require fundamental commitments to the incentives, culture, and leadership that foster continuous "learning”, as the lessons from research and each care experience are systematically captured, assessed, and translated into reliable care.
In the face of these realities, the IOM convened the Committee on the Learning Health Care System in America to explore these central challenges to health care today. The product of the committee’s deliberations, Best Care at Lower Cost, identifies three major imperatives for change: the rising complexity of modern health care, unsustainable cost increases, and outcomes below the system’s potential. But it also points out that emerging tools like computing power, connectivity, team-based care, and systems engineering techniques—tools that were previously unavailable—make the envisioned transition possible, and are already being put to successful use in pioneering health care organizations. Applying these new strategies can support the transition to a continuously learning health system, one that aligns science and informatics, patient-clinician partnerships, incentives, and a culture of continuous improvement to produce the best care at lower cost. The report’s recommendations speak to the many stakeholders in the health care system and outline the concerted actions necessary across all sectors to achieve the needed transformation.
Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment
Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment
Source: Institute of Medicine
Prior to the military conflicts in Iraq and Afghanistan, wars and conflicts have been characterized by such injuries as infectious diseases and catastrophic gunshot wounds. However, the signature injuries sustained by United States military personnel in these most recent conflicts are blast wounds and the psychiatric consequences to combat, particularly posttraumatic stress disorder (PTSD), which affects an estimated 13 to 20 percent of U.S. service members who have fought in Iraq or Afghanistan since 2001. PTSD is triggered by a specific traumatic event – including combat – which leads to symptoms such as persistent re-experiencing of the event; emotional numbing or avoidance of thoughts, feelings, conversations, or places associated with the trauma; and hyperarousal, such as exaggerated startle responses or difficulty concentrating.
As the U.S. reduces its military involvement in the Middle East, the Departments of Defense (DoD) and Veterans Affairs (VA) anticipate that increasing numbers of returning veterans will need PTSD services. As a result, Congress asked the DoD, in consultation with the VA, to sponsor an IOM study to assess both departments’ PTSD treatment programs and services. This first of two mandated reports examines some of the available programs to prevent, diagnose, treat, and rehabilitate those who have PTSD and encourages further research that can help to improve PTSD care.
Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment
Treatment for Posttraumatic Stress Disorder in Military and Veteran Populations: Initial Assessment
Source: Institute of Medicine
Prior to the military conflicts in Iraq and Afghanistan, wars and conflicts have been characterized by such injuries as infectious diseases and catastrophic gunshot wounds. However, the signature injuries sustained by United States military personnel in these most recent conflicts are blast wounds and the psychiatric consequences to combat, particularly posttraumatic stress disorder (PTSD), which affects an estimated 13 to 20 percent of U.S. service members who have fought in Iraq or Afghanistan since 2001. PTSD is triggered by a specific traumatic event – including combat – which leads to symptoms such as persistent re-experiencing of the event; emotional numbing or avoidance of thoughts, feelings, conversations, or places associated with the trauma; and hyperarousal, such as exaggerated startle responses or difficulty concentrating.
As the U.S. reduces its military involvement in the Middle East, the Departments of Defense (DoD) and Veterans Affairs (VA) anticipate that increasing numbers of returning veterans will need PTSD services. As a result, Congress asked the DoD, in consultation with the VA, to sponsor an IOM study to assess both departments’ PTSD treatment programs and services. This first of two mandated reports examines some of the available programs to prevent, diagnose, treat, and rehabilitate those who have PTSD and encourages further research that can help to improve PTSD care.
The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?
The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?
Source: Institute of Medicine
From press release:
Millions of baby boomers will likely face difficulties getting diagnoses and treatment for mental health conditions and substance abuse problems unless there is a major effort to significantly boost the number of health professionals and other service providers able to supply this care as the population ages, says a new report from the Institute of Medicine. The magnitude of the problem is so great that no single approach or isolated changes in a few federal agencies or programs will address it, said the committee that wrote the report.
The report calls for a redesign of Medicare and Medicaid payment rules to guarantee coverage of counseling, care management, and other types of services crucial for treating mental health conditions and substance use problems so that clinicians are willing to provide this care. Organizations that accredit health and social service professional schools and license providers should ensure that all who see older patients — including primary care physicians, nurses, physicians’ assistants, and social workers — are able to recognize signs and symptoms of geriatric mental health conditions, neglect, and substance misuse and abuse and provide at least basic care, the committee said.
Top leaders of the U.S. Department of Health and Human Services need to promote national attention to building a work force of sufficient size that is trained in geriatric mental health and substance abuse care. They should ensure that all the department’s relevant agencies are devoting sufficient attention and resources to these conditions.
Accelerating Progress in Obesity Prevention: Solving the Weight of the Nation
Accelerating Progress in Obesity Prevention: Solving the Weight of the NationSource: Institute of Medicine
Two-thirds of adults and one-third of children are overweight or obese. Left unchecked, obesity’s effects on health, health care costs, and our productivity as a nation could become catastrophic.
The staggering human toll of obesity-related chronic disease and disability, and an annual cost of $190.2 billion for treating obesity-related illness, underscore the urgent need to strengthen prevention efforts in the United States. The Robert Wood Johnson Foundation asked the IOM to identify catalysts that could speed progress in obesity prevention.
The IOM evaluated prior obesity prevention strategies and identified recommendations to meet the following goals and accelerate progress
- Integrate physical activity every day in every way
- Market what matters for a healthy life
- Make healthy foods and beverages available everywhere
- Activate employers and health care professionals
- Strengthen schools as the heart of health
On their own, accomplishing any one of these might help speed up progress in preventing obesity, but together, their effects will be reinforced, amplified, and maximized.
