Institute of Medicine (IOM) Reports

1
Institute of Medicine (IOM) Reports
This summary was prepared by the 2009 JEMF
Project Team
2
IOM Reports

• The Institute of Medicine of the National
  Academies has sponsored comprehensive reports on
  health disparities, the health of unique and
  vulnerable populations, workforce issues, health
  care quality, genetics and genomics and health,
  research in health care, and other topics.
• IOM Reports cite the evidence base and set the
  national standards in health and health care.

3
IOM Reports

• Search by topic or keywords on the Institute of
  Medicine home page http//www.iom.edu/Reports.as
  px
• We reviewed IOM reports from the past 10 years
  and color coded them by topic.
• See the next slide for the color coding key and
  IOM reports listed in this document.

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Topics
Slides
5
Health Disparities

• In its work around select populations, the IOM
  examines significant health concerns that may
  affect groups of individuals categorized by
  common occupation, environment, health conditions
  or characteristics, or a shared exposure to a
  unique health risk. Of particular note are the
  IOMs efforts around racial and ethnic
  disparities in health and health care.

From IOM topic Select Populations and Health
Disparities http//www.iom.edu/Global/Topics/Sele
ct-Populations-Health-Disparities.aspx
6
Focusing on Childrens Health Community
Approaches to Addressing Health Disparities.
Workshop Summary

• Released September 2, 2009
• Socioeconomic conditions are known to have
  profound and long-term effects on health at all
  stages of life, from pregnancy through childhood
  and adulthood. 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 care system is
  insufficient to influence health outcomes early
  in life. On January 24, 2008, the Institute of
  Medicines Roundtable on Health Disparities and
  Board on Children, Youth, and Families co-hosted
  a public workshop to discuss the important
  foundations of adult health that are laid
  prenatally and in early childhood.
• http//www.iom.edu/Reports/2009/FocusChildrensHeal
  th.aspx

7
Race, Ethnicity, and Language Data
Standardization for Health Care Quality
Improvement

• Released August 31, 2009
• The quality of health care in the United States
  is not optimal, and the pace of improvement is
  slow. In addition, disparities persist for
  specific population groups. A fundamental step in
  identifying which populations are most at risk is
  to collect data on race, ethnicity, and
  English-language proficiency. The Institute of
  Medicine (IOM) formed the Subcommittee on
  Standardized Collection of Race/Ethnicity Data
  for Healthcare Quality Improvement to examine
  approaches to standardization. In this 2009
  report, the subcommittee recommends collection of
  more granular ethnicity and language need
  according to national standards in addition to
  OMB race and Hispanic ethnicity categories.
• http//www.iom.edu/Reports/2009/RaceEthnicityData.
  aspx

8
Toward Health Equity and Patient-Centeredness
Integrating Health Literacy, Disparities
Reduction, and Quality Improvement. Workshop
Summary

• Released February 23, 2009
• During a time of economic uncertainty, the
  national discussion of health reform
  understandably focuses on insurance coverage and
  cost. To receive the greatest value for health
  care, it is important to focus on issues of
  quality and disparity, and the ability of
  individuals to make appropriate decisions based
  on basic health knowledge and services, or health
  literacy. Three IOM bodies (the Forum on the
  Science of Health Care Quality Improvement and
  Implementation, the Roundtable on Health
  Disparities, and the Roundtable on Health
  Literacy) jointly convened a workshop to discuss
  these concerns.
• http//www.iom.edu/Reports/2009/Toward-Health-Equi
  ty-and-Patient-Centeredness-Integrating-Health-Lit
  eracy-Disparities-Reduction-and-Quality-Improvemen
  t-Workshop-Summary.aspx

9
Challenges and Successes in Reducing Health
Disparities. Workshop Summary

• Released June 17, 2008
• In early 2007, the Institute of Medicine convened
  the Roundtable on Health Disparities to increase
  the visibility of racial and ethnic health
  disparities as a national problem, to further the
  development of programs and strategies to reduce
  disparities, to foster the emergence of
  leadership on this issue, and to track promising
  activities and developments in health care that
  could lead to dramatically reducing or
  eliminating disparities.
• http//www.iom.edu/Reports/2008/Challenges-and-Suc
  cesses-in-Reducing-Health-Disparities-Workshop-Sum
  mary.aspx

10
Examining the Health Disparities Research Plan of
the National Institutes of Health Unfinished
Business

• Released March 6, 2006
• The health of racial and ethnic minorities, poor
  people, and other disadvantaged groups in the
  United States is worse than the health of the
  overall population. National concerns for these
  differences, termed health disparities, and the
  associated excess mortality and morbidity have
  been expressed as a high priority in national
  health status reviews, including Healthy People
  2000 and 2010. The National Institutes of Health
  (NIH) ranks this issue third among its top five
  priorities.
• http//www.iom.edu/Reports/2006/Examining-the-Heal
  th-Disparities-Research-Plan-of-the-National-Insti
  tutes-of-Health-Unfinished-Business.aspx

11
Estimating the Contributions of Lifestyle-Related
Factors to Preventable Death A Workshop Summary

• Released June 1, 2005
• The Institute of Medicine of the National
  Academies held a workshop, December 13-14, 2004,
  to estimate the contributions of
  lifestyle-related factors to preventable death.
• http//www.iom.edu/Reports/2005/Estimating-the-Con
  tributions-of-Lifestyle-Related-Factors-to-Prevent
  able-Death-A-Workshop-Summary.aspx

12
Guidance for the National Healthcare Disparities
Report

• Released September 27, 2002
• Research has extensively documented the
  pervasiveness of racial and ethnic disparities in
  health care. In 1999, as part of a national
  effort to eliminate health care disparities,
  Congress required the Agency for Healthcare
  Research and Quality (AHRQ) to produce an annual
  report to be called the National Healthcare
  Disparities Report (NHDR). In this report, titled
  Guidance for the National Healthcare Disparities
  Report, an IOM committee was asked to provide
  guidance to AHRQ to help fulfill the potential of
  the NHDR.
• http//www.iom.edu/Reports/2002/Guidance-for-the-N
  ational-Healthcare-Disparities-Report.aspx

13
Speaking of Health Assessing Health
Communication Strategies for Diverse Populations

• Released July 6, 2002
• Communication interventions intended to affect
  health behavior are an increasingly important
  strategy for improving the health of the American
  people. However, effective communication is
  highly dependent upon the social and cultural
  milieu that shapes the individuals, families, and
  communities that are the intended recipients.
  Because we live in an increasingly diverse
  nation, it is important to understand more fully
  how these different messages should be
  constructed and delivered. This report, Speaking
  of Health Assessing Health Communication
  Strategies for Diverse Populations, addresses the
  challenge of improving health communications in a
  racially and culturally diverse society.
  http//www.iom.edu/Reports/2002/Speaking-of-Health
  -Assessing-Health-Communication-Strategies-for-Div
  erse-Populations.aspx

14
Unequal Treatment Confronting Racial and Ethnic
Disparities in Health Care

• Released March 20, 2002
• Congress, in 1999, requested an IOM study to
  assess the extent of disparities in the types and
  quality of health services received by U.S.
  racial and ethnic minorities and non-minorities
  explore factors that may contribute to inequities
  in care and recommend policies and practices to
  eliminate these inequities. The report from that
  study, Unequal Treatment Confronting Racial and
  Ethnic Disparities in Health Care, found that a
  consistent body of research demonstrates
  significant variation in the rates of medical
  procedures by race, even when insurance status,
  income, age, and severity of conditions are
  comparable.
• http//www.iom.edu/Reports/2002/Unequal-Treatment-
  Confronting-Racial-and-Ethnic-Disparities-in-Healt
  h-Care.aspx

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Health Literacy

• Health literacy is defined in Healthy People 2010
  as "The degree to which individuals have the
  capacity to obtain, process, and understand basic
  health information and services needed to make
  appropriate health decisions.
• Healthy People 2010 http//www.healthypeople.gov/
  Document/pdf/uih/2010uih.pdf

From IOM topic Select Populations and Health
Disparities http//www.iom.edu/Global/Topics/Sel
ect-Populations-Health-Disparities.aspx
16
Measures of Health Literacy. Workshop Summary

• Released December 8, 2009
• Understanding and using basic health information
  and being able to navigate the complexities of
  the health care system are critical to good
  health. Health literacy can be difficult to
  assess, however, as it is not only a measure of
  individuals understanding of health information
  at various points in time but also a measure of
  how well various health care systems have been
  organized. The Roundtable on Health Literacy held
  a workshop on February 26, 2009, to examine what
  is known about measures of health literacy.
• http//www.iom.edu/Reports/2009/Measures-of-Health
  -Literacy.aspx

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Health Literacy, eHealth, and Communication
Putting the Consumer First. Workshop Summary

• Released March 24, 2009
• There is great enthusiasm over the use of
  emerging interactive health information
  technologiesoften referred to as eHealthand the
  potential these technologies have to improve the
  quality, capacity, and efficiency of the health
  care system. However, many doctors, advocacy
  groups, policy makers and consumers are concerned
  that electronic health systems might help
  individuals and communities with greater
  resources while leaving behind those with limited
  access to technology. In order to address this
  problem, the Institute of Medicines Roundtable
  on Health Literacy held a workshop.
• http//www.iom.edu/Reports/2009/Health-Literacy-eH
  ealth-and-Communication-Putting-the-Consumer-First
  -Workshop-Summary.aspx

18
Health Literacy A Prescription to End Confusion

• Released April 8, 2004
• Nearly half of all American adults--90 million
  people--have difficulty understanding and using
  health information, and there is a higher rate of
  hospitalization and use of emergency services
  among patients with limited health literacy, says
  a report from the Institute of Medicine titled
  Health Literacy A Prescription to End Confusion.
  Limited health literacy may lead to billions of
  dollars in avoidable health care costs. A
  concerted effort by the public health and health
  care systems, the education system, the media,
  and health care consumers is needed to improve
  the nation's health literacy, the report says.
• http//www.iom.edu/Reports/2004/Health-Literacy-A-
  Prescription-to-End-Confusion.aspx

19
Mental Health

• Individuals who have substance abuse or mental
  health problems can face particular health
  challenges. For example, they frequently
  experience difficulties in accessing, receiving,
  and benefiting from care. The IOM examines such
  concerns in its activities related to
  neuroscience and mental and behavioral health.

From the IOM website under topic Substance Abuse
and Mental Health http//www.iom.edu/Global/Topi
cs/Substance-Abuse-Mental-Health.aspx
20
Depression in Parents, Parenting, and Children
Opportunities to Improve Identification,
Treatment, and Prevention

• Released June 9, 2009
• 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. This report 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.
• http//www.iom.edu/Reports/2009/Depression-in-Pare
  nts-Parenting-and-Children-Opportunities-to-Improv
  e-Identification-Treatment-and-Prevention.aspx

21
Preventing Mental, Emotional, and Behavioral
Disorders Among Young People Progress and
Possibilities

• Released March 12, 2009
• Mental health and substance use disorders among
  children, youth, and young adults are major
  threats to the health and well-being of younger
  populations which often carryover into adulthood.
  The costs of treatment for mental health and
  addictive disorders, which create an enormous
  burden on the affected individuals, their
  families, and society, have stimulated increasing
  interest in prevention practices that can impede
  the onset or reduce the severity of the
  disorders. This report updates a 1994 Institute
  of Medicine book, Reducing Risks for Mental
  Disorders, focusing on the research base and
  program experience with younger populations that
  have emerged since that time.
• http//www.iom.edu/Reports/2009/Preventing-Mental-
  Emotional-and-Behavioral-Disorders-Among-Young-Peo
  ple-Progress-and-Possibilities.asp

22
Improving the Quality of Health Care for Mental
and Substance-Use Conditions Quality Chasm
Series

• Released November 1, 2005
• This report, Improving the Quality of Health Care
  for Mental and Substance-Use Conditions Quality
  Chasm Series, examines the differences in health
  care for mental and substance-use conditions,
  finds that the Quality Chasm framework is
  applicable to health care for mental and
  substance-use conditions, and describes a
  multifaceted and comprehensive strategy to apply
  the Quality Chasm framework.
• http//www.iom.edu/Reports/2005/Improving-the-Qual
  ity-of-Health-Care-for-Mental-and-Substance-Use-Co
  nditions-Quality-Chasm-Series.aspx

23
The Unequal Burden of Cancer An Assessment of
NIH Research and Programs for Ethnic Minorities
and the Medically Underserved

• Released January 1, 1999
• 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 report provides an
  authoritative view of cancer as it is experienced
  by ethnic minorities and the medically
  underserved.
• http//www.iom.edu/Reports/1999/The-Unequal-Burden
  -of-Cancer-An-Assessment-of-NIH-Research-and-Progr
  ams-for-Ethnic-Minorities-and-the-Medically-Unders
  erved.aspx

24
Vulnerable Populations

• The term "vulnerable populations," refers to
  social groups with increased relative risk (i.e.
  exposure to risk factors) or susceptibility to
  health-related problems. This vulnerability is
  evidenced in higher comparative mortality rates,
  lower life expectancy, reduced access to care,
  and diminished quality of life. Vulnerable
  populations are often discriminated against,
  marginalized and disenfranchised from mainstream
  society, contributing to their lower social
  status and lack of power in personal, social, and
  political relationships.
• Center for Vulnerable Populations Research,
  http//www.nursing.ucla.edu/orgs/cvpr/who-are-vuln
  erable.html

From the Center for Vulnerable Populations
Research http//www.nursing.ucla.edu/orgs/cvpr/wh
o-are-vulnerable.html
25
Adolescent Health Services Missing Opportunities

• Released December 9, 2008
• Adolescence is a time when youth establish health
  habits, both good and bad, that often last a
  lifetime. Yet the U.S. health care system today
  is not designed to help young people develop
  healthy routines, behaviors, and relationships to
  prepare them for adulthood. Adolescent Health
  Services examines the health status of
  adolescents and reviews the separate and
  uncoordinated programs and services that
  currently exist in multiple public and private
  health care settings.
• http//www.iom.edu/Reports/2008/Adolescent-Health-
  Services-Missing-Opportunities.aspx

26
The National Children's Study Research Plan A
Review

• Released September 12, 2008
• The National Children's Study (NCS) is planned to
  be the largest long-term study of environmental
  and genetic effects on children's health ever
  conducted in the United States. It proposes to
  examine the effects of environmental influences
  on the health and development of approximately
  100,000 children across the United States,
  following them from before birth until age 21. By
  archiving all of the data collected, the NCS is
  intended to provide a valuable resource for
  analyses conducted many years into the future.
  This book evaluates the research plan for the
  NCS, by assessing the scientific rigor of the
  study and the extent to which it is being carried
  out with methods, measures, and collection of
  data and specimens to maximize the scientific
  yield of the study.
• http//www.iom.edu/Reports/2008/The-National-Child
  rens-Study-Research-Plan-A-Review.aspx

27
Challenges in Adolescent Health Care. Workshop
Report

• Released October 26, 2007
• This report summarizes two workshops convened by
  the Committee on Adolescent Health Care Services
  and Models of Care for Treatment, Prevention, and
  Healthy Development, which is conducting a
  two-year study of adolescent health services in
  the United States with funding from the Atlantic
  Philanthropies. This workshop report, which is
  the first in a series of products associated with
  this study, takes stock of the current knowledge
  base on adolescent health services, settings and
  systems and offers perspectives from researchers,
  health professionals who work with youth, and
  youth themselves in describing the current
  status, strengths, and shortcomings of current
  delivery systems.
• http//www.iom.edu/Reports/2007/Challenges-in-Adol
  escent-Health-Care-Workshop-Report.aspx

28
A Study of Interactions Emerging Issues in the
Study of Adolescence A Workshop Summary

• Released March 22, 2006
• Summarizing the major themes discussed at a
  September 2005 workshop, this report provides an
  initial overview of key findings from different
  fields of research on adolescence and highlights
  fundamental processes that shape adolescent
  health and development.
• http//www.iom.edu/Reports/2006/A-Study-of-Interac
  tions-Emerging-Issues-in-the-Study-of-Adolescence-
  A-Workshop-Summary.aspx

29
Workshop on Disability in America A New Look -
Summary and Background Papers

• Released March 1, 2006
• This report from the Institute of Medicine
  summarizes a workshop convened in August 2005 for
  the first phase of a project that will take a new
  look at disability in America and update the 1991
  IOM report by that name. The final report, which
  will include recommendations, is now available
  and is titled The Future of Disability in
  America.
• http//www.iom.edu/Reports/2006/Workshop-on-Disabi
  lity-in-America-A-New-Look---Summary-and-Backgroun
  d-Papers.aspx

30
The Future of Disability in America

• Released April 23, 2007
• To better understand disability in the United
  States, the Centers for Disease Control, the
  Department of Education, and the National
  Institutes of Health (NIH) asked the Institute of
  Medicine (IOM) to assess the current situation
  and provide recommendations for improvement,
  which culminated in the report The Future of
  Disability in America.
• http//www.iom.edu/Reports/2007/The-Future-of-Disa
  bility-in-America.aspx

31
Ethical Considerations for Research Involving
Prisoners

• Released July 12, 2006
• Because prisoners face restrictions on liberty
  and autonomy, limited privacy, and often
  inadequate health care, they require specific
  protections when involved in research,
  particularly in todays correctional settings.
  Given these issues, the Department of Health and
  Human Services Office for Human Research
  Protections commissioned the Institute of
  Medicine to review the ethical considerations
  regarding research involving prisoners. Ethical
  Considerations for Research Involving Prisoners
  emphasizes five broad actions to provide
  prisoners involved in research with critically
  important protections.
• http//www.iom.edu/Reports/2006/Ethical-Considerat
  ions-for-Research-Involving-Prisoners.aspx

32
Cancer in Elderly People Workshop Proceedings

• Released March 22, 2007
• The IOM's National Cancer Policy Forum sponsored
  a public workshop addressing several issues
  related to cancer and aging including cancer
  rehabilitation, increased prevalence of cancer
  survivors, end of life care, the role of nurses,
  and Medicare costs in geriatric oncology.
• http//www.iom.edu/Reports/2007/Cancer-in-Elderly-
  People-Workshop-Proceedings.aspx

33
Quality Through Collaboration The Future of
Rural Health

• Released November 1, 2004
• Rural America is a vital component of American
  society. Representing nearly 20 percent of the
  population, rural communities, like urban
  landscapes, are rich in cultural diversity.
  However, the smaller, poorer, and more isolated a
  rural community is, the more difficult it is to
  ensure the availability of high-quality health
  services. The Institute of Medicine report,
  Quality Through Collaboration The Future of
  Rural Health examines the quality of health care
  in rural America.
• http//www.iom.edu/Reports/2004/Quality-Through-Co
  llaboration-The-Future-of-Rural-Health.aspx

34
Children's Health, the Nation's Wealth Assessing
and Improving Child Health

• Released June 24, 2004
• Children's health has clearly improved over the
  past several decades. Yet major questions still
  remain about how to assess the status of
  children's health, what factors should be
  monitored, and the appropriate measurement tools
  that should be used. Children's Health, The
  Nation's Wealth provides a detailed examination
  of the information about children's health that
  is needed to help policy makers and program
  providers at the federal, state, and local
  levels.
• http//www.iom.edu/Reports/2004/Childrens-Health-t
  he-Nations-Wealth-Assessing-and-Improving-Child-He
  alth.aspx

35
Ethical Conduct of Clinical Research Involving
Children

• Released March 24, 2004
• To address concerns about the adequacy of the
  current system for protecting child participants
  in research given a public commitment to
  expanding pediatric clinical research, the
  Institute of Medicine convened the Committee on
  Clinical Research Involving Children.
• http//www.iom.edu/Reports/2004/Ethical-Conduct-of
  -Clinical-Research-Involving-Children.aspx

36
Lesbian Health Current Assessment and Directions
for the Future

• Released April 7, 2003
• Women's health, as a field of study, is a
  developing discipline. Health theories in general
  have been based on studies of men. However, in
  recent years, more attention has shifted to
  women's health, realizing the disparities between
  men and women in relation to their health. During
  the last two decades, a similar shift has
  occurred for a group of women--lesbian women--to
  further identify and specify their health needs.
  Lesbian Health Current Assessment and Directions
  for the Future takes a frank look at the
  political pressures, community attitudes, and
  professional concerns uniquely affecting the
  study of lesbian health issues.
• http//www.iom.edu/Reports/2003/Lesbian-Health-Cur
  rent-Assessment-and-Directions-for-the-Future.aspx

37
Adolescent Risk and Vulnerability Concepts and
Measurements

• Released October 18, 2001
• Adolescent Risk and Vulnerability is a summary of
  a workshop held in 2001 by the Board on Children,
  Youth, and Families. The workshop's goal was to
  put into perspective the total burden of
  vulnerability that adolescents have, taking
  advantage of the growing societal concern for
  adolescents, the need to set priorities for
  adolescents' needs, and the opportunity to apply
  decision-making perspectives to this critical
  area.
• http//www.iom.edu/Reports/2001/Adolescent-Risk-an
  d-Vulnerability-Concepts-and-Measurements.aspx

38
Exploring the Biological Contributions to Human
Health Does Sex Matter?

• Released April 24, 2001
• The Institute of Medicine formed a committee to
  evaluate and consider the current understanding
  of sex differences and determinants at the
  biological level and to identify current and
  potential barriers to the conduct of research in
  this area.
• http//www.iom.edu/Reports/2001/Exploring-the-Biol
  ogical-Contributions-to-Human-Health-Does-Sex-Matt
  er.aspx

39
Children of Immigrants Health, Adjustment, and
Public Assistance

• Released January 1, 1999
• Children of Immigrants represents some of the
  very best and most extensive research efforts to
  date on the circumstances, health, and
  development of children in immigrant families and
  the delivery of health and social services to
  these children and their families.
• http//www.iom.edu/Reports/1999/Children-of-Immigr
  ants-Health-Adjustment-and-Public-Assistance.aspx

40
Gender Differences in Susceptibility to
Environmental Factors A Priority Assessment

• Released January 1, 1998
• In 1996 the Office for Research on Women's Health
  at the National Institutes of Health asked the
  Institute of Medicine to conduct a workshop study
  to review some of the current federal research
  programs devoted to women's health and to clarify
  the state of knowledge regarding gender-related
  differences in susceptibility. This book contains
  a general outline of research needs, a summary of
  the workshop proceedings (as well as summaries of
  the speakers' presentations), and an analysis of
  the participating federal agencies' research
  portfolios.
• http//www.iom.edu/Reports/1998/Gender-Differences
  -in-Susceptibility-to-Environmental-Factors-A-Prio
  rity-Assessment.aspx

41
From Generation to Generation The Health and
Well-Being of Children in Immigrant Families

• Released January 1, 1998
• From Generation to Generation explores what we
  know about the development of white, black,
  Hispanic, and Asian children and youth from
  numerous countries of origin. Describing the
  status of immigrant children and youth as
  "severely understudied," the committee both draws
  on and supplements existing research to
  characterize the current status and outlook of
  immigrant children.
• http//www.iom.edu/Reports/1998/From-Generation-to
  -Generation-The-Health-and-Well-Being-of-Children-
  in-Immigrant-Families.aspx

42
Health Insurance

• For many, lack of health care is a persistent
  barrier to good health. The IOM examines the twin
  issues of health insurance coverage and access as
  well as taking a broad view of health care
  services. The IOM considers subjects such as the
  organization, financing, effectiveness,
  workforce, and delivery of health care.

From the IOM topic Health Services, Coverage, and
Access http//www.iom.edu/Global/Topics/Health-Ser
vices-Coverage-Access.aspx
43
America's Uninsured Crisis Consequences for
Health and Health Care

• Released February 23, 2009
• For decades, the health insurance crisis has
  grown without any decisive action by policy
  makers to stop it. Now is the time for action,
  say the reports authors, recommending that the
  President work with Congress and other public and
  private sector leaders on an urgent basis to
  achieve health insurance coverage for everyone
  and, in order to make that coverage sustainable,
  to reduce the costs of health care and the rate
  of increase in health care spending.
• http//www.iom.edu/Reports/2009/Americas-Uninsured
  -Crisis-Consequences-for-Health-and-Health-Care.as
  px

44
Coverage Matters Insurance and Health Care

• Released October 11, 2001
• This is the first of six reports on the problems
  of uninsurance in the United States and addresses
  the extent to which Americans are without
  coverage, identifies social, economic, and policy
  factors that contribute to the situation, and
  reports the relative probability of being
  uninsured for various groups.
• http//www.iom.edu/Reports/2001/Coverage-Matters-I
  nsurance-and-Health-Care.aspx

45
Care Without Coverage Too Little, Too Late

• Released May 21, 2002
• Care Without Coverage Too Little, Too Late, the
  second report in a series of six from the
  Institiute of Medicine's Committee on the
  Consequences of Uninsurance, examines the real
  consequences for adults who lack health
  insurance.
• http//www.iom.edu/Reports/2002/Care-Without-Cover
  age-Too-Little-Too-Late.aspx

46
Health Insurance is a Family Matter

• Released September 18, 2002
• Health Insurance Is a Family Matter is the third
  of a series of six reports on the problems of
  uninsurance in the United States and addresses
  the impact on the family of not having health
  insurance. The report examines the consequences
  for family health, financial stability, and
  general well-being. In the report, the Committee
  concludes that the financial, physical, and
  emotional well-being of all members of a family
  may be adversely affected if any family member
  lacks coverage.
• http//www.iom.edu/Reports/2002/Health-Insurance-i
  s-a-Family-Matter.aspx

47
A Shared Destiny Community Effects of
Uninsurance

• Released April 2, 2003
• A Shared Destiny Community Effects of
  Uninsurance is the fourth of a series of six
  reports on the problems of uninsurance in the
  United States. The report examines how the
  quality, quantity, and scope of health services
  within the community can be affected adversely by
  having a large or growing uninsured population.
• http//www.iom.edu/Reports/2003/A-Shared-Destiny-C
  ommunity-Effects-of-Uninsurance.aspx

48
Hidden Costs, Value Lost Uninsurance in America

• Released June 18, 2003
• Hidden Costs, Value Lost Uninsurance in America,
  the fifth of a series of six reports on the
  consequences of uninsurance in the United States,
  illustrates some of the economic and social
  losses to the country of maintaining so many
  people without health insurance. The report
  explores the potential economic and societal
  benefits that could be realized if everyone had
  health insurance on a continuous basis, as people
  over age 65 currently do with Medicare.
• http//www.iom.edu/Reports/2003/Hidden-Costs-Value
  -Lost-Uninsurance-in-America.aspx

49
Insuring America's Health Principles and
Recommendations

• Released January 13, 2004
• This report is the culmination of a series that
  offers the most comprehensive examination to date
  of the consequences of lack of health insurance
  on individuals, their families, communities and
  the whole society. The principles to guide health
  finance reform that are recommended in this sixth
  and final report of the series are based on the
  evidence reviewed in the Committee's previous
  five reports and on new analyses of past and
  present federal, state, and local efforts to
  reduce uninsurance.
• http//www.iom.edu/Reports/2004/Insuring-Americas-
  Health-Principles-and-Recommendations.aspx

50
General Public Health

• Since its founding, the IOM has advanced the best
  ways to ensure the publics health. Studies range
  from core principles and needs in the field of
  public health to specific issues such as vaccine
  safety and smoking cessation. Our scope includes
  population-based public health measures and the
  public health infrastructure.

From IOM topic Public Health http//www.iom.edu/
Global/Topics/Public-Health.aspx
51
State of the USA Health Indicators. Letter Report

• Released December 9, 2008
• In 2008, the nonprofit State of the USA, Inc.
  (SUSA) asked the Institute of Medicines
  Committee on the State of the USA Health
  Indicators to provide guidance on 20 key
  indicators to be used on the organizations
  website that would be valuable in assessing
  health. Taken together, the selected indicators
  reflect the overall health of the nation and the
  efficiency and efficacy of U.S. health systems.
  The complete list of 20 can be found in the
  report brief and report.
• http//www.iom.edu/Reports/2008/State-of-the-USA-H
  ealth-Indicators-Letter-Report.aspx

52
Knowing What Works in Health Care A Roadmap for
the Nation

• Released January 24, 2008
• Solutions to some of the nations most pressing
  health policy problems hinge on the ability to
  identify which diagnostic, treatment, and
  prevention services work best for various
  patients and circumstances. A new Institute of
  Medicine report, Knowing What Works in Health
  Care A Roadmap for the Nation, provides a
  blueprint for a national program to assess the
  effectiveness of clinical services and to provide
  credible, unbiased information about what really
  works in health care.
• http//www.iom.edu/Reports/2008/Knowing-What-Works
  -in-Health-Care-A-Roadmap-for-the-Nation.aspx

53
1st Annual Crossing the Quality Chasm Summit A
Focus on Communities

• Released September 14, 2004
• On January 6 and 7, 2004, the Institute of
  Medicine (IOM) hosted the 1st Annual Crossing the
  Quality Chasm Summit, convening a diverse group
  of national and community health care leaders to
  pool their knowledge and resources with regard to
  strategies for improving patient care for five
  common chronic illnesses asthma, depression,
  diabetes, heart failure, and pain control in
  advanced cancer.
• http//www.iom.edu/Reports/2004/1st-Annual-Crossin
  g-the-Quality-Chasm-Summit-A-Focus-on-Communities.
  aspx

54
Measuring What Matters Allocation, Planning, and
Quality Assessment for the Ryan White CARE Act

• Released November 7, 2003
• In response to a congressional mandate, an IOM
  committee was formed to reevaluate whether CARE
  allocation strategies are an equitable and
  efficient way of distributing resources to
  jurisdictions with the greatest needs and to
  assess whether quality of care can be refined and
  expanded.
• http//www.iom.edu/Reports/2003/Measuring-What-Mat
  ters-Allocation-Planning-and-Quality-Assessment-fo
  r-the-Ryan-White-CARE-Act.aspx

55
Leading Health Indicators for Healthy People
2010 Final Report

• Released April 7, 2003
• http//www.iom.edu/Reports/2003/Leading-Health-Ind
  icators-for-Healthy-People-2010-Final-Report.aspx

56
Priority Areas for National Action Transforming
Health Care Quality

• Released January 7, 2003
• In this report, the committee recommends a set of
  20 priority areas that the U.S. Department of
  Health and Human Services (DHHS) and other groups
  in the public and private sectors should focus on
  to improve the quality of health care delivered
  to all Americans. The priority areas selected
  represent the entire spectrum of health care from
  preventive care to end of life care. They also
  touch on all age groups, health care settings and
  health care providers. Collective action in these
  areas could help transform the entire health care
  system.
• http//www.iom.edu/Reports/2003/Priority-Areas-for
  -National-Action-Transforming-Health-Care-Quality.
  aspx

57
Health and Behavior The Interplay of Biological,
Behavioral, and Societal Influences

• Released May 21, 2001
• Health and Behavior reviews our improved
  understanding of the complex interplay among
  biological, psychological, and social influences
  and explores findings suggested by recent
  research-including interventions at multiple
  levels that we can employ to improve human
  health.
• http//www.iom.edu/Reports/2001/Health-and-Behavio
  r-The-Interplay-of-Biological-Behavioral-and-Socie
  tal-Influences.aspx

58
Measuring the Quality of Health Care

• Released February 1, 1998
• This report first describes quality of care based
  on the IOM's 1990 definition and then outlines
  the burden of harm from poor quality. It then
  describes major approaches to and recent advances
  in quality measurement. Finally, it describes
  some of the challenges facing this field.
• http//www.iom.edu/Reports/1998/Measuring-the-Qual
  ity-of-Health-Care.aspx

59
Research

• Underlying health and health care is an important
  science base. The IOM work in biomedical and
  health research pertains to both the discovery
  and application of new knowledge.

From IOM topic Biomedical and Health
Research http//www.iom.edu/Global/Topics/Biomedi
cal-Health-Research.aspx
60
Integrity in Scientific Research Creating an
Environment That Promotes Responsible Conduct

• Released July 15, 2002
• This report focuses on the research environment
  and attempts to define and describe those
  elements that allow and encourage unique
  individuals, regardless of their role in the
  research organization or their backgrounds on
  entry, to act with integrity.
• http//www.iom.edu/Reports/2002/Integrity-in-Scien
  tific-Research-Creating-an-Environment-That-Promot
  es-Responsible-Conduct.aspx

61
Preserving Public Trust Accreditation and Human
Research Participant Protection Programs

• Released April 17, 2001
• Preserving Public Trust Accreditation and Human
  Research Participant Protection Programs,
  responds, at the request of DHHS, to the
  increasing concern over patient safety and
  shutdowns of research operations in the United
  States.
• http//www.iom.edu/Reports/2001/Preserving-Public-
  Trust-Accreditation-and-Human-Research-Participant
  -Protection-Programs.aspx

62
Toward Environmental Justice Research,
Education, and Health Policy Needs

• Released March 1, 1999
• Is environmental degradation worse in poor and
  minority communities? Do these communities suffer
  more adverse health effects as a result? The
  committee addresses these questions and explores
  how current fragmentation in health policy could
  be replaced with greater coordination among
  federal, state, and local parties.
• http//www.iom.edu/Reports/1999/Toward-Environment
  al-Justice-Research-Education-and-Health-Policy-Ne
  eds.aspx

63
Responsible Research A Systems Approach to
Protecting Research Participants

• Released October 3, 2002
• Broader federal oversight is needed to ensure
  that all people who take part in research
  studies, regardless of whether they are publicly
  or privately funded, have the same necessary
  protections for their health and well-being, says
  the report, Responsible Research A Systems
  Approach to Protecting Research Participants.
• http//www.iom.edu/Reports/2002/Responsible-Resear
  ch-A-Systems-Approach-to-Protecting-Research-Parti
  cipants.aspx

64
Complementary and Alternative Medicine

• Complementary and alternative medicine (CAM)
  refers to a group of diverse medical and health
  care systems, practices, and products that are
  not generally considered part of conventional
  medicine.

65
Use of Dietary Supplements by Military Personnel

• Released June 9, 2008
• The use of dietary supplements has become
  increasingly popular among members of the
  military. While some supplements may provide
  benefits to health, others could carry adverse
  effects that might compromise the readiness and
  performance of service members. The U.S.
  Department of Defense, the Samueli Institute, the
  National Institutes of Health (NIH), with
  additional support from the Food and Drug
  Administration (FDA), requested that the
  Institute of Medicine (IOM) review the use of
  dietary supplements by military personnel,
  recommending a framework to identify the need for
  management of dietary supplement use within the
  military, and developing an approach to report
  adverse health events.
• http//www.iom.edu/Reports/2008/Use-of-Dietary-Sup
  plements-by-Military-Personnel.aspx

66
Complementary and Alternative Medicine in the
United States

• Released January 12, 2005
• At the request of the National Institutes of
  Health (NIH) and the Agency for Healthcare
  Research and Quality, the IOM produced the report
  titled Complementary and Alternative Medicine in
  the United States, which assesses what is known
  about Americans' reliance on those therapies and
  also assists the NIH in developing research
  methods and setting priorities for evaluating
  products and approaches within CAM.
• http//www.iom.edu/Reports/2005/Complementary-and-
  Alternative-Medicine-in-the-United-States.aspx

67
Dietary Supplements A Framework for Evaluating
Safety

• Released April 1, 2004
• Although vitamin and supplement manufacturers are
  restricted from claiming that using their
  products leads to therapeutic benefits, surveys
  show that many people take supplements for
  purposes such as treating colds or alleviating
  depression. According to other survey data, the
  majority of consumers believe these products to
  be either reasonably or completely safe. To
  bolster the FDA's ability to evaluate the safety
  of dietary supplements, the Institute of Medicine
  report Dietary Supplements A Framework for
  Evaluating Safety outlines a science-based
  process for assessing supplement ingredients,
  even when data about a substance's safety in
  humans is scarce.
• http//www.iom.edu/Reports/2004/Dietary-Supplement
  s-A-Framework-for-Evaluating-Safety.aspx

68
Health Care Workforce

• Chief among the resources of our health care
  system is the workforce that assumes the task.
  The IOM recognizes the importance of the health
  care workforce and examines such issues as the
  preparedness of certain sectors to meet patient
  demand and the protection of health care workers
  against threats like pandemics, among others.

From IOM topic Healthcare Workforce http//www.i
om.edu/Global/Topics/Health-Care-Workforce.aspx
69
In the Nation's Compelling Interest Ensuring
Diversity in the Health Care Workforce

• Released February 5, 2004
• The report examines institutional and
  policy-level strategies - defined as specific
  policies and programs of health professions
  schools, their associations and accreditation
  bodies, health care systems/organizations, and
  state and federal governments - to increase
  diversity among health professionals.
• http//www.iom.edu/Reports/2004/In-the-Nations-Com
  pelling-Interest-Ensuring-Diversity-in-the-Health-
  Care-Workforce.aspx

70
Who Will Keep the Public Healthy? Workshop
Summary

• Released August 4, 2003
• On May 22, 2003 in Washington, DC the Institute
  of Medicine held a workshop to explore the
  recently released report, Who Will Keep the
  Public Healthy? Educating Public Health
  Professionals for the 21st Century.
  Representatives of the public health practice and
  academic communities joined to review the report
  and to discuss how to proceed to implement the
  recommendations of this report. This summary is a
  report of that meeting. It includes suggestions
  from the six workgroups for next steps necessary
  to move forward in implementing the
  recommendations.
• http//www.iom.edu/Reports/2003/Who-Will-Keep-the-
  Public-Healthy-Workshop-Summary.aspx

71
Health Professions Education A Bridge to Quality

• Released April 18, 2003
• On June 17-18, 2002 over 150 leaders and experts
  from health professions education, regulation,
  policy, advocacy, quality, and industry attended
  the Health Professions Education Summit to
  discuss and help the committee develop strategies
  for restructuring clinical education to be
  consistent with the principles of the
  21st-century health system.
• http//www.iom.edu/Reports/2003/Health-Professions
  -Education-A-Bridge-to-Quality.aspx

72
The Right Thing to Do, The Smart Thing to Do
Enhancing Diversity in Health Professions.
Summary of the Symposium on Diversity in Health
Professions in Honor of Herbert W. Nickens, M.D.

• Released August 31, 2001
• The Symposium on Diversity in the Health
  Professions in Honor of Herbert W. Nickens, M.D.
  was convened in March 2001 to provide a forum for
  health policymakers, health professions
  educators, education policymakers, researchers,
  and others to address three significant and
  contradictory challenges. The Right Thing to Do,
  The Smart Thing to Do Enhancing Diversity in
  Health Professions illustrates how the health
  care industry and health care professions are
  fighting to retain the publics confidence so
  that the U.S. health care system can continue to
  be the worlds best.
• http//www.iom.edu/Reports/2001/The-Right-Thing-to
  -Do-The-Smart-Thing-to-Do-Enhancing-Diversity-in-H
  ealth-Professions-Summary-of-the-Symposium-on-Dive
  rsity-in-Health-Professions-in-Honor-of-Herbert-W-
  Nickens-MD.aspx

73
Genetics and Genomics

• By studying the relationship between genes,
  environment, and behaviors, researchers and
  practitioners can learn why some people get sick,
  while others do not. Family health history
  information can also help to identify people who
  may have a higher risk for certain diseases.
  Better understanding of genetic and family
  history information can help researchers and
  practitioners identify, develop, and evaluate
  screening and other interventions that can
  improve health and prevent disease.
• Centers for Disease Control and Prevention,
  Genomics and Health http//www.cdc.gov/genomics/
  public/index.htm

From CDC website Genomics and Health http//www.
cdc.gov/genomics/public/index.htm
74
Policy Issues in the Development of Personalized
Medicine in Oncology. Workshop Summary

• Released February 8, 2010
• As cancer care becomes more personalized,
  patients will receive preventive or therapeutic
  interventions based on their susceptibilities or
  predicted responses. But before the use of
  personalized cancer care can reach its full
  potential, the health care system must resolve a
  number of policy issues. To explore these policy
  challenges, the National Cancer Policy Forum held
  this workshop in June 2009.
• http//www.iom.edu/Reports/2010/Policy-Issues-in-t
  he-Development-of-Personalized-Medicine-in-Oncolog
  y.aspx

75
Systems for Research and Evaluation for
Translating Genome-Based Discoveries for Health.
Workshop Summary

• Released November 11, 2009
• The correlation between genetic variations and
  variations in disease risk has been a subject of
  study for more than 100 years. Initially,
  research focused on single genes that give rise
  to rare genetic diseases such as cystic fibrosis
  or Huntingtons disease. With new studies,
  however, numerous associations have been found
  between genes and more common diseases, for
  example breast cancer, type II diabetes, coronary
  artery disease, asthma, and bipolar disorder.
  This rapidly advancing field of genomics has
  stirred great interest in personalized health
  care. The hope is that using genomic information
  in care will lead to reduced health care costs
  and improved health results, as preventive
  measures and treatments are tailored to patients
  genetic susceptibilities. On February 12, 2009,
  the Institute of Medicines Roundtable on
  Translating Genomic-Based Research for Health
  hosted a workshop to examine how to evaluate the
  clinical use of genomic information and the
  impact of genetic information in caring for
  patients.
• http//www.iom.edu/Reports/2009/Systems-Research-E
  valuation-Translating-Genome-Based-Discoveries-Hea
  lth.aspx

76
Innovations in Service Delivery in the Age of
Genomics. Workshop Summary

• Released May 13, 2009
• New discoveries in genomicsthat is, the study of
  the entire human genomeare changing how we
  diagnose and treat diseases. As the trend shifts
  from genetic testing largely being undertaken for
  rare genetic disorders to, increasingly,
  individuals being screened for common diseases,
  general practitioners, pediatricians,
  obstetricians, gynecologists, and other providers
  need to be knowledgeable about and comfortable
  using genetic information to improve their
  patients health. To address these changes, the
  Roundtable on Translating Genomic-Based Research
  for Health held the public workshop Innovations
  in Service Delivery in the Age of Genomics on
  July 27, 2008.
• http//www.iom.edu/Reports/2009/Innovations-in-Ser
  vice-Delivery-in-the-Age-of-Genomics-Workshop-Summ
  ary.aspx

77
Cancer-Related Genetic Testing and Counseling.
Workshop Proceedings

• Released August 20, 2007
• The Institute of Medicines National Cancer
  Policy Forum held a workshop and released the
  proceedings entitled Cancer-Related Genetic
  Testing and Counseling. The workshop focused on
  the fact that genetic testing and counseling are
  becoming more complex and important for informing
  patients and families of the risks and benefits
  of certain courses of action, but at the same
  time organized expert programs are in short
  supply. The workshop covered the scientific and
  clinical aspects of genetic testing and
  counseling as well as workforce and reimbursement
  issues, among others.
• http//www.iom.edu/Reports/2007/Cancer-Related-Ge
  netic-Testing-and-Counseling-Workshop-Proceedings.
  aspx

78
Nutrigenomics and Beyond Informing the Future
Workshop Summary

• Released May 22, 2007
• Nutrition science is uniquely poised to serve as
  the crossroads for many disciplines and, using
  genomics tools, can bridge this knowledge to
  better understand and address diet-related
  chronic diseases and molecular responses to
  dietary factors. To address these issues, the
  Institute of Medicine held a two-day workshop,
  and released Nutrigenomics and Beyond Informing
  the Future Workshop Summary, which explores the
  state of the science, examines its potential, and
  discusses how that potential might best be
  realized.
• http//www.iom.edu/Reports/2007/Nutrigenomics-and-
  Beyond--Informing-the-Future-Workshop-Summary.aspx

79
Diffusion and Use of Genomic Innovations in
Health and Medicine. Workshop Summary

• Released June 19, 2008
• The Institute of Medicines Roundtable on
  Translating Genomic-Based Research for Health,
  established in 2007, held its first workshop to
  address the following questions (1) Are there
  different pathways by which new scientific
  findings move from the research setting into
  health care? (2) If so, what are the implications
  of those different pathways for genomics? (3)
  What can we learn from the translation of other
  new technologies as we seek to understand the
  translation of genome science into health care?
• http//www.iom.edu/Reports/2008/Diffusion-and-Use-
  of-Genomic-Innovations-in-Health-and-Medicine-Work
  shop-Summary.aspx

80
Genes, Behavior, and the Social Environment
Moving Beyond the Nature/Nurture Debate

• Released August 11, 2006
• Genes, Behavior, and the Social Environment
  examines a number of well-described
  gene-environment interactions, reviews the state
  of the science in researching such interactions,
  and recommends priorities not only on research
  itself but also on its workforce, resource, and
  infrastructural needs.
• http//www.iom.edu/Reports/2006/Genes-Behavior-and
  -the-Social-Environment-Moving-Beyond-the-NatureNu
  rture-Debate.aspx

81
Implications of Genomics for Public Health.
Workshop Summary

• Released March 28, 2005
• This workshop summary, titled Implications of
  Genomics for Public Health, summarizes speaker
  presentations on major scientific and policy
  issues related to genomics and public health,
  major supports for and challenges to the
  translation of genetic research into population
  health benefits, and approaches for the
  integration of genomic information into
  strategies for promoting health and preventing
  disease.
• http//www.iom.edu/Reports/2005/Implications-of-Ge
  nomics-for-Public-Health-Workshop-Summary.aspx

82
Cancer and the Environment Gene-Environment
Interactions. Workshop Summary

• Released August 9, 2002
• Both environmental and genetic factors are known
  to be involved in the development of cancer. On
  May 16-17, 2001, the Roundtable on Environmental
  Health Sciences, Research and Medicine convened a
  workshop on Cancer and the Environment
  Gene-Environment Interactions to address the link
  between environmental factors and the development
  of cancer in the light of recent advances in
  genomics and, more specifically, in
  toxicogenomics and gene-environment interactions.
  
• http//www.iom.edu/Reports/2002/Cancer-and-the-Env
  ironment-Gene-Environment-Interactions-Workshop-Su
  mmary.aspx