The Color Line and the Quality of Life in America


Book Description

Is the United States a nation divided by the "color line," as W.E.B. Dubois declared? What is the impact of race on the lives of Americans today? In this powerful new assessment of the social reality of race, Reynolds Farley and Walter Allen compare demographic, social, and economic characteristics of blacks and whites to discover how and to what extent racial identity influences opportunities and outcomes in our society. They conclude that despite areas of considerable gain, black Americans continue to be substantially disadvantaged relative to whites. A Volume in the Russell Sage Foundation Census Series




Dying in America


Book Description

For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.




U.S. Health in International Perspective


Book Description

The United States is among the wealthiest nations in the world, but it is far from the healthiest. Although life expectancy and survival rates in the United States have improved dramatically over the past century, Americans live shorter lives and experience more injuries and illnesses than people in other high-income countries. The U.S. health disadvantage cannot be attributed solely to the adverse health status of racial or ethnic minorities or poor people: even highly advantaged Americans are in worse health than their counterparts in other, "peer" countries. In light of the new and growing evidence about the U.S. health disadvantage, the National Institutes of Health asked the National Research Council (NRC) and the Institute of Medicine (IOM) to convene a panel of experts to study the issue. The Panel on Understanding Cross-National Health Differences Among High-Income Countries examined whether the U.S. health disadvantage exists across the life span, considered potential explanations, and assessed the larger implications of the findings. U.S. Health in International Perspective presents detailed evidence on the issue, explores the possible explanations for the shorter and less healthy lives of Americans than those of people in comparable countries, and recommends actions by both government and nongovernment agencies and organizations to address the U.S. health disadvantage.




The Quality of Life in Latin American Cities


Book Description

A growing number of cities around the world have established systems for monitoring the quality of urban life. Many of those systems combine objective information with subjective opinions and cover a wide variety of topics. This book assesses a method that takes advantage of both types of information and offers criteria to identify and rank the issues of potential importance for urban dwellers. This method which combines the so-called 'hedonic price' and 'life satisfaction' approaches to value public goods was tested in pilot studies in six Latin American cities: Bogot , Buenos Aires, Lima, Medell n, Montevideo, and San Jos of Costa Rica. It provides valuable insights to address key questions such as, Which urban problems have the greatest impact on people s opinions of city management and the most widespread effects on their lives? Do gaps between perception and reality vary from one area of the city to another, especially between high- and low-income neighborhoods? Where can homebuilders most feasibly seek solutions to problems such as inadequate road infrastructure, a lack of recreational areas, or poor safety conditions? Which problems should government authorities address first, in light of their impact on the well-being of various groups of individuals and given private actors abilities to respond? Which homeowners benefit the most from public infrastructure or services? When can or should property taxes be used to finance the provision of certain services or the solution of certain problems? 'The Quality of Life in Latin American Cities: Markets and Perception' proposes a monitoring system that is easy to operate and that entails reasonable costs but also has a solid conceptual basis. Long the ideal of many scholars and practitioners, such a system may soon become a reality and have the potential to make a significant contribution to the decision-making processes in any city concerned with the well-being of its residents.




Indicators of Quality of Life in Latin America


Book Description

This volume sheds new light on the use of quantitative, qualitative and synthetic indicators for the measurement of quality of life in different countries of Latin America. Organized in three parts, the book presents the methodology for the construction of new indicators, discusses quality of urban life from a geographical perspective, and examines quality of life of different populations. The book focuses on the social, economic, political, geographical and demographic dimensions. It covers a wide range of topics, including the ways to measure social, political and spatial inequalities, the changes in urban quality of life, the construction of a synthetic indicator for the assessment of habitability, the measuring of spatial segregation in midsize and smaller cities by using thematic cartography and synthesis maps, and the concept of habitability. It includes research conducted on the quality of life of different population groups: working boys and girls, high-school students, and older people.




Explaining Divergent Levels of Longevity in High-Income Countries


Book Description

During the last 25 years, life expectancy at age 50 in the United States has been rising, but at a slower pace than in many other high-income countries, such as Japan and Australia. This difference is particularly notable given that the United States spends more on health care than any other nation. Concerned about this divergence, the National Institute on Aging asked the National Research Council to examine evidence on its possible causes. According to Explaining Divergent Levels of Longevity in High-Income Countries, the nation's history of heavy smoking is a major reason why lifespans in the United States fall short of those in many other high-income nations. Evidence suggests that current obesity levels play a substantial part as well. The book reports that lack of universal access to health care in the U.S. also has increased mortality and reduced life expectancy, though this is a less significant factor for those over age 65 because of Medicare access. For the main causes of death at older ages-cancer and cardiovascular disease-available indicators do not suggest that the U.S. health care system is failing to prevent deaths that would be averted elsewhere. In fact, cancer detection and survival appear to be better in the U.S. than in most other high-income nations, and survival rates following a heart attack also are favorable. Explaining Divergent Levels of Longevity in High-Income Countries identifies many gaps in research. For instance, while lung cancer deaths are a reliable marker of the damage from smoking, no clear-cut marker exists for obesity, physical inactivity, social integration, or other risks considered in this book. Moreover, evaluation of these risk factors is based on observational studies, which-unlike randomized controlled trials-are subject to many biases.




Forgotten Americans


Book Description

A sobering account of a disenfranchised American working class and important policy solutions to the nation’s economic inequalities One of the country’s leading scholars on economics and social policy, Isabel Sawhill addresses the enormous divisions in American society—economic, cultural, and political—and what might be done to bridge them. Widening inequality and the loss of jobs to trade and technology has left a significant portion of the American workforce disenfranchised and skeptical of governments and corporations alike. And yet both have a role to play in improving the country for all. Sawhill argues for a policy agenda based on mainstream values, such as family, education, and work. While many have lost faith in government programs designed to help them, there are still trusted institutions on both the local and federal level that can deliver better job opportunities and higher wages to those who have been left behind. At the same time, the private sector needs to reexamine how it trains and rewards employees. This book provides a clear-headed and middle-way path to a better-functioning society in which personal responsibility is honored and inclusive capitalism and more broadly shared growth are once more the norm.




How’s Life in Latin America? Measuring Well-being for Policy Making


Book Description

Many Latin American countries have experienced improvements in income over recent decades, with several of them now classified as high-income or upper middle-income in terms of conventional metrics. But has this change been mirrored in improvements across the different areas of people’s lives? How’s Life in Latin America? Measuring Well-being for Policy Making addresses this question by presenting comparative evidence for Latin America and the Caribbean (LAC) with a focus on 11 LAC countries (Argentina, Brazil, Chile, Colombia, Costa Rica, the Dominican Republic, Ecuador, Mexico, Paraguay, Peru and Uruguay).




Communities in Action


Book Description

In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.




Crossing the Global Quality Chasm


Book Description

In 2015, building on the advances of the Millennium Development Goals, the United Nations adopted Sustainable Development Goals that include an explicit commitment to achieve universal health coverage by 2030. However, enormous gaps remain between what is achievable in human health and where global health stands today, and progress has been both incomplete and unevenly distributed. In order to meet this goal, a deliberate and comprehensive effort is needed to improve the quality of health care services globally. Crossing the Global Quality Chasm: Improving Health Care Worldwide focuses on one particular shortfall in health care affecting global populations: defects in the quality of care. This study reviews the available evidence on the quality of care worldwide and makes recommendations to improve health care quality globally while expanding access to preventive and therapeutic services, with a focus in low-resource areas. Crossing the Global Quality Chasm emphasizes the organization and delivery of safe and effective care at the patient/provider interface. This study explores issues of access to services and commodities, effectiveness, safety, efficiency, and equity. Focusing on front line service delivery that can directly impact health outcomes for individuals and populations, this book will be an essential guide for key stakeholders, governments, donors, health systems, and others involved in health care.