An argument that health is optimal responsiveness and is often best treated at the system level. Medical education centers on the venerable “no-fault” concept of homeostasis, whereby local mechanisms impose constancy by correcting errors, and the brain serves mainly for emergencies. Yet, it turns out that most parameters are not constant; moreover, despite the importance of local mechanisms, the brain is definitely in charge. In this book, the eminent neuroscientist Peter Sterling describes a broader concept: allostasis (coined by Sterling and Joseph Eyer in the 1980s), whereby the brain anticipates needs and efficiently mobilizes supplies to prevent errors. Allostasis evolved early, Sterling explains, to optimize energy efficiency, relying heavily on brain circuits that deliver a brief reward for each positive surprise. Modern life so reduces the opportunities for surprise that we are driven to seek it in consumption: bigger burgers, more opioids, and innumerable activities that involve higher carbon emissions. The consequences include addiction, obesity, type 2 diabetes, and climate change. Sterling concludes that solutions must go beyond the merely technical to restore possibilities for daily small rewards and revivify the capacities for egalitarianism that were hard-wired into our nature. Sterling explains that allostasis offers what is not found in any medical textbook: principled definitions of health and disease: health as the capacity for adaptive variation and disease as shrinkage of that capacity. Sterling argues that since health is optimal responsiveness, many significant conditions are best treated at the system level.

How do communities protect and improve the health of their populations? Health care is part of the answer but so are environmental protections, social and educational services, adequate nutrition, and a host of other activities. With concern over funding constraints, making sure such activities are efficient and effective is becoming a high priority. Improving Health in the Community explains how population-based performance monitoring programs can help communities point their efforts in the right direction. Within a broad definition of community health, the committee addresses factors surrounding the implementation of performance monitoring and explores the "why" and "how to" of establishing mechanisms to monitor the performance of those who can influence community health. The book offers a policy framework, applies a multidimensional model of the determinants of health, and provides sets of prototype performance indicators for specific health issues. Improving Health in the Community presents an attainable vision of a process that can achieve community-wide health benefits.

"The Nation has lost sight of its public health goals and has allowed the system of public health to fall into 'disarray'," from The Future of Public Health. This startling book contains proposals for ensuring that public health service programs are efficient and effective enough to deal not only with the topics of today, but also with those of tomorrow. In addition, the authors make recommendations for core functions in public health assessment, policy development, and service assurances, and identify the level of government--federal, state, and local--at which these functions would best be handled.

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.

To maintain their own health and the health of their families and communities, consumers rely heavily on the health information that is available to them. This information is at the core of the partnerships that patients and their families forge with today's complex modern health systems. This information may be provided in a variety of forms â€" ranging from a discussion between a patient and a health care provider to a health promotion advertisement, a consent form, or one of many other forms of health communication common in our society. Yet millions of Americans cannot understand or act upon this information. To address this problem, the field of health literacy brings together research and practice from diverse fields including education, health services, and social and cultural sciences, and the many organizations whose actions can improve or impede health literacy. Health Literacy: Prescription to End Confusion examines the body of knowledge that applies to the field of health literacy, and recommends actions to promote a health literate society. By examining the extent of limited health literacy and the ways to improve it, we can improve the health of individuals and populations.

Healthcare decision makers in search of reliable information that compares health interventions increasingly turn to systematic reviews for the best summary of the evidence. Systematic reviews identify, select, assess, and synthesize the findings of similar but separate studies, and can help clarify what is known and not known about the potential benefits and harms of drugs, devices, and other healthcare services. Systematic reviews can be helpful for clinicians who want to integrate research findings into their daily practices, for patients to make well-informed choices about their own care, for professional medical societies and other organizations that develop clinical practice guidelines. Too often systematic reviews are of uncertain or poor quality. There are no universally accepted standards for developing systematic reviews leading to variability in how conflicts of interest and biases are handled, how evidence is appraised, and the overall scientific rigor of the process. In Finding What Works in Health Care the Institute of Medicine (IOM) recommends 21 standards for developing high-quality systematic reviews of comparative effectiveness research. The standards address the entire systematic review process from the initial steps of formulating the topic and building the review team to producing a detailed final report that synthesizes what the evidence shows and where knowledge gaps remain. Finding What Works in Health Care also proposes a framework for improving the quality of the science underpinning systematic reviews. This book will serve as a vital resource for both sponsors and producers of systematic reviews of comparative effectiveness research.

Public health is a term much used in the media, by health professionals, and by activists. At the national or the local level there are ministries or departments of public health, whilst international agencies such as the World Health Organisation promote public health policies, and regional organisations such as the European Union have public health funding and policies. But what do we mean when we speak about 'public health'? In this Very Short Introduction Virginia Berridge explores the areas which fall under the remit of public health, and explains how the individual histories of different countries have come to cause great differences in the perception of the role and responsibilities of public health organisations. Thus, in the United States litigation on public health issues is common, but state involvement is less, while some Scandinavian countries have a tradition of state involvement or even state ownership of industries such as alcohol in connection with public health. In its narrowest sense, public health can refer to the health of a population, the longevity of individual members, and their freedom from disease, but it can also be anticipatory, geared to the prevention of illness, rather than simply the provision of care and treatment. In the way public health deals with healthy as well as sick people it is therefore a separate concept from health services, which deal with the sick population. Drawing on a wide range of international examples, Berridge demonstrates the central role of history to understanding the amorphous nature of public health today. ABOUT THE SERIES: The Very Short Introductions series from Oxford University Press contains hundreds of titles in almost every subject area. These pocket-sized books are the perfect way to get ahead in a new subject quickly. Our expert authors combine facts, analysis, perspective, new ideas, and enthusiasm to make interesting and challenging topics highly readable.