Hospitals and nursing homes are responding to changes in the health care system by modifying staffing levels and the mix of nursing personnel. But do these changes endanger the quality of patient care? Do nursing staff suffer increased rates of injury, illness, or stress because of changing workplace demands? These questions are addressed in Nursing Staff in Hospitals and Nursing Homes, a thorough and authoritative look at today's health care system that also takes a long-term view of staffing needs for nursing as the nation moves into the next century. The committee draws fundamental conclusions about the evolving role of nurses in hospitals and nursing homes and presents recommendations about staffing decisions, nursing training, measurement of quality, reimbursement, and other areas. The volume also discusses work-related injuries, violence toward and abuse of nursing staffs, and stress among nursing personnelâ€"and examines whether these problems are related to staffing levels. Included is a readable overview of the underlying trends in health care that have given rise to urgent questions about nurse staffing: population changes, budget pressures, and the introduction of new technologies. Nursing Staff in Hospitals and Nursing Homes provides a straightforward examination of complex and sensitive issues surround the role and value of nursing on our health care system.

This book explores how low fertility levels could fundamentally change a country's population and society. It analyzes the profound effects below average birthrates have on virtually all aspects of society, from the economy to religion, from marriage to gender roles. An introduction written by Dudley L. Poston Jr. provides a general overview of this relatively new phenomenon that has already impacted nearly one-half of the countries of the world today. Poston also discusses the broad implications of the changes that these societies are currently experiencing and the ones that they will soon confront. Next, each of the 12 essays collected in this volume look into how a low fertility level affects a particular demographic or societal structure or process. In addition, case studies offer an in-depth portrait of these changes in the United States and China. Coverage includes the dynamics of low and lowest-low (where the birthrate is well below average) fertility, high and increasing life expectancies in the United States, the implications of native-born fertility and other socio-demographic changes for less-skilled U.S. immigration, ageing and age dependency in post-industrial societies, good mothering and gender roles in China, the increasing prevalence of voluntary childlessness, how low fertility and prolonged longevity could result in slow economic growth, the decreasing relevance of traditional religious systems, and more. The emergence and persistence of population decline produced by low fertility levels has the potential to greatly alter key aspects of society as well as individual lives. Containing insightful analysis from some of the top minds in demography today, this book will arm readers with the knowledge they need to fully understand these transformations.

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.

The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

The America of the near future will look nothing like the America of the recent past. America is in the throes of a demographic overhaul. Huge generation gaps have opened up in our political and social values, our economic well-being, our family structure, our racial and ethnic identity, our gender norms, our religious affiliation, and our technology use. Today's Millennials -- well-educated, tech savvy, underemployed twenty-somethings -- are at risk of becoming the first generation in American history to have a lower standard of living than their parents. Meantime, more than 10,000 Baby Boomers are retiring every single day, most of them not as well prepared financially as they'd hoped. This graying of our population has helped polarize our politics, put stresses on our social safety net, and presented our elected leaders with a daunting challenge: How to keep faith with the old without bankrupting the young and starving the future. Every aspect of our demography is being fundamentally transformed. By mid-century, the population of the United States will be majority non-white and our median age will edge above 40 -- both unprecedented milestones. But other rapidly-aging economic powers like China, Germany, and Japan will have populations that are much older. With our heavy immigration flows, the US is poised to remain relatively young. If we can get our spending priorities and generational equities in order, we can keep our economy second to none. But doing so means we have to rebalance the social compact that binds young and old. In tomorrow's world, yesterday's math will not add up. Drawing on Pew Research Center's extensive archive of public opinion surveys and demographic data, The Next America is a rich portrait of where we are as a nation and where we're headed -- toward a future marked by the most striking social, racial, and economic shifts the country has seen in a century.

Strategic health planning, the cornerstone of initiatives designed to achieve health improvement goals around the world, requires an understanding of the comparative burden of diseases and injuries, their corresponding risk factors and the likely effects of invervention options. The Global Burden of Disease framework, originally published in 1990, has been widely adopted as the preferred method for health accounting and has become the standard to guide the setting of health research priorities. This publication sets out an updated assessment of the situation, with an analysis of trends observed since 1990 and a chapter on the sensitivity of GBD estimates to various sources of uncertainty in methods and data.