A History of the National Academy of Medicine 50 Years of Transformational Leadership (2022) / Chapter Skim
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6 Advancing the Health of the Public in the United States and Globally
6 Advancing the Health of the Public in the United States and Globally
Pages 139-184
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DEFINING AND SHAPING PUBLIC HEALTH Throughout its history, the IOM played a crucial role in defining and shaping the field of public health and public health programs in the United States. For example, in 1988 the IOM released a report called The Future of Public Health.
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4 Impact of IOM Reports (Database) , IOM/NAM Records.
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The IOM's work on HIV/AIDS had a notable impact on public health decisions at the time and became the standard by which future IOM activities would be judged in terms of impact. Throughout its history, the IOM released nearly 30 consensus studies that reviewed various aspects of HIV/AIDS, including prevention, screening, and treatment; research and drug discovery; health policy and financing; and global health issues (see Box 6-1)
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.7 Under the direction of Robbins, the IOM dedicated its 7 IOM Council Meeting, Minutes, July 20, 1985, IOM/NAM Records.
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. The committee, which was chaired by external volunteer Theodore Cooper,11 also affirmed the view, current at the time, that "virtually all [HIV-]
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A separate committee produced a report called The AIDS Research Program of the National Institutes of Health that was released in 1991. The report suggested that the NIH should increase its HIV/AIDS research activities in behavioral science, basic science, patient care research, and vaccine development.
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health professionals. The committee, which was chaired by NAM member Fitzhugh Mullan,17 recommended the creation of a United States Global Health Service that would send health care professionals to the PEPFAR countries, functioning somewhat like the Peace Corps but with an emphasis on providing care for individuals with HIV/AIDS.
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A press release from the Department of State spelled out the overarching goals for PEPFAR's next phase, many of which were justified in the PEPFAR reauthorization legislation with references to the IOM report: • Transition from emergency response to promotion of sustainable country programs; • Strengthen partner government capacity to lead the response to this epidemic and other health demands; • Expand prevention, care, and treatment in both concentrated and generalized epidemics; • Integrate and coordinate HIV/AIDS programs with broader global health and development programs to maximize impact on health systems; and • Invest in innovation and operations research to evaluate impact, improve service delivery and maximize outcomes. These goals were well aligned with the IOM report's emphasis on the importance of shifting the program's focus from emergency relief to long-term strategic planning and capacity building; strengthening a country's ownership and leadership of its response to the epidemic; and collecting and using data on the precise nature of the epidemic in each country to determine the most appropriate interventions and target them most effectively.20 The IOM's second report, Evaluation of PEPFAR, was published in February 2013.
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Torrens, an external volunteer who chaired the committee,22 "each year, decisions by more than 1 million youths to become regular smokers" take an average of 15 years off their lives and commit the health care system "to $8.2 billion in extra medical expenditures over their lifetimes" (p.
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. In 2009, President Obama enabled FDA regulation through the Family Smoking Prevention and Tobacco Control Act, which granted the FDA "broad authority to regulate the manufacturing, distribution, and marketing of tobacco products, including ‘modified risk tobacco products'" -- fulfilling recommendations from Clearing the Smoke (IOM, 2001f)
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used to fund the expansion of the Children's Health Insurance Program.26 Three years later, the IOM released a report called Scientific Standards for Studies on Modified Risk Tobacco Products. This report provided a minimum set of scientific standards that the FDA should use to confirm that a "product has the potential to reduce tobacco related harms as compared to conventional tobacco products" (IOM, 2012i)
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The purpose of the report, sponsored by the White House Office of National Drug Control Policy, was to review the available evidence on the risks associated with medical marijuana and the potential therapeutic value for conditions such as glaucoma, multiple sclerosis, chronic pain, nausea and vomiting associated with chemotherapy, and wasting associated with AIDS. The committee, which was chaired by NAM members John A
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that resulted in a report called Violence in Families: Assessing Prevention and Treatment Programs. The report was released in 1998 and covered topics such as child abuse, domestic violence, and elder abuse.
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41 Impact of IOM Reports (Database) , IOM/NAM Records.
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To address violence as an ongoing global public health epidemic, the IOM launched the Forum on Global Violence Prevention in 2010. With an overarching goal "to reduce violence worldwide by promoting research on both protective and risk factors and encouraging evidence-based prevention efforts" (NASEM, n.d.s)
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Living Well was not the IOM's first report to review topics related to chronic conditions; throughout its history, the organization recognized chronic conditions as serious public health concerns and reviewed topics related to cardiovascular diseases, epilepsy, obesity, mental health, and substance use either as standalone reports or in the context of broader issues related to the health care system, health care research, or public health in general. Cardiovascular Disease Cardiovascular disease (CVD)
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, which was followed by a 2010 report called Promoting Cardiovascular Health in the Developing World: A Critical Challenge to Achieve Global Health. The 2010 report found that 30 percent of deaths in low- and middleincome countries were associated with CVD.
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49 Impact of IOM Reports (Database) , IOM/NAM Records.
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. Dietary Reference Intakes The FNB has a long history in advising the nation on dietary intake recommendations that date back to its origins.
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As of 2019, the IOM's DRI framework had been adopted by the governments of the Netherlands and China, the Australia-New Zealand Food Authority, and nutrition societies in Germany, Austria, and Switzerland.53 The 2002/2005 report Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (IOM, 2005e) contributed to a 2003 decision by the FDA to require manufacturers to list trans fat on the Nutrition Facts Panel for foods and some 52 Food and Nutrition Board: 80th Anniversary Symposium (IOM/NAM Records)
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. In 2019, the HMD released Dietary Reference Intakes for Sodium and Potassium, which updated a portion of the IOM's 2005 report, Dietary Reference Intakes for Water, Potassium, Sodium, Chloride, and Sulfate (IOM, 2005f; NASEM, 2019l)
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Henney was at the College of Medicine at the University of Cincinnati, Ohio, when this report was published. 56 Impact of IOM Reports, January–March 2011 in IOM Council Minutes, April 11, 2011, IOM/NAM Records.
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Weight Gain During Pregnancy: Reexamining the Guidelines was released in 2009. The committee, which was chaired by external volunteer Kathleen M
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Koplan,62 developed a range of recommendations that highlighted actions for federal policy makers, private industry, states and local communities, schools, and parents, all with the goal of improving children's diets and increasing physical activity (IOM, 2005c) .63 In 2007, the IOM released a follow-up report called Progress in Preventing Childhood Obesity: How Do We Measure Up?
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Research Institute of the Children's Hospital at the University of Pennsylvania Perelman School of Medicine in Philadelphia when this report was published. 70 Impact of IOM Reports (Database)
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. To drive progress, the committee -- chaired by external volunteer Daniel R
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The standing committee, which was sponsored by the RWJF, was designed to bring together leaders from government, academia, and corporate entities to have ongoing policy discussions and guide the selection of topics for future IOM workshops and consensus studies. Between 2009 and 2013, the standing committee held six meetings and workshops that covered topics related to food marketing, legal strategies, parents and children, and health equity in the prevention of childhood obesity.
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The committee, which was chaired by Richard J Bonnie,77 identified underage drinking as a serious public health concern due to risks associated with "traffic fatalities, violence, unsafe sex, suicide, educational failure, and other problem behaviors." In an effort to curb underage drinking and attempt to prevent it altogether, the committee described strategies that could be 75 Mary Jane England was President of Regis College in Weston, Massachusetts, when this report was released.
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The report, which was produced by a committee chaired by external 78 Impact of IOM Reports (Database) , IOM/NAM Records.
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Isham81 -- reviewed counseling options, TRICARE requirements, and determinants of high-quality care. In its report, the committee recommended that TRICARE BOX 6-6 IOM Reports on Posttraumatic Stress Disorder (PTSD)
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. The IOM followed up on the 2010 TRICARE report with a pair of reports in 2013 and 2014 that responded to the physical and psychosocial needs of military personnel returning from wars in Afghanistan and Iraq, as well as the needs of their families: Returning Home from Iraq and Afghanistan: Assessment of Readjustment Needs of Veterans, Service Members, and Their Families82 (2013)
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For example, in 1996 the IOM released a report called In Her Lifetime: Female Morbidity and Mortality in Sub-Saharan Africa, which cut across a variety of neglected health concerns and chronic conditions. In sub-Saharan Africa, women's health had largely been neglected due in large part to competing public health and social priorities.
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In the early 1990s, the Board on International Health (later renamed the Board on Global Health) proposed an international symposium and series of workshops to examine lead in the environment and possible health risks in the Americas.
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In 2004 the IOM followed up on Clearing the Air with a related report called Damp Indoor Spaces and Health. The report included a comprehensive literature review that confirmed that there was sufficient evidence to support a linkage between "damp indoor environments and some upper respiratory tract symptoms, coughing, wheezing, and asthma symptoms" in sensitive populations (IOM, 2004f)
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. The committee, chaired by external volunteer Irva Hertz-Picciotto,97 presented 13 research-oriented recommendations that, if implemented, could lead to a better understanding of the underlying environmental risk factors for breast cancer and how these risk factors might be mitigated.
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The first time the board stepped into this advisory function was during the Carter administration, when Congress requested an IOM study "to determine opportunities, if any, for broadened programs in areas of international health." The board's first report, Strengthening U.S. 99 "Report of the Visiting Committee on Global Health," April 9, 2001, IOM/NAM Records.
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investments in health systems abroad in a report called Investing in Global Health Systems: Sustaining Gains, Transforming Lives. In its review, the committee, which was co-chaired by external volunteers John E
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Gostin was the Linda and Timothy O'Neill Professor of Global Health Law and the Director of the World Health Organization Collaborating Centre on Public Health Law and Human Rights at the Georgetown University Law Center in Washington, DC, when this report was released. 112 IOM Council Minutes, July 8, 2013, IOM/NAM Records.
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. The committee, which was co-chaired by NAS member Joshua Lederberg114 and external volunteer Robert E
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. In addition to its broad review of infectious diseases and emerging global health threats, the IOM also concentrated a segment of its work on specific mosquito-borne diseases such as malaria and Zika, and other infectious diseases, such as TB.
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. The presenters and participants at these international workshops discussed a range of topics that included the "increasing burden of drug-resistant tuberculosis," the "new challenges to traditional TB control and treatment programs" that drug-resistant TB presented, and the urgent need for "the global health community to collaborate and share scientific information in new and different ways," as well as country-specific experiences and needs in managing drug-resistant TB locally (IOM, 2012p, p.
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Disaster Preparedness and Response As with infectious diseases and emerging health threats, terrorism and natural disasters often have a global reach that requires varying degrees of international response and preparedness. Following the terrorist attacks of September 11, 2001, the IOM along with many government agencies and interested stakeholders, began reevaluating disaster preparedness plans.
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and education of service providers, ensuring appropriate guidelines for the protection of service providers, and developing public health surveillance for pre-event, event, and post-event factors related to psychological consequences" (IOM, 2003j, p.
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In 2015, the IOM released a report called Healthy, Resilient, and Sustainable Communities After Disasters. Not 127 Robert R
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leadership and investment in global health -- a position that gained new importance amid the COVID-19 pandemic and drove an related focus on environmental health and climate change, which threatened to increase the spread of novel infectious diseases. Over five decades, the IOM, the NAM, and the HMD produced a sweeping body of work in the area of public health -- with subjects ranging from individual infectious disease outbreaks to the worldwide burden of chronic illness, from recommendations for the implementation of specific U.S.
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