Advancing Health Equity For Native American Youth

More than 2 million Americans below age 24 self-identify as being of American Indian or Alaska Native descent. Many of the serious behavioral, emotional, and physical health concerns facing young people today are especially prevalent with Native youth (e.g., depression, violence, and substance abuse). Adolescent Native Americans have death rates two to five times the rate of whites in the same age group because of higher levels of suicide and a variety of risky behaviors (e.g., drug and alcohol use, inconsistent school attendance). Violence, including intentional injuries, homicide, and suicide, accounts for three-quarters of deaths for Native American youth ages 12 to 20. Suicide is the second leading cause of deathâ€"and 2.5 times the national rateâ€"for Native youth ages 15 to 24. Arrayed against these health problems are vital cultural strengths on which Native Americans can draw. At a workshop held in 2012, by the National Academies of Sciences, Engineering, and Medicine, presenters described many of these strengths, including community traditions and beliefs, social support networks, close-knit families, and individual resilience. In May 2014, the Academies held a follow-up workshop titled Advancing Health Equity for Native American Youth. Participants discussed issues related to (1) the visibility of racial and ethnic disparities in health and health care as a national problem, (2) the development of programs and strategies by and for Native and Indigenous communities to reduce disparities and build resilience, and (3) the emergence of supporting Native expertise and leadership. This report summarizes the presentations and discussions from the workshop.

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.

This book focuses on promoting health equity and addressing health disparities among Indigenous peoples of the United States (U.S.) and associated Territories in the Pacific Islands and Caribbean. It provides an overview of the current state of health equity across social, physical, and mental health domains to provide a preliminary understanding of the state of Indigenous health equity. Part 1 of the book traces the promotive, protective, and risk factors related to Indigenous health equity. Part 2 reports promising pathways to achieving and transcending health equity through the description of interventions that address and promote wellness related to key outcomes. The chapters in this book were originally published as a special issue of the Journal of Ethnic & Cultural Diversity in Social Work.

In November 2017, the The Forum on Promoting Children's Cognitive, Affective, and Behavioral Health, in collaboration with the Roundtable on the Promotion of Health Equity, convened a workshop on promoting children's behavioral health equity. The workshop used a socio-ecological developmental model to explore health equity of children and families, including those with complex needs and chronic conditions. Particular attention was paid to challenges experienced by children and families in both rural and urban contexts, to include but not limited to poverty, individual and institutional racism, low-resourced communities, and hindered access to educational and health care services. Workshop participants also engaged in solution-oriented discussions of initiatives, policies, and programs that aim to improve social determinants of health, opportunities for behavioral health promotion, and access to quality services that address the behavioral health of all children and families. This publication summarizes the presentations and discussion of the event.

Children are the foundation of the United States, and supporting them is a key component of building a successful future. However, millions of children face health inequities that compromise their development, well-being, and long-term outcomes, despite substantial scientific evidence about how those adversities contribute to poor health. Advancements in neurobiological and socio-behavioral science show that critical biological systems develop in the prenatal through early childhood periods, and neurobiological development is extremely responsive to environmental influences during these stages. Consequently, social, economic, cultural, and environmental factors significantly affect a child's health ecosystem and ability to thrive throughout adulthood. Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity builds upon and updates research from Communities in Action: Pathways to Health Equity (2017) and From Neurons to Neighborhoods: The Science of Early Childhood Development (2000). This report provides a brief overview of stressors that affect childhood development and health, a framework for applying current brain and development science to the real world, a roadmap for implementing tailored interventions, and recommendations about improving systems to better align with our understanding of the significant impact of health equity.

For children and youth, summertime presents a unique break from the traditional structure, resources, and support systems that exist during the school year. For some students, this time involves opportunities to engage in fun and enriching activities and programs, while others face additional challenges as they lose a variety of supports, including healthy meals, medical care, supervision, and structured programs that enhance development. Children that are limited by their social, economic, or physical environments during the summer months are at higher risk for worse academic, health, social and emotional, and safety outcomes. In contrast, structured summertime activities and programs support basic developmental needs and positive outcomes for children and youth who can access and afford these programs. These discrepancies in summertime experiences exacerbate pre-existing academic inequities. While further research is needed regarding the impact of summertime on developmental domains outside of the academic setting, extensive literature exists regarding the impact of summertime on academic development trajectories. However, this knowledge is not sufficiently applied to policy and practice, and it is important to address these inequalities. Shaping Summertime Experiences examines the impact of summertime experiences on the developmental trajectories of school-age children and youth across four areas of well-being, including academic learning, social and emotional development, physical and mental health, and health-promoting and safety behaviors. It also reviews the state of science and available literature regarding the impact of summertime experiences. In addition, this report provides recommendations to improve the experiences of children over the summertime regarding planning, access and equity, and opportunities for further research and data collection.

The case for evidence and collaboration in pursuit of health equity In this second volume of the Culture of Health series, Advancing Health and Well-Being convenes experts from academia, policy, journalism, and community-based organizations, among other sectors, to examine how data and narrative can catalyze progress toward building a national Culture of Health. Tackling topics such as health inequity, mass incarceration, and climate change, Advancing Health and Well-Being does more than draw lines between cause and effect; its 70+ voices lend context and lived experience to critical conversations that may lack such elements. The result is a work that shows the power and promise of evidence and collaboration. Amid continued interest in population health and well-being, this book offers essential reading for those advancing such efforts, and those seeking an early grounding, in pursuit of a Culture of Health.