The Institute of Medicine (IOM) Roundtable on Population Health Improvement brings together individuals and organizations that represent different stakeholders (e.g., from the public and private sectors and from health and health care) in a dialogue about what is needed to improve population health. The roundtable engages members and outside experts, practitioners, and organizations on three core issues: exploring community action in transforming the conditions that influence the public’s health, supporting fruitful interaction between clinical care and public health, and strengthening governmental public health.
The IOM Roundtable on the Promotion of Health Equity and the Elimination of Health Disparities was created to enable dialogue and the discussion of 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 to reduce disparities, and (3) the emergence of new leadership.
On December 5, 2013, the two roundtables co-sponsored a workshop, Accelerating a Movement to Improve Health and Promote Health Equity, to explore the lessons that may be gleaned from social movements, both those that are health-related and those that are not primarily focused on
1 The planning committee’s role was limited to planning the workshop. Statements, recommendations, and opinions expressed are those of individual presenters and participants, and are not necessarily endorsed or verified by the IOM, and they should not be construed as reflecting any group consensus.
health. The workshop was organized by an independent planning committee in accordance with the procedures of the National Academy of Sciences. The planning committee was co-chaired by David Kindig and Mildred Thompson and was composed of Terry Allan, Marthe Gold, George Isham, Sanne Magnan, and Mary Pittman. The task of the committee was to plan and conduct a public workshop featuring presentations about and discussions of such topics as (1) elements identified from the history and sociology of social change movements and (2) optimizing how such elements can be applied to present-day efforts nationally and across communities to improve the chances for long, healthy lives for all (i.e., with health equity) (see Box 1-1). Unlike a consensus committee report, a workshop summary may not contain conclusions and recommendations, except as expressed by and attributed to individual presenters and participants. Therefore, this summary has been prepared by the workshop rapporteurs as a factual summary of what occurred at the workshop.
Roundtable members became interested in learning about movement building as they became increasingly aware of the signs of movements occurring across the country, focused on organizing communities around issues important to them and linked with health. The roundtable members believed it was important to learn and engage in dialogue about scholarship and practical experiences with movement building both in the realm of health and in other areas of society.
The idea of movements and movement building is inextricably linked with the history of public health (see, for example, Hoffman, 2003; Morley, 2007; and Appendix C). Historically, most movements—including, for example, those for safer working conditions, for clean water, and for safe
BOX 1-1 Statement of Task
An ad hoc committee will plan and hold a public workshop that will feature presentations on and discussion of topics such as (1) elements identified from the history and sociology of social change movements and (2) optimizing how such elements are applied to present-day efforts nationally and across communities to improve the chances for long, healthy lives for all (i.e., with health equity). The committee will develop the agenda and identify specific meeting objectives, select and invite speakers and other participants, and moderate the discussions. An individually authored summary of the presentations and discussions at the workshop will be prepared by a designated rapporteur in accordance with institutional guidelines. An individually-authored brief workshop summary will also be prepared by a designated rapporteur in accordance with institutional guidelines
food—have emerged from the sustained efforts of many different groups of individuals, which were often organized in order to protest and advocate for changes in the name of such values as fairness and human rights.
Movements are complex phenomena in the social life of nations and communities; their causes, evolution, tools, objectives, and achievements are varied, contested, and sometimes controversial. Social scientists, advertising executives, and other experts may disagree greatly about what constitutes a movement. The purpose of the workshop was not to focus on definitions and theoretical purity, but instead simply to have a conversation about how to support the fragments of health movements that roundtable members believed they could see occurring in society and in the health field. Recent reports from the National Academies have highlighted evidence that the United States gets poor value on its extraordinary investments in health—in particular, on its investments in health care—as American life expectancy lags behind that of other wealthy nations (IOM, 2012; NRC and IOM, 2013). As a result, many individuals and organizations, including the U.S. Department of Health and Human Services Healthy People 2020 initiative, have called for putting the nation on the track for better health and longer lives for all; hence the interest of the two roundtables in learning about movement building. As Kindig and Thompson explained in their opening remarks, exploring the essential ingredients of social movements, as described by scholars and practitioners, is important information for accelerating a population health and health equity movement. The equity component relates to a recognition that socially unfair circumstances, sometimes created by longstanding policies, force some individuals and groups to live, work, study, and play in environments that make the healthy choice the harder choice. Many examples provided by speakers illustrate how the disempowered can become empowered to make their voices heard, and ultimately, to join with others in actions that change their neighborhoods and communities.
The workshop was moderated by roundtable leaders Thompson, Isham, and Kindig, and it featured invited speakers providing three standalone presentations and taking part in two topical panels. Chapter 2 of the workshop summary offers a synopsis of the morning’s keynote presentations, which provided insights from sociology and the history of social movements. Chapters 3 through 5 focus on specific topics and include overviews of one or more speaker presentations; in each chapter the overview is followed by a section that synthesizes a group discussion that was led by moderators and included roundtable members and audience members. Chapter 3 summarizes the first panel’s presentations on lessons from practitioners in health-related movements, Chapter 4 describes the perspective of a philanthropic organization that supports communities