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The Institute of Medicine: Adising the Nation, Improing Health The Institute of Medicine (IOM) is an independent, nonprofit organization that works outside of government to provide unbiased and authoritative advice to decision makers and the public. Established in 1970, the IOM is the health arm of the National Academy of Sciences, which was chartered under President Abraham Lincoln in 1863. Nearly 150 years later, the National Academy of Sciences has expanded into what is collectively known as The National Academies, which comprises the National Academy of Sciences, the National Academy of Engineering, the National Research Council, and the IOM. During the century-and-a-half that has passed, much has changed in the world, particularly in the field of health and medicine. In 1863, for example, doctors conducted surgery, but infection and death were wide- spread, largely because hands and instruments often went unwashed before surgery. Surgical antisepsis did not begin to spread widely in prac- tice until after the late 1860s. Since then, we have seen the development of vaccines for diseases ranging from tetanus to polio. The world has wit- nessed the eradication of smallpox, a disease that sickened an estimated 50 million people per year as recently as the early 1950s. During the same time that such major advances were made, new diseases continued to emerge. HIV/AIDS, identified in the early 1980s, has killed millions around the globe. Humans are living longer, more productive lives, but increasing numbers are also burdened by chronic disease. While hunger remains a 

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 I NforMINg THe fuTure: Critical Issues in Health serious problem in disadvantaged populations, affluent countries such as the United States are experiencing an alarming rise in obesity. The IOM is well equipped to adapt to such an ever-changing environment. With a mission to advise the nation on matters of health and med- icine, the IOM takes its role very seriously. Many of the studies that the IOM undertakes begin as specific mandates by Congress; still others are requested by federal agencies and independent organizations. The IOM applies a distinct research process to provide objective and straightforward answers to difficult questions of national importance. Committees who conduct these studies are carefully composed to ensure the requisite expertise and to avoid conflict of interest. These leading national and international scientists, all of whom serve as volunteers, are asked to set aside preconceptions and to rely on evidence in the pursuit of knowledge and truth. Even after this work is accomplished, the rigorous IOM process is not yet complete. Before any IOM report is released, it undergoes extensive peer review by a second group of experts, which remains anonymous to the authoring committee until the study is published. For nearly 40 years, this process has resulted in sound IOM reports providing policy makers, the health professions, and the American people with objective advice grounded in evidence. Each year, more than 2,000 individuals, members, and nonmembers volunteer their time, knowledge, and expertise to advance the nation’s health through the work of the IOM. Membership in the IOM is offered to 65 individuals each year, elected by the current membership, and drawn from a range of health care professions; the natural, social, and behavioral sciences; and fields such as law, economics, engineering, and the humani- ties. For those at the top of their field, membership in the Institute of Medicine reflects the height of professional achievement and commitment to service. The IOM works to improve health through shared knowledge. While expert, consensus committees are vital to its advisory role, the IOM also convenes a series of forums, roundtables, and standing committees to facil- itate discussion, discovery, and critical, cross-disciplinary thinking. The forums and roundtables at the IOM bring together leaders in government and industry, scientists and other experts from academia, practitioners, representatives of public interest groups, and consumers. The IOM offers

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 The Institute of Medicine a mutual venue for open dialogue, on topics as complex and diverse as new drug discovery and development, public health and medical preparedness, evidence-based medicine, environmental health sciences, neuroscience and nervous system disorders, health disparities, and microbial threats. At the IOM, individuals of goodwill from diverse perspectives can gain shared understanding and fresh insights. If a topic matters in an important way to health, sooner or later it will find a place on the agenda of the IOM. In addition, the IOM is home to several fellowship programs. For more than three decades, the IOM has managed The Robert Wood Johnson Foundation Health Policy Fellowships Program, which is designed to develop the capacity of outstanding mid-career health professionals in aca- demic and community-based settings to assume leadership roles in health policy and management. The body of this book illustrates the work of IOM committees in selected, major areas in recent years, followed by a description of IOM’s convening and collaborative activities and fellowship programs. The last section provides a comprehensive bibliography of IOM reports published since 2007.

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