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Forging Connections in a Disconnected World The part can never be well unless the whole is well.  —Plato, Charmides, or Temperance   Plato’s ancient dictum, written in 380 BCE, remains relevant today. The good health and well-being of any individual comprises the health of many different elements of the body, from the central nervous system to the skin. The health of a community similarly depends on such elements as walk- ability and access to healthcare services or play spaces. Likewise essential is a robust healthcare system that can effectively care for all people, healthy or infirm, old or young, rich or poor, without discrimination. And in an interconnected world, everyone’s health depends on containing infectious diseases, mutual progress against chronic diseases, and building capacity and sustainable systems, especially in countries with fewer resources. The Institute of Medicine (IOM) works at each of these levels, from the individual to the global, frequently bringing to light the ways in which meeting a need in one area can simultaneously serve other good ends. For example, among the recommendations in a 2010 IOM report on reduc- ing sodium intake was a call for food manufacturers to reduce sodium in processed foods. In response, America’s largest food retailer announced in January 2011 a commitment to reformulate many packaged foods, including national brands and its own brand, to reduce sodium. This deci- sion could have many consequences—for the thousands of individuals and families who shop for groceries there, as well as those who shop elsewhere for the same food products that have been modified to include less sodium. Reducing sodium consumption may result in fewer cases of hypertension, 1

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2 I NFORMING THE FUTURE: Critical Issues in Health or high blood pressure, which affects nearly one in three American adults and is one of the nation’s leading causes of death. A global reduction in sodium intake, in part spurred by reports such as this, could help reduce cardiovascular disease, which now accounts for nearly 30 percent of deaths in low- and middle-income countries each year and produces major eco- nomic repercussions. The IOM often generates just this type of ripple effect—a single recommendation by a committee of experts can result in behavior change and systems change worldwide.  The IOM is an independent, nonprofit organization that serves as adviser to the nation to improve health. Established in 1970 under the char- ter of the National Academy of Sciences, the IOM provides independent, objective, evidence-based advice to policy makers, health professionals, business and civic leaders, and the public. Every report from the IOM aims to untangle complicated health matters of great importance. Including both consensus studies, in which expert committees deliberate until coming to agreement on the recom- mendations they will make, and workshop summaries, which highlight the themes and presentations from working meetings, the IOM issues more than five dozen reports a year. Some of IOM’s consensus studies begin as specific mandates by Con- gress; others are requested by federal agencies or suggested by independent organizations. Work is conducted by committees that are carefully com- posed of the foremost thought leaders to ensure the requisite expertise and to avoid conflict of interest. Coming together from various fields of study, these national and international experts grapple with vexing problems and use science-based evidence to reach conclusions and recommendations. Valuable connections across different disciplines and perspectives— from government, academia, business, the professions, and the public—are made through the IOM’s forums and roundtables. These bring together diverse stakeholders who share common interests in a specific area of health policy. The conversation and collaboration that take place within the forums and roundtables foster mutual understanding, unexpected insights, and creative solutions.  The IOM is both a research and an honorific organization. Its 1,800 elected members and foreign associates bring a plethora of experience and donate their time and expertise to IOM activities. Membership in the IOM is an honor, presented to 70 accomplished individuals each year. The mem- bers are drawn from the health professions and from the natural, social,

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3 Forging Connections in a Disconnected World and behavioral sciences, as well as from law, ethics, engineering, admin- istration, and the humanities. Election to the IOM represents both high professional recognition and a commitment to service.   As part of its educational effort, the IOM houses several fellowship programs. For more than three decades, the IOM has managed the Robert Wood Johnson Health Policy Fellowships Program, which is designed to develop the capacity of outstanding midcareer health professionals in aca- demic and community-based settings to assume leadership roles in health policy and management. The more recently instituted Anniversary Fellowship Program, created to celebrate the 35th anniversary of the IOM’s establishment, enables talented, early-career health science scholars to participate actively in the work of the IOM and to further their careers as future leaders in the field.  This book highlights the work that IOM volunteers and staff have completed in recent years, followed by a description of IOM’s collaborative activities and fellowship programs. The final section provides a compre- hensive bibliography of IOM reports published since 2009. We hope this collection provides insight into the nature of our work and the distinctive, valuable role in health and health policy played by the IOM.

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