INSTITUTE OF MEDICINE

The Institute of Medicine was chartered by the National Academy of Sciences in 1970 "to improve the health of the American people and peoples of the world" by advancing health science and providing analysis of important issues in health and health policy for government, the professions, the private sector, and the public. The institute carries out its work largely through committees of pro bono experts who employ an evidence-based deliberative process to produce nonpartisan reports, symposia, workshops, and roundtables. Studies originate in several ways. The U.S. Congress may mandate a government agency to contract with the institute; there may be a direct request from government agencies, or from foundations or other private organizations; or, for those projects of high importance and sensitivity that might not be requested by outside organizations, studies may be initiated by the institute.

The institute's portfolio is extensive, ranging from issues of scientific integrity to the future of particular areas of health-science research. A landmark 1988 institute report, The Future of Public Health, identified many of the critical challenges to public health education, practice, and applications. That report is about to be updated. In 1998, the institute developed the prototype leading indicators for Healthy People 2010, the nation's blueprint for health prevention. The importance of community organization and partnerships in furthering public health has been underscored by a number of reports on healthy communities and community organization, and a series of studies on health and behavior and on the role of the social and behavioral sciences in health have important implications for public health as well as other aspects of medicine. A 1992 report, Emerging Infections: Microbial Threats to Health in the United States, was among the earliest warnings with regard to these issues, including the development of antibiotic-resistant organisms. It has been followed by a number of efforts in both public and private sectors to respond to these threats.

The Institute of Medicine is responsible for the recommended dietary allowances of vitamins and other nutrients in the American diet, and it has provided guidelines for nutrition, to diminish chronic illnesses. As an independent nongovern-mental entity, the institute has initiated studies with a profound impact on public health. The 1986 report, Confronting AIDS: Direction for Public Health, Healthcare, and Research, addressed what had been to that time a largely ignored epidemic. Subsequent reports have addressed needle exchange and perinatal AIDS (acquired immunodeficiency syndrome), and a 2000 report provided a new vision for HIV (human immunodeficiency virus) prevention in the United States. In addition to providing the research community with priorities for a new AIDS vaccine, this report also provided analysis and advice with regard to the complications of vaccines, barriers to immunization, and appropriate uses of vaccines.

Several studies have focused on environmental issues, including environmental justice, environmental and occupational instruction in medicine and nursing, and environmental roles in a number of illnesses, including asthma. Among the reports issued on tobacco, the 1994 report, Growing Up Tobacco Free: Preventing Nicotine Addiction in Children and Youths, was particularly influential in establishing national policy. The institute also conducts a program in international health, including efforts to control hepatitis and diarrheal diseases in the Middle East, conducted by a collaboration of American, Israeli, Egyptian, and Palestinian scientists. More recently, scientists from Jordan have participated in programs addressing problems of water conservation and micronutrients in the region.

The institute also has an honorific function. It elects sixty regular members, five senior members, and five foreign associates each year. Elected members include many leaders in public health, nutrition, environmental science, and social and community medicine. Members also include leading ethicists, economists, and social and behavioral scientists.

All of the publications of the Institute of Medicine are published on the web site of its publisher, the National Academy Press, at www.nap.edu. Information on the institute and its current activities can be found at www.iom.edu.

Kenneth I. Shine

(see also: National Academy of Sciences; Prevention Research )