AHSG’s latest report examines the epidemic proportion of firearm injury in the United States—more than 48,000 Americans lost their lives to firearms in 2021, twice that many were injured, and millions more experienced the trauma associated with such violence. This report presents AHSG’s five big ideas to address the problem and includes background papers providing an overview of the causes and consequences of gun violence, the American culture of guns, and the use of harm reduction and community intervention techniques to curb violence.

This Aspen Health Strategy Group report offers five big ideas for protecting health data privacy and improving patient care. Action steps include: Congress should update federal health data privacy laws, health data privacy laws should reflect social norms, all entities that hold health data should have clear policies, health sector leaders should advance a new covenant of health data use and consumer participation in health data privacy practices should become the norm. Background papers provide a fuller context for these ideas.

Despite having the highest incarceration rate in the world, the US pays little attention to the poor health of its incarcerated population and the widespread harm it causes. To reduce the danger, we need to repeal the Medicaid exclusion for this population, prioritize health in correctional systems, upgrade quality standards of carceral health, coordinate care within and outside carceral settings, and dramatically reduce the level and consequences of incarceration.

Every year, 700 US women die from pregnancy or delivery complications and 50,000 more face serious health consequences. Maternal mortality rates are rising steadily, with Black women facing much higher risks. To alter these outcomes, we need ambitious national goals for improvement, community-based models of care, insurance coverage aligned with women’s needs, a broad commitment to tackling the racism that weakens maternity care, and research investments.

Antimicrobial resistance kills 35,000 Americans every year and countless more at risk, and threatens effective treatment of cancer, tuberculosis, HIV, malaria and other diseases. Lodging antibiotic stewardship in health systems, reducing consumer demand for antibiotics, taking a coordinated One Health approach to their use in humans, animals and agriculture, redesigning the antibiotic pipeline, and investing in more research are critical to curbing dangerous trends.

Chronic diseases are the leading cause of death and disability in the United States, accounting for 86% of the nation’s $2.7 trillion annual health care expenditures, yet we spend more to treat them than to prevent them. Strategies to reduce the burden include a national campaign to reduce obesity, policies that promote healthy eating, engagement across sectors and at the community levels, and investments in prevention.

In the US alone, some 33,000 people died from opioid overdoses in 2015, a staggering two million people are abusing prescription pain relievers, and the crisis has shown no signs of abating. Confronting the epidemic requires that we reduce overprescribing; reorient policy to treat addiction as a medical condition, not a crime; distribute lifesaving naloxone more broadly; guarantee access to treatment, and invest in research.

Care toward the end of life reflects the best and worst of the American health system: amazing medical advances delivered by dedicated clinicians, but often provided in the context of a fragmented health system, with its attendant high costs and poor coordination and communication among clinicians, patients, and families. New approaches are needed to honor patient preferences and meet their medical, social, and spiritual needs.