Lebanon — Community efforts can have a big impact on improving health and addressing social ills that produce health disparities, but a range of supportive policies from federal, state and local governments also are necessary, according to a new report from the National Academies of Sciences, Engineering and Medicine.

“Health inequities are in large part the result of poverty, structural racism and discrimination,” Dartmouth-Hitchcock Chief Executive James Weinstein said at a Wednesday news conference in Washington.

Weinstein was chairman of a committee that released 463 pages of summaries, analyses and supporting materials that reported on a yearlong study that was funded by the Robert Wood Johnson Foundation.

The report cites studies that show the United States lags behind other countries in key measures of health and that within the U.S. there are wide disparities in health and overall well-being.

Weinstein noted a 25-year variation in life expectancies within such cities as New Orleans and Kansas City, and that 75 percent of 17- to 24-year-olds in the U.S. were disqualified from military service due to persistent health problems, lack of education or felony convictions.

Addressing the problems that underlie those numbers will require a comprehensive approach, he said: “We can talk about social determinants knowing that if we take on one, that’s only part of the problem.”

The committee examined programs and efforts in 105 communities and identified nine as models that could be emulated.

Bill Wyman, a Hanover consultant who also was on the 19-member committee, said the report “took a comprehensive view of the problem that no one else has ever done” and, by giving it the stamp of the National Academies of Sciences, had raised the profile of the issues addressed.

But the 11 a.m. news conference took place at the same time that President-elect Donald Trump held a long-awaited news conference in New York City. Trump and the Republican leadership in Congress have promised to repeal the 2010 Affordable Care Act.

That wouldn’t be good news for health, said Ned Calonge, a committee member and professor at the University of Colorado School of Medicine.

“Policies that decrease the number of insured Americans will have an inevitable impact on overall health,” he said. Still, he added, there are reasons for optimism.

Andrew Grant-Thomas, another committee member and co-founder of an Amherst, Mass., organization that promotes racial justice, took up that theme.

“Communities aren’t simply acted upon,” he said. “Communities are also actors in their own right.”

“Innovation can happen and can be scaled up,” he added.

Weinstein said that the promotion of the ideas in the report could get a boost by creating a database that would help “find explicit and implicit biases and eliminate them.”

“We all know this to be a crucial issue for the vibrancy … of our communities” and the nation, he said.

Addressing it will require collaboration and partnerships, he said. “Where the community makes those partnerships with the public-private sector, with the business community … the likelihood of success is much greater,” Weinstein said.

That view was reflected in the composition of the committee, according to Wyman.

“There was an attempt to bring to the committee expertise in a variety of fields,” he said, adding that he was included to offer a “business point of view.”

Weinstein also injected a note of optimism into the hourlong news conference.

“Nurture the next generation,” he said. “Give them the opportunity … to succeed, and we think they will.”

Rick Jurgens can be reached at rjurgens@vnews.com or 603-727-3229.