The diet of many Americans remains unhealthy, contributing to high rates of childhood and adult obesity that are associated with health outcomes such as heart disease and stroke. To promote wellness, the healthcare industry must go beyond treating individuals with chronic conditions to also address the risks of different population segments before they reach advanced stages of illness.

1. ACCESS TO HEALTHY FOOD:
A CRITICAL STRATEGY FOR SUCCESSFUL
POPULATION HEALTH MANAGEMENT
Rachel S. Permuth, PhD, MSPH
National Director of Research, Sodexo USA

2. A BROADER APPROACH TO IMPROVING
THE U.S. HEALTH STATUS
The diet of many Americans remains unhealthy, contributing
to high rates of childhood and adult obesity that are associated
with health outcomes such as heart disease and stroke. To
promote wellness, the healthcare industry must go beyond
treating individuals with chronic conditions to also address
the risks of different population segments before they reach
advanced stages of illness.
Population Health Management (PHM) is helping to shift the focus
towards wellness using a broader perspective that promotes
improved health outcomes for entire groups or populations.
Taking into consideration the social, economic, environmental
and behavioral factors that contribute to health disparities
and continuum of care, PHM takes a systematic approach by
stratifying populations across health-risk profiles and applying
different behavioral strategies to mitigate further risks.
For example, many lower income communities have little access to
supermarkets or outlets that sell healthy foods. As a result, these
populations adopt bad eating habits that contribute to their high
rates of obesity. According to the Healthy Eating Index developed
by the USDA Center for Nutrition Policy and Promotion, people
from low-income households, individuals with less education, and
persons who are 19 to 39 years of age are more likely to consume
a poor diet.1
One important strategy critical to the success of
PHM, therefore, is increasing national access to nutritious foods in
support of healthier diets and disease prevention.
THE LINK BETWEEN DIET AND CHRONIC DISEASE
Today, more than one-third (78.6 million) of U.S. adults are obese.3
In 2008, medical care costs in the U.S. associated with adult
obesity were estimated as high as $147 billion.4
Eighty-six percent
of the nation’s health care dollars are spent on the treatment of
chronic diseases.5
Many chronic diseases attributable to unhealthy
behaviors can be avoided by placing more emphasis on prevention
and identifying people at risk before they reach advanced stages
of illness. According to the CDC, state and federal governments
spend one thousand times more to treat disease than to prevent it
($1,390 vs. $1.21 per person each year).6
A healthier lifestyle that includes nutritious foods can help
individuals avoid obesity and other health risks. In fact, healthy
behaviors such as eating nutritious foods determine 50% of an
individual’s well being, while medical care only determines 10%.7
Population-level improvements in healthy eating, however, require
greater accessibility to nutritious food.
BARRIERS TO HEALTHY FOOD ACCESS
Eating healthily is not always a choice for many Americans, as
millions of low-income adults and children live in neighborhoods
that lack convenient access to healthy foods. Long distances
to food stores and lack of transportation hinder trips to the
supermarket, prompting residents to shop at local convenience
stores that do not offer an adequate selection of healthy foods.
Lack of accessibility of nutritious foods results in unhealthy food
choices, leading to obesity and other health issues.
Food insecurity poses another challenge to healthy food
consumption. According to the USDA, food security for a household
is defined as access by all members at all times to enough food
for an active, healthy life.8
In 2013, more than 14% of American
households were food insecure due to a lack of resources.
Americans struggling to afford food tend to consume poor quality
food linked to chronic disease. Food insecurity appears to be
strongly associated with diabetes, particularly at the most severe
levels of food insecurity.9
Even marginally food secure households
IMPROVING HEALTH OUTCOMES OF CHRONIC
PATIENTS IS CRITICAL TO REDUCING COSTS2
THE MAJORITY OF INDIVIDUAL WELL BEING
IS NOT DETERMINED BY CLINICAL CARE7
50% Individual Behaviors
20% Environment
20% Genetics
10% Access to Care
50%
30%
10%
7%
1%
7%
22%
19%
23%
28%
US
Population
Health
Expenditures
■ Healthy ■ Stable ■ At Risk ■ Multiple Chronic Conditions ■ Advanced Illness

3. — those with occasional food shortages — have been found to be
at risk for adverse health.10
A lack of food accessibility may be a
reason for lower fruit and vegetable consumption recommended
by dietary guidelines.
A number of factors affect accessibility to healthy food such
as race and ethnicity, household income, location, and age.
For example:
as far to get to the nearest supermarket than their peers in
wealthier parts of town) are typically low-income neighborhoods
whose occupants have limited access to healthy food choices.11
and 1.3 times as many convenience stores compared to
about half the number of chain supermarkets compared to
have only a third as many.12
live in low-income areas that are more than a mile from a
supermarket. Of the 23.5 million, just under half have incomes
at or below 200% of the poverty line, and almost 1 million do
not have access to a car.13
insecurity, while another 9% of households comprised of seniors
living alone were also food insecure.14
This lack of access is
less frequently associated with low income, but rather lack of
transportation, functional limitations or health problems, and
this number is growing rapidly as baby boomers age.15
INCREASING ACCESS TO HEALTHY FOODS
FOR THE U.S. POPULATION
Improving accessibility of nutritious foods to the entire
population, especially for those socioeconomic groups outlined
above, is key to improvement in health status. The following are
examples of initiatives that facilitate access to healthy foods
across different societal contexts.
1. Offering Healthful Choices at Work
In 2011, the CDC launched a National Healthy Worksite Program
in promoting good health to employees using wellness strategies
with measurable health outcomes. Among the NHWP’s initiatives
is support for good nutrition in the workplace, which includes
strategies for teaching employees about the benefits of healthy
eating as well as a food procurement policy that limits the
company’s purchase of certain foods and beverages for employee
consumption.16
Worksite nutrition programs consistent with NHWP guidelines
and whole-grain products; low-fat dairy products, lean meats,
poultry, fish, and legumes; and small amounts of salt, sugar and
saturated fat. Making these foods accessible, appealing, and
affordable to workers is an important step in the improvement of
worker health.
In 2014, the U.S. Departments of Health and Human Services,
Labor and the Treasury issued changes to workplace wellness
program rules that created new incentives and strengthened
policies to promote employer wellness programs and encourage
opportunities to support healthier workplaces (reference: http://
www.dol.gov/ebsa/newsroom/fswellnessprogram.html)
In addition to these federal programs, states such as California and
Texas have outlined worksite wellness programs that encourage
companies to voluntarily establish healthy meeting policies,
healthy menu dining guidelines, healthy vending machines and
other protocols that increase access to healthy foods.
While wellness programs do not necessarily provide access to
healthy foods, education, assessments and resources are provided
to support healthier eating. Because of the variability in program
components, populations and outcomes, it is difficult to determine
if wellness programs actually succeed in encouraging better eating.
Despite monetary and health incentives to eat and live healthier,
many people still do not make good decisions regarding their health
due to confusion about healthy foods, lack of motivation and
misconceptions about factors leading to chronic diseases.
While individual case studies from the NHWP program are not
yet available, studies on good nutrition at work have shown that
these programs contribute to better health, productivity gains,
improved worker morale, prevention of accidents and premature
deaths, as well as reduced healthcare costs. One study of 19,803
employees found that eating unhealthily is linked with a 66%
increased risk of loss of productivity.17
Another similar Vielife
study on 15,000 people in the United States and the U.K. found
U.S. HOUSEHOLDS BY FOOD SECURITY STATUS8
35%
of households below the
poverty threshold are
food insecure
20%
of households with
children are food insecure
9%
of all households
comprised of only seniors
are food insecure
49.1
million
people
live in food
insecure
households

4. that employees with poor nutritional balance reported 21%
more sickness-related absences and 11% lower productivity than
healthier colleagues.18
2. Emphasizing Healthier Foods in Schools
Schools provide an optimal opportunity to reinforce healthier
eating behaviors for children and adolescents. A number of
government programs administered by the Food and Nutrition
Service (FNS) focus on providing healthy food to children before,
during and after school, as well as in the summer.
One program in particular, the Fresh Fruit and Vegetable Program
(FFVP), provides free fresh fruits and vegetables to qualifying
elementary schools in an effort to introduce or increase children’s
consumption of a wider variety of produce.
On a broader basis, the Healthy, Hunger Free Kids Act of 2010
outlined new standards for school lunches to lead to better
nutrition. A recent Harvard study reported that under the updated
standards for school meals, kids are now eating 16% more
vegetables and 23% more fruit at lunch. During School Year 2014-
2015, schools will start to offer more fruits at breakfast.19
The Smarter Lunchroom Movement, initiated by the Cornell Center
for Behavioral Economics in Child Nutrition Program (B.E.N. Center),
also offers a set of best practices to improve children’s eating
behaviors in school lunchrooms. Focused on specific aspects of the
school meal, the best practices promote the use of signs, verbal
interaction and food displays, among other initiatives, to encourage
students to choose more fruits and vegetables with meals.
Best practices and lunchroom solutions endorsed by the
Smarter Lunchrooms Movement have been studied and proven
to be effective in schools throughout the nation.20
The B.E.N.
Center applies experimental research from the Cornell Food &
Brand Lab to school lunchrooms. Below are some results from
B.E.N. Center research:
102%
selection of vegetables from 40% - 70%
increase of up to 46% in white milk sales
advantage over the second option
line was introduced
Making It Happen!, a joint project of the Food and Nutrition
Service of the U.S. Department of Agriculture, the Division of
Adolescent and School Health of the CDC, Department of Health
and Human Services and the U.S. Department of Education,
shares school nutrition success stories from across the United
States. Reflecting diversity in both location and demographics,
featured schools explain how the implementation of innovative
strategies improved the nutritional quality of foods and beverages
sold outside of federal meal programs.
Among the successful tactics showcased in Making It Happen!
are the increased availability of healthful foods and beverages in
school lunchrooms, vending machines, concession stands, parties
and extra-curriculum activities, all of which make it easier for
students to make healthful food choices. Success stories can be
viewed at: http://www.fns.usda.gov/tn/making-it-happen-school-
nutrition-success-stories
3. Making Nutritious Food
More Accessible through SNAP
The Supplemental Nutrition Assistance
Program (SNAP), formerly the Food
Stamps Program, is the largest nutrition
assistance program administered by
the U.S. Department of Agriculture, with
more than 47.5 million participants.
While some studies note that SNAP contributes towards certain
aspects of improved nutrition, others speculate that it has led
some participants into greater risk of obesity.21
To encourage healthy eating and lifestyle behaviors, SNAP
participants are offered nutrition education through SNAP-Ed.
While states develop their own educational programs, the plan
follows federal nutrition guidelines, with a focus on a healthy diet,
physical activity, and balanced caloric intake.
90%
Percentage of schools reporting they are
meeting the updated nutrition standards19
SNAP INDIVIDUAL PARTICIPATION RATES BY AGE
FISCAL YEAR 2012
■ Children Under Age 18
■ Adults 18–59
■ Adults Age 60+
45%
9%
46%

5. To increase the availability of nutritious foods to SNAP
participants, new provisions were added to the Farm Bill in 2014
that require SNAP retailers to carry healthier food options. At
least 7 items in each of 4 basic food categories — fruits and
vegetables, grains, dairy and meat — and perishable items
in at least 3 of these categories, are required to meet certain
nutritional standards.22
The Farm Bill also offers financial incentives for food retailers
to operate in underserved communities. As many low-income
Americans do not have personal vehicles, the costs, security and
hassles associated with public transportation may limit shopping at
distant supermarkets. With supermarkets in more easy reach, SNAP
recipients are more likely to consume more fruits and vegetables.
Along the same lines, the Farm Bill supports the Food Insecurity
Nutrition Incentive (FINI) program for SNAP retailers, government
purchases of fruits and vegetables by SNAP participants through
incentives at the point of purchase.
4. Increasing Access to Farmers Markets
Community farmers markets are one of the best ways to make
healthy foods accessible to large numbers of people at one locale.
Produce sold at farmers markets usually costs the same or less
than seasonal produce at supermarkets. Over the past decade,
the number of markets across the United States has increased by
150%, growing to over 8,000 nationwide in 2014.23
Farmers markets provide an opportunity to bring affordable,
locally grown fruits and vegetables to low-income and urban
communities, particularly as the markets increasingly accept food
assistance programs like the Special Supplemental Program for
Women, Infants, and Children (WIC), the Farmers Market Nutrition
Program (FMNP) and SNAP.
Streamlined requirements for SNAP certification and grants
funding the installation of electronic benefit transfer (EBT)
systems are enabling more farmer markets to accommodate
SNAP customers. Between 2010 and 2011, the number of farmers
to over 2,400.20 SNAP sales also increased dramatically due to
new EBT projects, up 298% from $4,173,323 in fiscal year 2009
to $16,598,255 in fiscal year 2012.24
Some of the funds for the new EBT systems came from the
Farmers Market Promotion Program (FMPP) that, in 2011, began
toward improving access to fresh food in these areas. As a result
of the FMPP program, farmers markets who opened a new market
or local food distribution outlet to serve a vulnerable community
in 2011 were still in business serving that socioeconomic group a
year later.25
The Farm Bill also expands the FMPP in supporting direct farmer-
to-consumer marketing channels such as farmers markets and
community-supported agriculture. The newly expanded program
will provide grants to farm-to-institution, food hubs, and other
food enterprises to increase access to locally and regionally
produced agricultural products.
Through local funding and a grant secured through the FMPP,
a community activist, Adelante Mujeres, worked with the poor
Hispanic population (27% poverty rate) in a rural community west
of Forest Grove, Oregon, to increase economic and social equity
and boost healthy food access. This was achieved by initiating
a training program that mentored local producers about local
growing conditions and farm/business management so they
could successfully grow and market their produce.26
Products were guaranteed to be sold at the Forest Grove Farmers’
Market, which continues to draw new SNAP customers through the
introduction of EBT technology. Using USDA funding as leverage,
Adelante secured support from Pacific University and others for a
SNAP incentive program that provides a $5 match per customer
using SNAP to purchase food at the market. A FMPP grant supported
an outreach and marketing campaign targeted at senior and low-
income customers, who represent 40% of the local population.
During the FMPP funding period, foot traffic at the Forest Grove
Farmers’ Market nearly doubled, increasing from 800 customers per
week to 1,500. EBT redemption increased by 422% and 25 farmers
now regularly sell within Adelante Mujeres’ guaranteed markets,
which represent approximately 80% of their sales.
5. Bringing Healthier Foods To Seniors
In addition to participating in SNAP for assistance with buying
healthy foods, low-income seniors can engage in a Senior
Farmers’ Market Nutrition Program (SFMNP). The SFMNP provides
coupons for use at farmers’ markets and roadside stands in
participating states. In 2010, over 21,000 seniors visited 850
farmers, at 210 farmers’ markets and 70 roadside stands, to
purchase locally-grown fruits and vegetables.27
representing community-based senior nutrition programs across
the nation, provides over 1 million hot nutritious meals to seniors
2004 2006 2008 2010 2011 2012 2013 2014
9000
7200
5400
3600
1800
0
NATIONAL COUNT OF FARMERS MARKET
DIRECTORY LISTINGS23
3,706
4,385
4,685
6,132
7,175
7,864
8,144 8,268

6. on a daily basis. In October 2011, the U.S. Administration on Aging
entered into a cooperative agreement with the Meals On Wheels
Association of America to establish a new National Resource
Center on Nutrition and Aging (NRC) to cultivate innovative ideas
related to nutrition and aging in the United States.28
The NRC’s mission is to provide nutrition services for both current
and future older adult populations integrated into a home- and
community-based service system, and provide training and technical
assistance to the aging network regarding nutrition services.
Nutrition programs for older adults provide an important link
to other supportive in-home and community-based services. In
a recent national study, 80% of communities have programs
providing home-delivered meals for the elderly, while 25% provide
nutrition education.29
Another federal program, the Emergency Food Assistance
Program, supplements the diets of low-income Americans,
including seniors, by providing free emergency food and nutrition
assistance. Food is shipped to state centers and distributed
through different qualifying agencies.
Other state-sponsored food and nutrition programs and services
are available to seniors based on their residence. For example, the
New York State Office for Aging offers several programs to older
adults to maintain nutritious diets. Among them are Congregate
Meals where seniors can be transported to a congregration locale,
such as a senior center or church offering healthy meals. The state
also offers home-delivered meals for those who are housebound,
in addition to providing easy access to federal programs such as
SNAP and SFMNP.
6. Supporting Local Community Programs
In addition to serving seniors, local community programs are
successfully increasing healthy food access to low-income and
other socioeconomic groups. Understanding the particular issues
of their communities, local governments can support and even
expand public policies and programs to increase healthy food
access. Strategies can include creating incentives to attract
more grocery stores and food outlets to certain neighborhoods,
advertising programs such as SNAP to create greater awareness
and participation among low-income residents, and improving
transportation routes to supermarkets.
Local food councils can take advantage of grant money and
ensure programs are working to boost accessibility of healthy
foods to different communities. Incentives could include tax
credits, grant and loan programs, and small business or economic
development programs.
Some of the resources that support community programs include:
USDA’s Farmers’ Market Promotion Program, Specialty Crop Block
Grants, Community Food Projects, Community Facilities Program,
Business and Industry Guaranteed Loan Program, Healthy
Urban Food Enterprise Development Center, and Sustainable
Communities Regional Planning Grant Program; HHS’ Community
Economic Development Program; and the U.S. Department of
Housing and Urban Development’s Community Development
Block Grant and Choice Neighborhood Initiative.
Across the country, these resources are funding community and
urban programs that focus on healthy food access. For example,
New York City uses a combination of incentives and restrictions to
get green produce carts in areas of the city with the least access
to fruits and vegetables. Detroit and Cleveland have reclaimed
vacant land and lots for community gardens. And vendors in
Kansas City who sell healthy foods pay a reduced permit fee.13
OTHER FACTORS SUPPORTING
POPULATION HEALTH MANAGEMENT
While it is evident that the United States is taking a closer look
at guiding its population toward healthier foods, rising food
costs and sustainability are other important issues related to
Population Health Management. Some of these issues go hand-
in-hand, as many low-income Americans cannot afford to buy
healthier foods even if they have access to them.
Addressing inequitable access to food is a major step in leading
Americans to eat healthier. By identifying the health risks of
different socioeconomic groups and formulating strategies that
address their specific needs, Population Health Management can
help Americans adopt healthier eating habits. According to the
USDA, healthier diets could prevent at least $71 billion per year in
medical costs, lost productivity, and lost lives.6
At the same time,
a healthier workforce leads to greater productivity and savings by
American corporations.
Through collaborative efforts on federal, state and local
levels, and especially by U.S. businesses that employ diverse
population groups, these different strategies can be successfully
implemented, with results tracked to ensure their effectiveness.
By taking a more proactive and broader approach to improving
America’s health through a variety of initiatives focused on
specific groups, Population Health Management can lead the
U.S. population to healthier behaviors that will ultimately
reduce healthcare costs — while improving quality of life — by
preventing obesity-related chronic diseases.

7. References
1
Center for Nutrition Policy and Promotion. (n.d.). The Healthy Eating Index. Retrieved from http://www.cnpp.usda.gov/sites/default/files/healthy_eating_index/
HEI89-90report.pdf
2
Duncan, Ian. (2011). Healthcare Risk Adjustment and Predictive Modeling. Winsted, Connecticut: ACTEX Publications.
3
Centers for Disease Control and Prevention. (n.d.). Overweight and Obesity. Retrieved from http://www.cdc.gov/obesity/data/adult.html
4
Centers for Disease Control and Prevention. (n.d.). Chronic Disease Prevention and Health Promotion: Obesity. Retrieved from http://www.cdc.gov/chronicdisease/
resources/publications/aag/obesity.htm
5
Centers for Disease Control and Prevention. (n.d.). Chronic Disease Prevention and Health Promotion. Retrieved from http://www.cdc.gov/chronicdisease/
6
Nutrition Policy. (n.d.). Why good nutrition is important. Retrieved from https://www.cspinet.org/nutritionpolicy/nutrition_policy.html
7
Bipartisan Policy Center. (2012, August). “F” as in Fat: How Obesity Threatens America’s Future. Retrieved from http://www.rwjf.org/content/dam/farm/reports/
reports/2013/rwjf407528
8
United States Department of Agriculture. (2013). Food Security Status of US Households in 2013. Retrieved from http://www.ers.usda.gov/topics/food-nutrition-
assistance/food-security-in-the-us/key-statistics-graphics.aspx
9
Seligman, H.K., Laraia, B.A., & Kushel, M.B. (2010). Food insecurity is associated with chronic disease among low-income NHANES participants. The Journal of
Nutrition, 140(2), 304-310. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2806885/
10
Cook, J.T., Black, M., Chilton, M., et al. (2013). Are food insecurity’s health impacts underestimated in the U.S. population? Marginal food security also predicts
adverse health outcomes in young U.S. children and mothers. Advances in Nutrition, 4, 51-61. Retrieved from http://advances.nutrition.org/content/4/1/51.full.
pdf+html
11
Weisbecker, A. (2010, May 21). Few Healthy Food Choices in Urban Food Deserts. Food Safety News. 21 May 2010. Retrieved from http://www.foodsafetynews.
com/2010/05/few-healthy-food-choices-in-urban-food-deserts/#.VGEfGTTF-Dk
12
Treuhaft, S. & Karpyn, A. (2010). The Grocery Gap: Who Has Access to Healthy Food and Why It Matters. Retrieved from http://thefoodtrust.org/uploads/media_
items/grocerygap.original.pdf
13
Let’s Move. (n.d.). Solving the Problem of Childhood Obesity. Retrieved from http://www.letsmove.gov/sites/letsmove.gov/files/TFCO_Access_to_Healthy_
Affordable_Food.pdf
14
Coleman-Jensen, A., Gregory, C., & Singh, A. (2014). Household Food Security in the United States in 2013, Table 2. USDA ERS. Retrieved from
http://www.ers.usda.gov/media/1565415/err173.pdf
15
Ziliak, J.P. & Gundersen, C. (2013). Spotlight on Food Insecurity among Senior Americans: 2011. National Foundation to End Senior Hunger (NFESH).
16
Huffington Post Healthy Living. (2012). Healthy eating, exercise linked with workplace productivity. Retrieved from http://www.huffingtonpost.
com/2012/08/12/health-workplace-productivity-eating-nutrition-exercise_n_1752749.html
17
O’Reilly, S. (2006). Eating the Profits. Personnel Today. 4 July 2006: 26.
18
Centers for Disease Control and Prevention. (2013, August). National Healthy Worksite Program. Retrieved from http://www.cdc.gov/nationalhealthyworksite/
about/index.html
19
United States Department of Agriculture. (2014). Healthier School Day. Retrived from http://www.fns.usda.gov/healthierschoolday/tools-schools-offering-
fruits-and-vegetables
20
Cornell Center for Behavioral Economics in Child Nutrition Program. (n.d.). Smarter Lunchrooms Movement. Retrieved from http://smarterlunchrooms.org/ideas
21
Snap To Health. (n.d.). Snap and Obesity: The Facts and Fiction of SNAP Nutrition. Retrieved from http://www.snaptohealth.org/snap/snap-and-obesity-the-
facts-and-fictions-of-snap-nutrition/
22
The State of Obesity. (2014). The 2014 Farm Bill and Obesity Prevention. Retrieved from http://stateofobesity.org/farm-bill/
23
United States Department of Agriculture. (2014). Farmers Markets and Local Food Marketing. Retrieved from http://www.ams.usda.gov/AMSv1.0/ams.
fetchTemplateData.do?template=Template S&leftNav=WholesaleandFarmersMarkets&page= WFMFarmersMarketGrowth&description=Farmers+Market+Growth
24
United States Department of Agriculture. (2012). Healthy Food Access. Retrieved from http://www.usda.gov/documents/7-Healthyfoodaccess.pdf
25
United States Department of Agriculture, Food and Nutrition Service, Benefits Redemption Division. (2012).
26
Miller, S. & Roper, N. (2013). Farmers Market Promotion Program: grant activities & impacts 2006 – 2011. Retrieved from http://fmpp.farmersmarketcoalition.
org/wp-content/uploads/2013/06/FMC_FMPP_SurveyReport_7.10.2013.pdf
27
United States Department of Agriculture. (2014). Senior Farmer’s Market Nutrition Program. Retrieved from http://www.usda.gov/wps/portal/usda/
usdahome?contentid=kyf_grants_fns1_content.html
28
Meals On Wheels Association of America. (n.d.). Key Initiatives, Projects and Grants. Retrieved from http://www.mowaa.org/keyinitiatives
29
National Association of Area Agencies on Aging, International City/County Management Association, National Association of Counties, National League of
Cities and Partners for Livable Communities. (2005). The Maturing of America – Getting Communities on Track for an Aging Population, 2005. Retrieved from
http://www.livable.org/storage/documents/reports/AIP/maturing_of_america.pdf

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