Population health is The health outcomes of a group of individuals, including the distribution of such outcomes within the group.(Source: ) It is a method of treating illness that seeks to enhance general human health. Three components have been identified as its constituent parts. These include “health outcomes, patterns of health determinants, and policies and interventions” .(Source: )
Reducing health inequities or disparities among various population groups caused by the social determinants of health (SDOH), among other factors, is a priority thought to be crucial to reaching the goal of population health. The social, environmental, cultural, and physical elements that affect various populations at birth, as they develop, and as they go through life are all included in the SDOH.
The concept of population health denotes a shift in emphasis from individual-level care, which is the hallmark of most mainstream medical practices. Additionally, by targeting a wider range of issues that have been demonstrated to effect the health of various populations, it aims to supplement the traditional efforts of public health authorities.
According to a 2008 report by the Commission on Social Determinants of Health of the World Health Organization, these factors account for the majority of illnesses and injuries and are the main drivers of health disparities worldwide.[/3] According to estimates, 70% of preventable deaths in the US are due to SDOH.*[4]
Population of Healthy People 2020
The US Department of Health and Human Services is the sponsor of the website Healthy People 2020, which is the culmination of 34 years of work by the Surgeon General’s office and other stakeholders. About 1200 distinct goals are explored to promote population health, and 42 issues are identified as social determinants of health. In order to realistically address these issues, it recognizes and promotes the necessity of community involvement and offers links to the most recent research on a few chosen areas.(8)
Economic inequality
Epidemiologists’ interest in the topic of economic disparity and its connection to population health has grown recently. The relationship between health and socioeconomic position is quite strong. This correlation implies that illnesses including heart disease, ulcers, type 2 diabetes, rheumatoid arthritis, some types of cancer, and premature aging are prevalent across all socioeconomic levels, and that it is not just the poor who get sick when everyone else is well. The cause of the SES Gradient is up for question, despite its existence. Due to the superior financial means of the wealthy, several academics (A. Leigh, C. Jencks, and A. Clarkwest; see also Russell Sage working papers) detect a clear correlation between economic position and mortality.
Even after adjusting for financial means and access to healthcare, socioeconomic position has a significant impact on health, according to study by other scientists like Richard G. Wilkinson, J. Lynch, and G.A. Kaplan. The Whitehall studies, a group of investigations on London’s public officials, are most known for establishing a connection between socioeconomic position and health.
The research revealed a robust relationship between socioeconomic position and health, even though all civil officials in England had equal access to healthcare. The results of the research showed that this association persisted even after accounting for behaviors that have an impact on health, like drinking, smoking, and exercise. Additionally, it has been seen that receiving medical care will not lessen a person’s risk of developing type 1 diabetes.
Finally, research has shown that there is no correlation between a nation’s wealth and overall population health among the richest 25% of nations on Earth (a group that includes Slovakia and Luxembourg)[1]. This finding suggests that, beyond a certain threshold, relative wealth levels within a nation have a greater influence on population health than absolute wealth levels.
The idea of psychosocial stress makes an attempt to explain how various diseases linked to the SES gradient can be caused by psychosocial phenomena like social stratification and status. Elevated economic disparity typically exacerbates societal stratification and generally deteriorates the caliber of interpersonal connections, culminating in elevated degrees of stress and stress-associated ailments.
Richard Wilkinson discovered that this held true for both the wealthiest and the poorest members of society. Everyone’s health suffers from economic inequality. The health of human populations is not the only thing that inequality affects. Less egalitarian social systems among several monkey species were shown to be connected with greater levels of stress hormones among socially subordinate individuals, according to research by David H. Abbott of the Wisconsin National monkey Research Center. Similar results are obtained by Stanford University researcher Robert Sapolsky.
Geographic Inequality
Numerous nations worldwide have well-documented differences in health outcomes according to geographic location. This covers the United States of America along with the geographic variance in health care consumption and expenditures, all the way down to the level of Hospital Referral Regions, which are defined as regional health care markets that may span state lines and of which there are 306 in the country.
[10][9] Nonetheless, there are restrictions on the quantity, source, and geographic scope of health indicator data available for sub-national regions. Region, or comparable major subnational organizations, is the predominant geographic level for both mortality and morbidity indicators among the 38 OECD nations.
The availability of health indicators in smaller geographic areas was few and varied greatly depending on the geographic definition, health indicator, population age range, and years available. Geographic boundaries were all based solely on administrative definitions.11]
The proportional contributions of place, education level, poverty, gender, and race to these variations are still up for debate. In order to lessen the confounding effects of neighborhood (geographic) variables on the outcomes, the Office of Epidemiology of the Maternal and Child Health Bureau advises applying an analytical technique (Fixed Effects or hybrid Fixed Effects) to studies on health inequalities.[Reference required]
Subfields
Family planning
Population health is greatly impacted by family planning initiatives, which include contraception, sexuality education, and the encouragement of healthy sexual behavior. One of the medical therapies that is most cost-effective is family planning.In [14] Family planning lowers the risk of unplanned pregnancy and the spread of STDs, saving lives and money.In [14]
As an illustration, the US Agency for International Development enumerates the following advantages of its global family planning initiative:In [15]\
“Protecting the health of women by reducing high-risk pregnancies”
“Protecting the health of children by allowing sufficient time between pregnancies”
“Fighting HIV/AIDS through providing information, counseling, and access to male and female condoms”
“Reducing abortions”
“Supporting women’s rights and opportunities for education, employment, and full participation in society”
“Protecting the environment by stabilizing population growth”
Mental health
Public health practice interventions, social, economic, and environmental policy interventions, and health care system interventions are the three primary categories of population-based approaches to mental health. Hospital administrators and the healthcare system work together to mediate health care system initiatives.
Enhancing the effectiveness of clinical mental health services, advising and educating community partners, and exchanging aggregate health data to guide public mental health policy, practice, and planning are a few examples of these approaches. Public health department representatives mediate public health practice initiatives.
Changing policies, starting PSAs to lessen the stigma associated with mental illness, and reaching out to more people to make community mental health resources more accessible are some examples of these initiatives. Social, economic, and environmental policy interventions are carried out by administrative policy makers and elected politicians.
These can include lessening the instability associated with money and housing, altering the built environment to add more green space to cities and reduce noise pollution at night, and lessening the structural stigma associated with mental illness.In [16]
Population health management (PHM)
Population health management (PHM) is “the technical field of endeavor which utilizes a variety of individual, organizational, and cultural interventions to help improve the morbidity patterns (i.e., the illness and injury burden) and the health care use behavior of defined populations” and is one way to improve population health.(17) By incorporating additional chronic illnesses and disorders, using “a single point of contact and coordination,” and utilizing “predictive modeling across multiple clinical conditions,” PHM differs from disease management.18]
Because PHM encompasses both “personal health management… for those at lower levels of predicted health risk” and “intensive care management for individuals at the highest level of risk,” it is thought to be more comprehensive than disease management.19]
To assist healthcare organizations in navigating the path toward implementing efficient population health management, the following road map has been suggested:21]
Create accurate patient databases
Identify the patient-provider relationship.
Establish accurate numerators in the patient databases.
Track and evaluate cost and clinical metrics
Follow the fundamental guidelines for clinical practice.
Take part in outreach for risk management
Obtain outside data
Interact with patients
Inform and interact with patients
Create and follow guidelines for difficult clinical practice.
Effectively coordinate the patient’s care with the care team.
Monitor certain results
Healthcare reform and population health
Modifications to established hospital reimbursement structures are being driven by healthcare reform. Before the Patient Protection and Affordable Care Act (PPACA) was passed, hospitals received payment via fee-for-service models that were contingent on the number of procedures performed.
Value-based reimbursement models are replacing volume-based approaches under the PPACA. The foundation of new reimbursement models is pay for performance, or value-based reimbursement, which links financial rewards to patient outcomes and has fundamentally altered how US hospitals must operate to stay in business.21] Hospitals must prioritize enhancing population health in addition to lowering expenses and enhancing the patient experience (IHI Triple Aim[23]).
Initiatives like accountable care organizations (ACOs), which are based on value-based reimbursement, will contribute to population health as their participation grows.24] Hospitals operating under the ACO model are required to focus on prevention, adhere to strict quality standards, and closely monitor patients with chronic illnesses.Reference [25] More money is paid to providers who keep their patients well and out of the hospital.Reference [25]
Research indicates that throughout the last ten years, the number of hospital admissions has decreased in areas that were among the first to adopt the ACO model and that used population health strategies to treat “less sick” patients in the outpatient environment.(26] Inpatient use rates decreased in all age categories, with an average 5% decrease in inpatient admissions, according to a Chicago region research.In [27]
Hospitals are discovering that concentrating on population health management and maintaining community health is financially beneficial.(28) Improving patient outcomes and building health capital are the two main objectives of population health management. Preventing illness, bridging care gaps, and lowering provider costs are other objectives.29] The development of telehealth services, community-based clinics in areas where a high percentage of residents use the emergency room for primary care, and patient care coordinator positions to coordinate healthcare services across the care continuum have all received increased attention in the past few years.(28)