What is Population Health Anyway?
Population Health seems to be quite the buzzword these days. Unfortunately, many of us are still in the dark as to what the real definition of Population Health truly is, even though the term was defined after a study published in the American Journal of Health back in 2003. That’s when Dr. David Kindig and Dr. Greg Stoddart got together and realized that Population Health was being used more and more often and the longer it went without an actual definition, the more confusing it would become. They decided to do some research and put together a clear definition of Population Health, including a definition for the field that studies Population Health.
The same time that Kindig and Stoddart put their heads together to define Population Health, other countries were beginning to apply the same concept to their own healthcare industries. In fact, Canada was in front of the U.S. in terms of addressing Population Health, although they had yet to clearly define it themselves. So right before Kindig and Stoddart came out with their definition, the Health Promotion and Programs Branch of Health Canada released this statement:
“The overall goal of population health approach is to maintain and improve the health of an entire population and to reduce inequalities in health between population groups.”
Health Canada indicated that there should be one guiding principle of a population health approach and that that was to be “An increased focus on health outcomes (as opposed to inputs, processes, and products) and on determining the degree of change that can actually be attributed to our work.”
Still, there wasn’t a clear definition and the risk of not clearly defining what population health truly was meant that the more widely used the term became, would render its meaning more confusing than helpful so for that reason, Kindig and Stoddart published their study and proposed what is now the widely-accepted meaning of Population Health. Here is what their study proposed:
“We propose that the definition be “the health outcomes of a group of individuals, including the distribution of such outcomes within the group,” and we argue that the field of population health includes health outcomes, patterns of health determinants, and policies and interventions that link these two.
You can read the full study by Kindig and Stoddart as published by the American Journal of Public Health here: Am J Public Health. 2003 March; 93(3): 380–383.
So why has Population Health become so important to the healthcare industry overall? Recent studies have shown that actual medical care only accounts for somewhere between 10-20% of overall health. After that, aside from genetics, you’ll find that upwards of 60-80% of health is attributed to individual behavioral patterns, social factors, and environmental exposures. Based on these findings, improving overall health outcomes of your patients will rely on more than just providing medical care. You’ll need to go beyond the regular care you provide to truly gain an understanding of the health determinants affecting that patient. In other words, you need to gain an understanding of the range of personal, social, economic, and environmental factors that influence the health status of the patient. This is what Population Health is all about.
In an article published by the World Health Organization, they purport that the context of people’s lives determines their health, and so blaming individuals for having poor health or crediting them for good health is inappropriate. Individuals are unlikely to be able to directly control many of the determinants of health. Here are few of the health determinants that made their list.
· Income and social status – higher income and social status are linked to better health. The greater the gap between the richest and poorest people, the greater the health differences.
· Education – low education levels are linked with poor health, more stress, and lower self-confidence.
· Physical Environment – safe water and clean air, healthy workplaces, safe houses, communities, and roads all contribute to good health.
· Employment and working conditions – people in employment are healthier, particularly those who have more control over their working conditions.
Their list goes on to include social support networks, culture, genetics, personal behavior and coping skills, health services and gender. You can read the entire article about determinants of health here: The Determinants of Health.
With the onset of MACRA and the Quality Payment Program, it is going to be very important that providers across the U.S. begin to understand their patient population much more than they previously did. Because the industry overall is turning to reimbursement based on quality of care instead of quantity of care, it will become crucial that clinicians understand the bigger picture to have a better impact on improving health outcomes. Population Health technology, as it begins to emerge for private practices, will be an essential tool for achieving success in today’s healthcare environment.