Moving Forward

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By Tom Dennison, Faculty Director

Population Health – The Next Challenge

The term ‘population health’ has become increasingly popular in discussions about health and health care in the United States. It has been welcomed by many in the public health community because it resonates with public health’s historic focus on community and population-wide interventions that collectively help people to be healthy. For public health, the term “population health” can be used to link good health with upstream drivers of health for entire communities. Interestingly though, this term has also been adopted by the medical care delivery system, which often adds ‘management’ to population health thereby changing its meaning.

‘Population Health Management’ has simultaneously broadened the definition of medical care to incorporate factors that impact health outside the traditional biomedical model (such as social determinants of health) and narrowed the definition of “public health” by focusing, often, on groups of patients, covered by a particular health plan or cared for by a particular provider to achieve specific outcomes. It has become a focus of the health information technology industry, which emphasizes the use of electronic health information to identify, assess, and stratify provider panels and manage groups of patients.

New care delivery and payment models, many of which were catalyzed by the Patient Protection and Affordable Care Act (PPACA), share a number of dimensions that are consistent with “population health” such as defined populations and use of population wide metrics. Increasingly, the way care is being paid for incorporates dimensions of population health management.

The challenge of population health is one that fits well with the work of the Lerner Center. The common theme that plays directly into and supports the work of “population health” is that health promotion, whether it is done by the traditional public health system or by the medical care delivery system, recognizes the importance of the social and economic determinants of health and the need to develop strategies to address them. The Center has a rich portfolio of such health promotion interventions, with the Monday Campaigns as a centerpiece.

But having this portfolio is not enough; to successfully incorporate these interventions in the community requires strong partnerships. The Lerner Center’s focus on community engagement and empowerment has built a strong foundation to address social determinants on the ground. And the partnerships that have formed with the local medical care delivery system positions the Center to help them broaden their focus from the medical care of their patient to providing care to that patient in his or her community context.

Regardless of how population health is defined, it is an opportunity to expand the reach of health promotion by integrating the traditional roles played by public health and the medical care system to collectively address social determinants of health. This is an opportunity that will shape the work of the Lerner Center in years to come.

 

Read more about the Lerner Center’s work over the past five years: