Population Health Policies And Interventions
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Population health Population health has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". It is an approach to health that aims to improve the health of an entire human population. It ha ...
, a field which focuses on the improvement of the health outcomes for a group of individuals, has been described as consisting of three components: "health outcomes, patterns of health determinants, and policies and interventions". Policies and Interventions define the methods in which health outcomes and patterns of health determinants are implemented. Policies which are helpful "improve the conditions under which people live". Interventions encourage healthy behaviors for individuals or populations through "program elements or strategies designed to produce behavior changes or improve health status". Policies and interventions are needed due to the inequalities amongst populations and the inconsistent way care is administered. Policies can include "necessary community and personal social and health services" as well as taxes on alcohol and soft drinks and implement smoking cessation policies. Interventions can include therapeutic or preventative health care and may also include actions taken by the individual or by someone on behalf of the individual. The application of population health is determined by the policies and interventions which can be implemented within an organization, city, state or country.


Common methodology

Countries, states, provinces and providers across the globe are shifting towards better systems to respond to inconsistent health outcomes, mitigate decreasing margins and replace outdated methods such as
fee-for-service Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality ...
health delivery. Payment model reforms, including the
Accountable Care Organization An accountable care organization (ACO) is a healthcare organization that ties provider reimbursements to quality metrics and reductions in the cost of care. ACOs in the United States are formed from a group of coordinated health-care practitione ...
(ACO), provide roadmaps for healthcare reform and drive many of its constituents towards more effective and innovative means for improving health outcomes. Population health management is a common approach for resolving these challenges but it involves new methods, tools, systems and implementations to correct inefficiencies and improve health outcomes. Population health tools and computer systems include data exchange, large datasets, and advanced software which are used to supply data scientists and research teams with appropriate information which can then be used by policy makers and change agents. This method helps to set policies around population health as well as intervention strategies which are then used to respond to the needs of a population.


Policies and policymakers

Policy for population health "sets priorities" and are a "guide to action to change what would otherwise occur". Policies are based on "social sciences of sociology, economics, demography, public health, anthropology, and epidemiology" and determine how outcomes can be accomplished are implemented at various levels. Such guides determine laws, policies, and ordinances and are defined by policymakers. Examples of policies include "smoking bans, excise taxes on cigarettes and alcohol, seat belt laws, water fluoridation, and restaurant menu labeling". They may be applied to a commercial establishment such as a restaurant, business workplace or within a city or state level. Policies should be evidence based and require academic studies or research to support the approach. This will assure that the appropriate measures needed for each demographic are promoted to encourage the necessary intervention practices which can be applied to each population or to the nation as a whole. Policymakers can be classified as both private and public and are defined as someone who is in a position of authority to implement health policies. A public policy maker could be a government official and a private policymaker could be a business owner or administrator. Policymakers are influenced by, and can also be, change agents. Change agents include "legislators in Washington, an attorney general, regulators at the FDA, an advocacy group or other organizations that clearly have influence".


Political strategy

The goal for any political strategies surrounding population health is to "improve chances of success for policy adoption and implementation". Such strategies include the creation of funds to support initiatives and the construction of strategies which limit conflicts of interest in the implementation of public policy.


Tobacco control

A political strategy implemented to limit the sale and exposure to tobacco products and restrict the tobacco company's ability to benefit politically from charitable donations is the creation of the World Health Framework Convention on Tobacco Control (FCTC) treaty. The legally binding document is supported by numerous countries, government/nongovernment agencies and provides the necessary power to prevent negative influences on population health policies.


Interventions

Interventions in population health "shift the distribution of health risk by addressing the underlying social, economic and environmental conditions" and are implemented through "programs or policies designed and developed in the health sector, but they are more likely to be in sectors elsewhere, such as education, housing or employment". They are aimed at reducing such things as
childhood obesity Childhood obesity is a condition where excess body fat negatively affects a child's health or well-being. As methods to determine body fat directly are difficult, the diagnosis of obesity is often based on BMI. Due to the rising prevalence of ...
,
cardiovascular disease Cardiovascular disease (CVD) is a class of diseases that involve the heart or blood vessels. CVD includes coronary artery diseases (CAD) such as angina and myocardial infarction (commonly known as a heart attack). Other CVDs include stroke, h ...
, smoking and mental health issues throughout society. The means in which interventions are devised is through extensive research and contributions from medical scientists, researchers, and medical professionals. They are implemented by but are not limited to educators, practicing physicians, business administrators and mental health professionals.


Approaches and implementations

A typical approach includes assessing the conditions and possible improvements which can be made within the social determinants that have been identified. Each approach is handled at a state or health plan level. One example was a workplace in China which implemented policies and interventions for their staff to fight depression. By recognizing the importance of mental health, they were able to reduce depression and improve job satisfaction across the company. The company published its research and findings to promote "enterprises taking more responsibility for the provision of mental health services to their employees". Another example was the implementation of a smoking cessation program to the province of Ontario. Studies were performed on weekly visit rates to psychiatric emergency departments before and after the implementation. The result was a "15.5% reduction in patient visits for patients with a primary diagnosis of psychotic disorder".


Inequalities and variance of implementation

As is the common understanding of population health, health inequalities, defined as a "generic term used to designate differences, variations, and disparities in the health achievements of individuals and groups", must be considered to correctly implement the most effective policies and interventions. Based on a population and its socioeconomic, geographic, ethnicity and other factors, policies and interventions may vary. Policies implemented for one population may be less effective and more costly than it would be for another similar population. For example, US policies tend to be more costly than European and have less impact. Research has shown that in some instances, "Americans had worse outcomes than their international peers" and also had "the lowest life expectancy at birth of the countries studied".


See also

*
Population health Population health has been defined as "the health outcomes of a group of individuals, including the distribution of such outcomes within the group". It is an approach to health that aims to improve the health of an entire human population. It ha ...
*
Community health Community health refers to simple health services that are delivered by laymen outside hospitals and clinics. Community health is also the subset of public health that is taught to and practiced by clinicians. Community health volunteers and communi ...
*
Economic inequality There are wide varieties of economic inequality, most notably income inequality measured using the distribution of income (the amount of money people are paid) and wealth inequality measured using the distribution of wealth (the amount of we ...
*
Health disparities Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequiti ...
* Health impact assessment *
Inequality in disease Social epidemiology focuses on the patterns in morbidity and mortality rates that emerge as a result of social characteristics. While an individual's lifestyle choices or family history may place him or her at an increased risk for developing cer ...
*
List of countries by income equality A ''list'' is any set of items in a row. List or lists may also refer to: People * List (surname) Organizations * List College, an undergraduate division of the Jewish Theological Seminary of America * SC Germania List, German rugby union ...
*
Social determinants of health The social determinants of health (SDOH) are the economic and social conditions that influence individual and group differences in health status. They are the health promoting factors found in one's living and working conditions (such as the d ...
*
Sin tax A sin tax is an excise tax specifically levied on certain goods deemed harmful to society and individuals, such as alcohol, tobacco, drugs, candies, soft drinks, fast foods, coffee, sugar, gambling, and pornography. In contrast to Pigovian tax ...
*
Sugary drinks tax A sugary drink tax, soda tax, or sweetened beverage tax (SBT) is a tax or surcharge (food-related fiscal policy) designed to reduce consumption of sweetened beverages. Drinks covered under a soda tax often include carbonated soft drinks, sport ...
*
WHO Framework Convention on Tobacco Control The World Health Organization Framework Convention on Tobacco Control (WHO FCTC) is a treaty adopted by the 56th World Health Assembly held in Geneva, Switzerland on 21 May 2003. It became the first World Health Organization treaty adopted under ...
(FCTC)


References


Further reading

* * Agafonow, Alejandro (2018)
Setting the bar of social enterprise research high. Learning from medical science
''Social Science & Medicine'' Vol 214, October, Pages 49–56, DOI: 10.1016/j.socscimed.2018.08.020


External links

* http://www.improvingpopulationhealth.org/blog/policies-and-programs.html {{Public health Demography Global health Health economics Social classes