Population Health and Nursing Care

Nursing Care and Population Health

Whats is Population Health,Model of Implementation of Population Health,Elements of Population Health,Management Activities,Model of Population Health,Main Focus of Population Health

Whats is Population Health

    The term population health is fairly new. Current emphasis on improving health outcomes, eliminating health disparities, and reducing health care costs amplify its importance, but a single accepted definition of population health has yet to emerge. 

    Szreter (2003) traces the origin of the concept of population health back to an historic 18th century debate over the relationship between economic growth and human health. 

    In an article titled Producing Health, Consuming Health Care, RG Evans and Stoddart (1990) merged concepts and principles from economics and epidemiology to support the idea that health is determined by multiple factors. In 1997 in a book titled Purchasing 

Population Health 

   Paying for Results, Kindig defined population health as “the aggregate health outcome of health adjusted life expectancy (quantity and quality) of a group of individuals, in an economic framework that balances the relative marginal returns . from multiple determinants of health” (p. 47). 

    Kindi's definition proposed a unit of measure for population health and underscored a relationship between economics and health.

Model of Implementation of Population Health

    In 2001, two models for implementing population health were published, one in Canada and the other in the United States. In July 2001, Health Canada published a draft document titled The Population Health Template: Key Elements and Actions That Define a Population Health Approach. 

    The publication consolidated current understandings of population health and outlined procedures and processes for implementing a population health approach. 

    The health Canada template defined population health as “the health of a population as measured by health status indicators and as influenced by social, economic, and physical environments, personal health practices, individual capacity and coping skills, human biology, early childhood development , and health services” (Health Canada, p. 2). 

Elements of Population Health

    The population health template also identified eight key elements of a population health approach: 

(1) focusing on the health of populations

(2) addressing the determinants of health and their interactions

(3) basing decisions on evidence

(4) increasing upstream investments

(5) applying multiple strategies

(6) collaborating across sectors and levels

(7) employing mechanisms for public involvement

(8) demonstrating accountability for health outcomes (Health Canada).

Management Activities 

    The Department of Defense Tricare Management Activity (DoDTMA) published a Population Health Improvement Plan and Guide in December 2001. 

    The guide adopted Kindig's definition of population health and outlined an approach to population health improvement focused on balancing awareness, education, prevention, and intervention activities to improve the health of a specified population (DoDTMA, 2001). 

    Much like the Health Canada template, the DoDTMA guide identified several process steps for population health improvement: 

(a) identifying the population

(b) forecasting demand

(c) managing demand

(d) managing capacity

(e) implementing evidence based primary, secondary, and tertiary prevention

(f) community outreach

(g) analyzing performance and health status.

Model of Population Health

    In 2003, McAlearney published a model for population health in a book titled Population Health Management: Strategies to Improve Outcomes. The author used the term “population health management to describe a variety of approaches developed to foster health and quality-of-care improvements while managing costs. 

    McAlhaney outlined several major steps for implementing population health management programs: targeting the program, selecting the strategies, implementing and managing the program, and integrating critical factors.

    In March of 2003, in an article titled What is Population Health? Kindig and Stoddart attempted to distinguish population health from public health, health promotion, and social epidemiology. The authors also set out to determine if population health was a field of study of health determinants or a concept of health. 

    Following a critique of existing definitions and understandings of population health dating back to the early 1990s, the authors concluded that population health is concerned with both the definition and measurement of health outcomes and the roles of determinants. 

    Kindig and Stoddart defined population health as the health outcomes of a group, including the distribution of the outcomes within the group, and argued that the field of population health included health outcomes, patterns of determinants of health, and interventions and policies that link outcomes with determinants.

Main Focus of Population Health

    Current understandings and definitions of population health emphasize the link between multiple determinants of health and health outcomes. Population health is focused on improving the health status of populations, enhancing health care quality and access, and decreasing costs. 

    A population health approach targets entire populations; intervenes with families, communities, systems, and individuals; recognizes and emphasizes multiple determinants of health; incorporates primary, secondary, and tertiary prevention ; and includes ongoing assessment, monitoring, and improvement.