Population health: At odds with person-centered healthcare

AJPM Focus, 2023

It has long been recognized that the majority of health outcomes are influenced by social circumstances, environmental exposures, behavioral patterns, and genetics and less than 15% come from medical care.1 Each person's risk of illness must be considered in the context of disease risk of the population to which he or she belongs, lending truth to the statement that one's zip code has greater impact on health than one's genetics. This powerful link between individual and population health outcomes was first articulated in 2003 by Kindig et al as the concept of population health, defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group".2 Kindig conceptualized populations as geographically defined communities or subgroups of people with a shared racial/ethnic background or comorbid conditions

Canadian Journal of Public Health, 2000

Population health is challenging health promotion as the dominant discourse in Canadian health policy. Its influence is seen in the renaming of government branches and departments and the numerous documents addressing population health. 1 The impetus for this challenge has come from work by the Population Health Group of the Canadian Institute for Advanced Research (CIAR), an international group consisting primarily of health economists and epidemiologists. 1,2 This editorial examines the implications for health research and action of the CIAR vision of health as presented in the key document, Why are Some

Population Health Management, 2017

Population health management (PHM) has increasingly been mentioned as a concept to realize improvements in population health and quality of care while reducing cost growth (the so-called Triple Aim). The concept of PHM has been used in various settings and has been defined in different ways. This study compared the definitions of PHM used in the literature in order to improve the understanding and interpretation of the concept of PHM. A scoping literature search was performed for papers published between January 2000 and January 2015 that defined PHM. PHM definitions were summarized, focusing on: (1) overall aim, (2) PHM activities, and (3) contextual factors. Eighteen articles were retrieved. The overall aim was defined in terms of health (N = 14), costs (N = 8), and/or quality of care (N = 10). Definitions varied regarding the description of PHM activities, though all definitions contained elements in common with disease management and health promotion. Data management, Triple Aim assessment, risk stratification, evaluation, and feedback cycles were less likely to be mentioned. Contextual factors were scarcely brought forward in the definitions. Moderate variations were found across definitions in the way PHM was conceptualized. Frequently, essential elements of PHM were not specified. Differences in conceptualizations of PHM should be taken into account when comparing PHM initiatives that are working toward improvements in population health, (experienced) quality of care, and reduction of costs. (Population Health Management 20xx;xx:xxx-xxx)

Journal of Health Politics, Policy and Law, 2003

Despite renewed interest in population health concerns, elevation of this field in policy considerations faces many challenges. At present there is much concern about disparities and meeting improved population health objectives, but interest waxes and wanes with scientific developments and especially with dominant political alignments and ideologies. If the field of population health is to have sustained policy influence, it requires a persistent constituency, a strong organizational base both within and outside of government, and academic respectability. Population health faces many issues in seeking to become legitimized as both a unique field of study and as a significant force in public policy. Among these are a clear definition of the boundaries of the field, a continuing flow of resources for development, and attractive career structures for new recruits and future leaders.

Health Promotion International, 2002

Population health as developed by the Canadian Institute for Advanced Research (CIAR) has influenced the shape and direction of Canadian public health policy, and has the potential to do so in the USA and elsewhere. There is reason to be concerned about this ascendence of CIAR thinking: population health is rooted within epidemiology, a militantly quantitative discipline; population health eschews analysis of societal structures as determinants of health; and population health elevates scientific understanding over health promotion action. Its lack of an explicit values base is also problematic. Policy makers should recognize these and other limitations as they consider models for a new public health.

2013

Owen B. Adams authorizes the University of Ottawa, its successors and assignees, to make reproductions of the thesis by photographic means of by photocopying and to lend or sell reproductions at cost to libraries and to scholars requesting them. The right to publish the thesis by other means and to sell it to the public is reserved for the author.

Australian Journal of Primary Health, 2005

This paper provides a review of recent developments in population-based approaches to community health and explores the origins of the population health concept and its implications for the operation of health service management. There is a growing perception among health professionals that the key to improving health outcomes will be the implementation of integrated and preventive population-based resource management rather than investment in systems that respond to crises and health problems at the acute end of the service provision spectrum only. That is, we will need increasingly to skew our community health and welfare investments towards preventive care, education, lifestyle change, self-management and environmental improvement if we are to reduce the rate of growth in the incidence of chronic disease and mitigate the impact of these diseases upon the acute health care system. While resources will still need to be devoted to the treatment and management of physical trauma, infectious diseases, inherited illness and chronic conditions, it is suggested we could reduce the rate at which demand for these services is increasing at present by managing our environment and communities better, and through the implementation of more effective early intervention programs across particular population groups. Such approaches are known generally as population health management, as opposed to individual or illness-based health management-or even public health-and suggest that health systems might productively focus in the future on population level causation and not just upon disease-specifi c problems or illness management after the fact. Population health approaches attempt to broaden our understanding of causation and manage health through an emphasis on the health of whole populations and by building healthy communities rather than seeing "health care" as predominantly about illness management or responses to health crises. The concept also presupposes the existence of cleaner and healthier environments, clean water and food, and the existence of vibrant social contexts in which individuals are able to work for the overall good of communities and, ultimately, of each other.

Population health management, 2017

In 2016, Keyes and Galea issued 9 foundational principles of population health science and invited further deliberations by specialists to advance the field. This article presents 7 foundational principles of population health policy whose intersection with health care, public health, preventive medicine, and now population health, presents unique challenges. These principles are in response to a number of overarching questions that have arisen in over a decade of the authors' collective practice in the public and private sectors, and having taught policy within programs of medicine, law, nursing, and public health at the graduate and executive levels. The principles address an audience of practitioners and policy makers, mindful of the pressing health care challenges of our time, including: rising health-related expenditures, an aging population, workforce shortages, health disparities, and a backdrop of inequities rooted in social determinants that have not been adequately tra...

Delaware Journal of Public Health, 2019

American Journal of Public Health, 2006