A Population’s Health Isn’t Just about Healthcare
Improvement in population health requires action on multiple determinants, including medical care, health behaviors, and the social and physical environments; therefore, no single entity can be held accountable for achieving improved outcomes. Medical organizations, the government, schools, businesses, and community organizations all need to make substantial changes in how they approach health and allocate resources.1
“Community organizations have important roles, such as social services and urban planning, and businesses need to understand that they have to invest in their communities if they want a healthy future workforce,” says David A. Kindig MD, PhD, emeritus professor of population health sciences at the University of Wisconsin Madison School of Medicine and Public Health. “Everyone has a role to play.”
Healthcare organizations need to reach beyond their traditional roles to support these interventions.
“It is a team sport in 2015,” Dr. Kindig says. “For many decades, medical care was considered the most prominent factor for a population’s health. Of course it remains so, but from a population health perspective, these other factors are equally or even more important.”
According to county health rankings and roadmaps compiled for the entire United States by the University of Wisconsin, the following factors play a role in population health: clinical care, 20%; health behaviors (e.g. tobacco use, diet and exercise, sexual activity), 30%; social and economic factors (e.g. jobs, education, and social support), 40%; and physical environment (i.e., air and water quality, housing, and transit), 10%.2
The bottom line is that most determinants of health (80%) are nonclinical.
“Social determinants are the principal driver of well-being,” says David Nash, MD, MBA, founding dean of the Jefferson College of Population Health at Thomas Jefferson University in Philadelphia. “It’s mostly about what someone does every day to stay healthy.” TH
References
1. Kindig DA, Isham G. Population health improvement: a community health business model that engages partners in all sectors. Front Health Serv Manage. 2014;30(4):3-20.
2. Our approach. County Health Rankings & Roadmaps website. Available at: http://www.countyhealthrankings.org/our-approach. Accessed November 8, 2015.
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