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Population health policies and interventions

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Population health, a field which focuses on the improvement of the health outcomes for a group of individuals, has been described as consisting of 3 components. These are "health outcomes, patterns of health determinants, and policies and interventions"[1]. 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" [2]. Interventions encourage healthy behaviors for individuals or populations through "program elements or strategies designed to produce behavior changes or improve health status"[3].

This is in in response to the inequalities amongst populations and inconsistent ways care is administered. Policies can include "necessary community and personal social and health services" [2] as well as taxes on alcohol and soft drinks and implement smoking cessation policies. Intervention practices can include therapeutic or preventative health care and may also include actions taken by the individual. The application of population health is determined by the policies and interventions which are implemented within an organization, city, state or country.

Though population Health consists of "social sciences of sociology, economics, demography, public health, anthropology, and epidemiology" [4] its' policies and interventions component is aimed at standardizing the way it is implemented.

Common practices

As fee-for-service health delivery breaks down, states and providers are shifting towards new systems to mitigate decreasing margins. Payment model reforms, including the Accountable Care Organization (ACO), provide roadmaps for the system and will drive many of the 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 improve efficiencies and health outcomes. Data exchange and computer systems are used to bring policymakers, change agents, and research teams together to set policies around population health as well as intervention strategies to treat the patients according to the relevant research data for the population.

Policies and Policymakers

Policies for population health "sets priorities" [2] and are a "guide to action to change what would otherwise occur" [2]. They 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" [5]. 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 where a private 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"[6].

Political strategy

The goal for any political strategies surrounding population health is to "improve chances of success for policy adoption and implementation" [2]. 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 and governments as well as 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"[7] 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"[7]. They are aimed at reducing such things as childhood obesity, cardiovascular disease, smoking and mental health issues throughout society. The means in which they are devised is through extensive research and contributions from medical scientists, researchers, and medical professionals. They are implemented by and are not limited to educators, practicing physicians, business administrators and mental health professionals.

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" [8], 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. For instance, if the population favors smoking, stronger policies may need to be implemented to encourage smoking cessation.

Approaches and Implementations

A typical approach includes assessing the conditions and possible improvements which can be made within the social determinants which have been identified. Each approach is handled at a state or health plan level. A population-focused strategy is implemented to address the concerns of the approach.

One example is 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 was able to publish its approach and findings to promote "enterprises taking more responsibility for the provision of mental health services to their employees" [9]. Another example was the implementation of a smoking cessation program to psychiatric emergency department across the province of Ontario. Studies were performed on psychiatric emergency department weekly visit rates before and after the implementation. The result was a "15.5% reduction in patient visits for patients with a primary diagnosis of psychotic disorder" [10].

See also

References

  1. ^ Kindig, David; Stoddart, Greg (2016-10-15). "What Is Population Health?". American Journal of Public Health. 93 (3): 380–383. ISSN 0090-0036.
  2. ^ a b c d e Milio, N (2016-10-10). "Glossary: healthy public policy*". Journal of Epidemiology and Community Health. 55 (9): 622–623. doi:10.1136/jech.55.9.622. ISSN 0143-005X.
  3. ^ "What is an intervention?". health.mo.gov. Retrieved 2016-10-15.
  4. ^ Kindig, David A (2016-10-13). "Understanding Population Health Terminology". The Milbank Quarterly. 85 (1): 139–161. doi:10.1111/j.1468-0009.2007.00479.x. ISSN 0887-378X.
  5. ^ http://www.improvingpopulationhealth.org/blog/policies-and-programs.html
  6. ^ Interdisciplinary Association for Population Health Science (IAPHS), Christina Roberto, Ph.D. (Nov 18, 2015). "Building Bridges to Improve Population Health” (2015) – Public Policy Presentation #2 (YouTube). Event occurs at 2:33. Retrieved Oct 9, 2016.{{cite AV media}}: CS1 maint: date and year (link)
  7. ^ a b Hawe, Penelope; Potvin, Louise (2017-02-01). "What is population health intervention research?". Canadian Journal of Public Health = Revue Canadienne De Santé Publique. 100 (1): Suppl I8–14. ISSN 0008-4263.
  8. ^ "A Glossary for Health Inequalities", Journal of Epidemiology and Community Health (56): 647–652, 2002 {{citation}}: Unknown parameter |authors= ignored (help)
  9. ^ Sun, Jing; Buys, Nicholas; Wang, Xinchao (2013-05-14). "Effectiveness of a Workplace-Based Intervention Program to Promote Mental Health among Employees in Privately Owned Enterprises in China". Population Health Management. 16 (6): 406–414. doi:10.1089/pop.2012.0113. ISSN 1942-7891.
  10. ^ Kurdyak, Paul; Cairney, John; Sarnocinska-Hart, Anna; Callahan, Russell C.; Strike, Carol (2008-11-01). "The impact of a smoking cessation policy on visits to a psychiatric emergency department". Canadian Journal of Psychiatry. Revue Canadienne De Psychiatrie. 53 (11): 779–782. ISSN 0706-7437.

Kindig, David, and Greg Stoddart. “What Is Population Health?” American Journal of Public Health 93.3 (2003): 380–383. Print.

Further reading

http://www.improvingpopulationhealth.org/blog/policies-and-programs.html

  1. ^ Sun, Jing; Buys, Nicholas; Wang, Xinchao (2013-05-14). "Effectiveness of a Workplace-Based Intervention Program to Promote Mental Health among Employees in Privately Owned Enterprises in China". Population Health Management. 16 (6): 406–414. doi:10.1089/pop.2012.0113. ISSN 1942-7891.
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