In the same way that superheroes all fight bad guys but go about it in different ways, population health, public health, and community health all have the goal of improving health but go about it in different ways as well. Let’s look at the traditional boundaries of these models and explore how those boundaries are converging under new care models.
What is Population Health
The simplest definition of population health is the health outcome of a group of individuals. In a broader sense, population health includes the health outcomes themselves and the efforts to influence those outcomes. While the terms “population” and “health” are generally understood terms, they can be used in a way that describes a more narrow group than may initially be apparent.
“Population” describes a patient population with a similar characteristic. But that characteristic can vary: age, geographic proximity, similar diagnosis, employees of the same company, disabled persons, or groups based on socioeconomic status or ethnicity are all examples of populations. Thus a “population” can be a broad term encompassing patients who are rather dissimilar clinically to a narrow term encompassing patients who share highly similar clinical profiles.
Even the term “health” can vary in meaning. It may mean a full return to healthy functionality, such as after an accident or temporary illness. It may mean patients achieving the best possible wellness given the complexity of long-term chronic diseases. It may mean health comprised of both physical and behavioral health, or it may mean healthy behaviors, such as patients undergoing substance abuse treatment. All of the above can be components addressed by population health.
Population Health vs Public Health
While public health shares some similarities with population health, it tends to be more focused on creating conditions in which individuals can be healthy. For example, public health may combat infectious disease, or work to educate teens and adults on tobacco and alcohol use, or work on air quality education for asthmatics.
Public health tends to focus primarily on large scale concerns or threats, such as vaccination and disease prevention, injury and illness avoidance, healthy behaviors, and minimizing outbreaks that jeopardize public health.
What is the Difference Between Community Health and Population Health
Community Health shares similarities with both population health and public health but tends to be more strictly geographically based. Community health often tackles a broader spectrum of issues than either population health or public health, such as influencing public policy, creating shared community resources, and taking a more holistic approach to healthy living. Community health directly addresses the social determinants of health — the collection of social and economic circumstances that can prevent people from attaining and maintaining positive health outcomes.
As caregivers strive for improved health outcomes, the traditional separation between models is diminishing. Methods to directly impact the social determinants of health may have been perceived as the role of community health but now providers across the spectrum of care are demanding access to social determinant information to help drive better care decisions and ultimately better outcomes.
Emerging care models reflect this convergence. State-based Medicaid Accountable Care Organizations (ACOs) involve a level of financial risk-sharing for providers. These financial incentives drive providers to expand care beyond the traditional walls of medicine to include social determinants of health, expand access to care, incorporate behavioral health, and consider alternative treatment options.
Behavioral health systems of care (SOC) deliver improved behavioral health services by viewing behavioral health as a community-wide problem that demands a community-wide solution. These SOCs incorporate behavioral health screening into multiple medical touchpoints, directly involve families in care decisions, and utilize community services and supports to build a network of care and support for individuals and families.
The trend toward whole-person care encompasses the goals and aims of many of these care models. Under whole person care, providers strive to treat the full care needs of a patient through one coordinated care delivery system. Patients may receive primary care, chronic care, behavioral health, and employment or housing assistance from a coordinated care network. Food pharmacies, for example, enable medical providers to write prescriptions for food and nutrition needs as a way to improve patient health.
Like superheroes, each care delivery model has its own unique strengths. But also like superheroes, their impact is greater when they unite together. As collaboration increases and traditional models give way to more comprehensive models of care, we all benefit as a result.