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Achieving Population Health Is About More Than Just Healthcare

ABSTRACT

Managing a population’s health can no longer fall solely at the hands of healthcare providers. One’s health is about more than just healthcare because it requires the interaction and integration of care across the entire health continuum, including multiple care settings and health disciplines, to tackle the numerous factors that impact a population’s health.

WHAT IS POPULATION HEALTH?

As today’s healthcare industry moves from a fee-for-service model to a value-based model, population health has taken on greater importance. Some date the concept back to 1849 when Dr. John Snow went door-to-door in London to diagnosis a cholera outbreak that spread throughout the city’s drinking water1, but at its heart, population health is the effort to improve the overall health and well-being of a given population in a consistent and personalized manner while minimizing the need for expensive interventions. The important thing to note in this definition is that a population’s health is dependent upon more than access to quality medical treatment. Population health is about providing care in a manner that helps people live healthier and happier lives no matter their demographic, genetic, environmental, medical, social, behavioral, or economic circumstances.

DISTINGUISHING THE DIFFERENCE BETWEEN HEALTH AND HEALTHCARE

Although the concept of population health is not new, there is now a clear distinction between health and healthcare. Looking beyond the traditional healthcare setting and understanding health factors are only beginning to take shape within the minds of the public.

Moving beyond the traditional healthcare setting to address a population’s health is what makes the concept simultaneously exciting and challenging. No longer can the responsibility for managing one’s health begin and end at the clinician’s office or in a hospital. From healthcare professionals to retailers to educators to community leaders, we must all understand the role we play in managing a given population’s health and our own. Historically, that role has been shrouded in complexity as we have struggled to blur the line between healthcare and health. The simple fact that access to and quality of medical treatment only accounts for about 10% of an individual’s health – approximately 40% is dependent upon behavioral choices, 30% on genetics, 15% on social circumstances, and 5% on environmental elements – further illustrates the point that managing and improving a population’s health requires the interaction and integration of care across the entire health continuum.2

No single healthcare organization is capable of addressing all of the variables that go into a population’s health, because the factors affecting one’s health often fall outside of reasonable responsibility for healthcare providers. For example, factors such as access to clean air and water, access to transportation, level of education, availability of employment, being a habitual smoker or drinker, or having a predisposition to certain chronic conditions play a role in shaping one’s health outlook.

LOOKING BEYOND TRADITIONAL HEALTHCARE

What can be done outside traditional healthcare settings to improve a population’s health? First and foremost, we need to stop addressing a population’s health after it is already too late to take corrective action. Instead, we need to start being more proactive about engaging in a greater level of preventive care. Taking this step in changing the way we address a population’s health is about thoughtfully designing our lives for better living.

Designing such a model for healthy living asks us all, whether we are consumers or healthcare providers, to take a great leap of faith. As traditional healthcare evolves, we can no longer go about business as usual. We must all look in the mirror and find ways in which to extend ourselves beyond traditional care management. Managing one’s health in the future will require an integrated ecosystem for preventative care, one that puts a defined population of consumers at the center of every decision being made. This ecosystem will extend far beyond the walls of a hospital or a clinic into the many interactions that we as a population have throughout our daily lives.

MANAGING HEALTH ON DIFFERENT LEVELS

Whether inside or outside the scope of what we define as traditional healthcare, successful care management will require finding ways to effectively foster and maintain a population’s engagement at all levels. To be successful in this total healthcare approach, all members of a population must focus on the single goal of finding ways to improve health through valued interactions and differentiated experiences no matter the circumstances. One working example of this shifting focus in action is that of the Blue Zone project in Albert Lea, Minn. (See sidebar.) The city of Albert Lea is a prime example of how the evolution brought about by population health challenges everyone in a community, big or small, to address health from multiple angles.

A population’s health can also be managed at a national level. As consumers, we are all constantly bombarded with advertisements from retailers in our daily lives. But what happens when those same retailers decide to take a role in improving a population’s health? Instead of blasting the population with advertisements that often go hand-in-hand with risky lifestyle choices (i.e., tobacco and alcohol), they work with a population to reduce the opportunity for us as consumers to put ourselves at risk.

That may mean that a fast food chain works to reduce portion sizes on some of its more popular items, while at the same time finding healthier menu item alternatives. It might also mean that tobacco and alcohol retailers reduce the volume of their advertisements to the general masses, while also finding ways to educate consumers as to the harmful effects of tobacco or alcohol dependency.

Asking retailers to shift the way they have been operating for years will be a challenge as these changes have the potential to negatively affect their bottom lines, but the challenge is worth the outcome. We often see the hypothetical train coming down the tracks at us, yet we still stay on the tracks without taking action to put ourselves in a better position. Population health is about seeing that train well in advance and taking corrective action to avoid it before it is too late.

BRINGING ABOUT A HEALTH UTOPIA

Transforming our thinking and our behavior as a society cannot occur unless we move beyond the simple act of monitoring and reacting to one’s health problems once they are in a state that cannot be treated or even reversed. Being reactionary in the past has led to more than 133 million Americans (roughly 45% of the population) having at least one chronic condition, and those conditions account for almost 75% of national healthcare spending costs.3

To truly achieve population health, all stakeholders, whether it be a healthcare professional or a local community leader, must be engaged and working together towards a common goal. We must take all of what we know, and turn that into action as a collective group. But achieving population health will require a great deal of coordination, effort, and time from us all.

If implemented successfully, it has the potential to bring about a health utopia. That benefit, as reported in an E&Y study, could come to the tune of an estimated $1 trillion in direct and indirect cost savings by 2023 on some of the most chronic diseases by improving population definition in terms of how best to serve members, providing that population with personalized care management, and delivering care when it makes the most sense.4 It also has the potential to eliminate some of nearly 40% of deaths within the US that are the direct result of modifiable behavior.5

Population health will drive us all to attain the best health possible no matter our geographic, economic, or demographic differences. Above all else, individuals and families within any given population will have the means and the opportunity to live the healthiest life possible. As we rethink the line between health and healthcare, it is important that we all realize the benefit in participating in the same business, the population health business.

ALBERT LEA

Blue Zone projects, which occur throughout the country, offer an approach in which a community’s citizens, schools, employers, restaurants, and leaders collaborate on initiatives that drive their community toward better health and well-being.

For the city of Albert Lea, this collaboration meant coming together to build community gardens, organizing daily walking trips for interested community members, banning students from eating in school hallways, and restricting the sale of candy at community events. These simple and easy-to-implement activities delivered profound results.

Ten months after the start of the project, 46 new community gardens were planted, 44% of the community’s population partook in the walking trips, healthcare claims dropped 49%, and most important of all, project participants added a projected three years to their life expectancy.6

End Notes
  1. Steven Johnson. “How the ‘ghost map’ helped end a killer disease.” TEDSalon video, 10:03. November 2006. View in Article
  2. “What Is Population Health, Anyway? – A Five-Part Series”. PYAPC. Pershing Yoakley & Associates, P.C. Web. 22 March 2016. View in Article
  3. “500m people will be using healthcare mobile applications in 2015”. Research 2 Guidance. Research 2 Guidance, 18 November 2010. Web. 24 March 2016. View in Article
  4. Fera, Bill. “Population health management – A strategy for success in the new age of accountable care.” Health Industry Post (2014). View in Article
  5. ch, Richard. “Population Health Management – A Roadmap for Provider Based Automation in a New Era of Healthcare.” Institute of Health Technology Transformation. 2012. View in Article
  6. “Albert Lea Project Successes”. Blue Zones. Blue Zones.com, 20 March 2014. Web. 19 April 2016. View in Article
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