Population health is an approach to health that aims to improve the health of an entire population. One major step in achieving this aim is to reduce health inequities among population groups. Population health seeks to step beyond the individual-level focus of mainstream medicine and public health by addressing a broad range of factors that impact health on a population-level, such as environment, social structure, resource distribution, and so forth.
Population health reflects a shift in thinking about health as it is usually defined. Population health recognizes that health is a resource and a potential as opposed to a static state. It includes the potential to pursue one's goals to acquire skills and education and to grow. Population health has been defined as “the capacity of people to adapt to, respond to, or control life's challenges and changes.”
An important theme in population health is importance of social determinants of health and the relatively minor impact that medicine and healthcare have on improving health overall. From a population health perspective, health has been defined not simply as a state free from disease but as "the capacity of people to adapt to, respond to, or control life's challenges and changes" (Frankish et al. 1996).Income inequality and mortality in 282 metropolitan areas of the United States. Mortality is correlated with both income and inequality.
Recently, there has been increasing interest from epidemiologists on the subject of economic inequality and its relation to the health of populations. There is a very robust correlation between socioeconomic status and health. This correlation suggests that it is not only the poor who tend to be sick when everyone else is healthy, but that there is a continual gradient, from the top to the bottom of the socioeconomic ladder, relating status to health. This phenomenon is often called the "SES Gradient." Lower socioeconomic status has been linked to chronic stress, heart disease, ulcers, type 2 diabetes, rheumatoid arthritis, certain types of cancer, and premature aging.
Population health parameters indicate, for example, that the economic inequality within the United States is a factor that explains why the United States ranks only 30th in life expectancy, right behind Cuba. which is 29th. All 29 countries that rank better than the United States have a much smaller gap of income distribution between their richest and poorest citizens.
Despite the reality of the SES Gradient, there is debate as to its cause. A number of researchers (A. Leigh, C. Jencks, A. Clarkwest) see a definite link between economic status and mortality due to the greater economic resources of the better-off, but they find little correlation due to social status differences. Other researchers (such as R. Wilkinson, J. Lynch, and G. A. Kaplan) have found that socioeconomic status strongly affects health even when controlling for economic resources and access to health care.
Most famous for linking social status with health are the Whitehall studies-a series of studies conducted on civil servants in London. The studies found that, despite the fact that all civil servants in England have the same access to health care, there was a strong correlation between social status and health. The studies found that this relationship stayed strong even when controlling for health-effecting habits such as exercise, smoking, and drinking. Furthermore, it has been noted that no amount of medical attention will help decrease the likelihood of someone getting type 1 diabetes or rheumatoid arthritis-yet both are more common among populations with lower socioeconomic status. Lastly, it has been found that among the wealthiest quarter of countries on earth (a set stretching from Luxembourg to Slovakia), there is no relation between a country's wealth and general population health7, suggesting that past a certain level, absolute levels of wealth have little impact on population health, but relative levels within a country do.
The concept of psychosocial stress attempts to explain how psychosocial phenomenon such as status and social stratification can lead to the many diseases associated with the SES Gradient. Higher levels of economic inequality tend to intensify social hierarchies and generally degrades the quality of social relations, leading to greater levels of stress and stress related diseases. Wilkinson found this to be true not only for the poorest members of society, but also for the wealthiest. Economic inequality is bad for everyone's health.
Inequality does not affect only the health of human populations. D. H. Abbott at the Wisconsin National Primate Research Center found that among many primate species, those with less egalitarian social structures correlated with higher levels of stress hormones among socially subordinate individuals. Research by R. Sapolsky of Stanford University provides similar findings.
Main article: Public health
Public health is concerned with threats to the overall health of a community based on population health analysis.
The size of the population in question can be limited to a dozen or less individuals, or, in the case of a pandemic, whole continents. Public health has many sub-fields, but is typically divided into the categories of epidemiology, biostatistics, and health services. Environmental, social and behavioral health, and occupational health are also important fields in public health.
The focus of a public health intervention is to prevent, rather than treat a disease, through surveillance of cases and the promotion of healthy behaviors. In addition to these activities, in many cases treating a disease can be vital to preventing it in others, such as during an outbreak of an infectious disease such as HIV/AIDS. Vaccination programs, distribution of condoms, and promotion of abstinence or fidelity in marriage are examples of public health measures advanced in various countries.
Many countries have their own government agencies, sometimes known as ministries of health, to respond to domestic health issues. In the United States, the frontline of public health initiatives are state and local health departments. The Surgeon General-led United States Public Health Service, and the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, although based in the United States, are also involved with several international health issues in addition to their national duties.
All of the areas of health, including individual health and wellness, environmental health, mental health, population health, and public health now need to be viewed in a global context. In a global society, the health of every human being is relevant to the health of each one of us. For example, a disease outbreak in one part of the world can quickly travel to other regions and continents, via international travel, creating a global problem.
Global health requires that the world's citizens collaborate to improve all types of health in all nations, rich or poor, and seek to prevent, reduce, and stop disease outbreaks at their source.
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All links retrieved December 12, 2017.
- World Health Organization
- National Center for Health Statistics (USA)
- National Institutes of Health (USA)
- Centers for Disease Control and Prevention (USA)