Population Health In Health Care, Community And Workplace

What is population health and why do we hear so much about it?

 Population Health is defined as “the health outcomes of a group of individuals, including the distribution of such outcomes within a group”1.  This term is used by health care and community organizations as well as in the employer setting to identify and understand groups of individuals whose health or health risk may lead to increased healthcare costs.

Health care systems use the term population health to explain the process that is occurring in the healthcare field to provide better patient outcomes and a better cost. Health care providers define their “group” as the provider’s set of patients that he/she is responsible to improve health outcomes. Population Health Management is the process these providers use to identify, track and intervene with their “group” to improve outcomes.

Public health organizations also are in the population health business to improve the outcomes of the community “group” and larger populations. These organizations identify many determinants 2 that effect health outcomes of communities, such as community environments that supports social, economic, and physical health as well as medical care in the community. These organizations can influence health by changing environments in the community and look to intervene by addressing food deserts, providing safer access to activity areas for children and adults and providing social and employment support where needed. 

Benefit consultant specialists use population health management in discussion with employers about ways employers can control health care costs.  Employers are looking at their “group” as members of their benefit plan and looking for ways to identify, track and intervene to improve outcomes and lower costs. In looking at the cost of health care claims it is clear that individuals with chronic disease tend to spend more on healthcare and medications, however, individuals working with a health care provider to manage their disease are spending less than those that are not managing their disease who tend to have more hospitalizations. Employers should be focusing on managing those with chronic disease but also identifying those at risk for chronic disease to avoid higher medical costs. The CDC estimates people diagnosed with diabetes have about 2.3 higher medical cost than people without diabetes3. By intervening with those at risk an employer hopes to avoid additional cost for both the employer and the employee.

The process of population health management also includes intervening which relies on being able to engage the individual in better lifestyle choices and managing their health. Individuals with multiple health risks are likely in all of these population health “groups” and are being tracked by their health care provider, public health organization and their employer. Coordination between these entities to avoid redundancy is often difficult and an individual can feel overwhelmed and singled out by repetitive engagement efforts.                         

What good is identifying and tracking if the individual does not engage in the intervention?

This is where wellness strategies come into play. The Global Wellness Institute (GWI) defines wellness as: the active pursuit of activities, choices, and lifestyles that lead to a state of holistic health4Providing opportunities for individuals to access wellness activities that encourage participation in healthy behaviors can help some individuals engage with little effort.  Others will need more structured environments where healthy choices are either the only choice or the first choice they encounter in the environment. Making the right choice an easy choice helps the individual to react favorable without laborious analysis of what the healthier choice should be. For example, providing nutrition information for a healthy meal choice as people first enter a cafeteria can set the stage for individuals to purchase this option. Likewise, easy access and visibility of stairs when entering a building rather than the elevator, can encourage individuals to use the stairs more often.

No matter what the population “group” is that you are trying to influence, providing an environment that promotes engaging in healthier choices will benefit all of us. Employees and visitors from the community can all benefit from walking paths, visible stairways (and slow elevators!), prominent and more economical healthy vending and cafeteria choices.

How do I get started?

Get out your camera and start taking pictures!

What do you see upon entering a new space? What are some low cost, easy things you can do to make this space more inviting to access healthier activities? Can you add a walking path, signage to the stairs, place healthy food in more visible spot? How about setting new expectations (or policies) with your management team to encourage meditation and activity breaks or providing healthy food options at celebrations? Review your policies and procedures. Are you providing a culture of health and wellness?  Be sure that your policies and procedures provide room for employees to engage in healthful activities and are not working against your efforts to improve health outcomes. Interventions and nurturing environment are only good if people are able to engage in them! 

Make wellness and health fun!

Utilizing wellness technology, like Motivation Alliance®, that promotes engagement in educational resources, provides challenge and ways to connect with others as well as rewards individuals for completing activities will help build engagement. Technology that continues to grow with your wellness strategy will help you connect and keep your program fresh for participants.

References:

  1. Am J Public Health. 2003 March; 93(3): 380–383.
  2. https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health
  3. https://www.cdc.gov/diabetes/data/statistics-report/deaths-cost.html
  4. Understanding Wellness:  Opportunities & Impacts of the Wellness Economy for Regional Development; Global Wellness Institute, White Paper Series; SEPTEMBER 2019.

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