Education, Epidemiology

What are Population Health, Public Health, and Community Health?

Author Chandana Balasubramanian , 22-02-2022

What is Population Health?

 

Population health is the study of the health outcomes for a group of people. The groups being studied can be residents of a nation, a specific community, or any other demographic. Apart from health outcomes, population health researchers are also interested in the distribution of health across the group being studied.

 

David Kindig, MD Ph.D., and Greg Stoddart, Ph.D. (2003) define population health as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.” The authors feel that population health must be considered a concept of health [1].

 

‘Population’ can mean a group of people in a specific geographical region like a country or state. It can also refer to a demographic like veterans, prisoners, people of a particular socioeconomic status, or others.

 

In some countries, like in the United States and Australia, population health is a term used to denote a population’s health – the more literal interpretation of the term. This type of interpretation is becoming more common around the world as governments, doctors, academics, epidemiologists, and more work together towards creating actionable health initiatives.

 

What are the Components of Population Health?

 

There is no uniform structure to population health. The foundational pillars of population health are still being categorized based on an organization or an academic’s needs.

For example, the American Health Association (AHA) lists three components of successful population health management. They are:

  • Information-powered clinical decision-making,
  • Primary care-led clinical workforce, and
  • Patient engagement and community integration.

As you can see, the three categories have been narrowed down to a more public and community health approach based on the AHA’s requirements and task force.

On the other hand, Kindig and Stoddart (2003) propose that the field of population health includes health outcomes, patterns of health determinants, and the policies and interventions that link them – a more broad description [1].

 

What is Public Health?

 

Public health is defined as “the science of protecting and improving the health of people and their communities” (CDC Foundation). Public health officials work on large-scale programs to help prevent diseases and improve the overall health of a group of people [2].

Let’s look at some examples of public health programs in action.

USA

 

  1. Reduction in vaccine-preventable diseases like rotavirus, herpes zoster, HPV, and the DTP vaccine for tetanus, Diptheria, and whooping cough (pertussis). According to the CDC, routine rotavirus vaccines from 2006 helped prevent 40,000 to 60,000 rotavirus-related hospitalizations a year. DTP vaccines were introduced in the late 40s, and whooping cough incidence dropped 75%.  
  2. Heart disease (CVD) deaths have declined significantly since the 1940s (though they have stalled in recent decades). Death rates from heart disease in the US decreased by 60% from 1950 to 1996. This is considered one of the most significant public health achievements of the 20th century. Public health initiatives included a two-pronged approach targeting high-risk individuals and the general population to practice preventive health.

 

UK (United Kingdom)

 

  1. The Public Health Act was introduced in 1848. The Act introduced better sanitation, sewage and waste disposal systems, and more medical officers in localities. They estimate that this helped increase the average lifespan in the UK.  
  2. Junk food advertising was banned across the London transportation network and during children’s programming on television from April 2007. This was a public health initiative to address the growing problem of childhood obesity [3].

 

Australia

 

  1. Australia set up the National Cervical Screening Program (NCSP) in 1991, and within ten years, it reduced cervical cancer incidence by half and lowered the death rate. Additionally, from 2007, Australia conducted one of the most extensive vaccination drives for the HPV (Human Papilloma Virus) for girls aged 12 – 13. With these vaccination campaigns, Australia saw a 77% reduction in the two types of HPV that caused 75% of all cervical cancers and much more.
  2. Smoking prevention public health programs caused smoking prevalence to drop drastically over 20 years. Initiatives included the world’s most stringent regulatory controls in 2012. Australia eliminated all brand imagery from cigarette and tobacco products. Health warnings about the effects of smoking were more visible upfront [4].

 

What is the Difference Between Population Health and Public Health?

 

In many countries, the lines between population health and public health are blurred. While the field of population health is more conceptual, public health involves multiple stakeholders that come together to benefit a group of individuals. These stakeholders include government health agencies, infectious disease experts, clinicians, public health researchers, epidemiologists, communications experts, community organizers, and many more.

Population health is a broad umbrella term, and studies in this field can help guide public health policies, initiatives, and communication.

 

What is Community Health?

 

Community health is a subdivision of the medical and public health fields. The World Health Organization (WHO) discusses ‘Community health’ as environmental, social, and economic resources to sustain emotional and physical well-being among people in ways that advance their aspirations and satisfy their needs in their unique environment.

In a nutshell, community health programs offer essential healthcare to local communities, including rural and remote areas.  

 

What is the Difference Between Public Health and Community Health?

 

Community health is a subset of public health. Improving the health of communities, in particular, those in rural and remote areas requires different approaches from general public health measures. Medicine and health are often steeped in local cultures. There is often greater reliance on community health professionals and community workers who live in their respective localities.

Why do These Definitions Matter?

 

Trying to draw boundaries around these definitions may look like splitting hairs to the uninitiated. When there is an existing overlap, why do experts in the field continue to hone these terms? 

One concern is that when definitions lose their meaning and usefulness without precision. More clarity to this aspect may better help guide public policy, research, and related funding activities, offer direction to government health initiatives, and much more.

The terms can help universities and other learning institutions tailor their programs better to help students and academics. Additionally, tightening definitions can help those in the field create metrics that can be used to improve quality control in research.

References
[1]K. David and S. Greg, “What Is Population Health?,” Am J Public Health, vol. 93, no. 3, pp. 380-383, 2003.
[2]CDC Foundation, “What is Public Health?,” CDC Foundation, 2022. [Online][Accessed 03 02 2022].
[3]Top 20 Public Health Achievements of the 21st Century, “Top 20 public health achievements of the 21st century,” RSPH (Royal Society for Public Health), [Online][Accessed 03 02 2022].
[4]Public Health Association Australia, “Top 10 Public Health Successes Over the Last 20 Years,” November 2018. [Online][Accessed 03 02 2022].
Author
Chandana Balasubramanian

Chandana Balasubramanian is an experienced healthcare executive who writes on the intersection of healthcare and technology. She is the President of Global Insight Advisory Network, and has a Masters degree in Biomedical Engineering from the University of Wisconsin-Madison, USA.

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