The University of Michigan Policies for Action Research Hub, under the leadership of Dr. Paula Lantz, conducts research on a number of issues related to population health improvement and health equity, with its primary focus on advancing effective public policy related to the social determinants of health. This includes research regarding social impact bonds, the Health in All Policies movement, and interventions focused on “super-utilizers” of health care.
Together with her team, Dr. Lantz has leveraged this innovative research portfolio to shed more light on the importance of upstream social policy and interventions for improving population health and reducing health inequities. In a recent opinion in The Milbank Quarterly*, Dr. Lantz builds on these insights to articulate concerns about the recent "medicalization" of population health within the health care system and its limits in making substantial improvements in population health. An excerpt of her piece appears below:
The Medicalization of Population Health: Who Will Stay Upstream?
Population health, defined broadly as the distribution of health-related risks and outcomes within and across populations, has been developing as a subject of scientific inquiry and public health practice for more than two centuries. More recent attention has been fueled by the growing understanding of both upstream (macro-level) and downstream (micro-level) social determinants of health, and increased recognition of the limits of medical care in reducing socially driven health disparities.
A robust finding from population health research is that the United States spends a much greater percentage of its GDP on medical care than any other developed country, yet ranks quite low in broad population-level indicators of health status, including life expectancy and infant mortality. In response, the Institute for Healthcare Improvement introduced the Triple Aim framework in 2007 to optimize health care system performance: reduce costs, improve quality, and improve population health.
This explicit focus on population health within the context of health care improvement has fueled significant growth in what is generally called “population health management.”
*Policies for Action did not provide funding for this article. The views expressed are solely the opinion of the author and not that of the Robert Wood Johnson Foundation.