Population Health Outcomes and the Role of Public Administration in the Community
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Population Health Outcomes and the Role of Public Administration
Administrators play a critical role in improving and maintaining population health in order to achieve outcomes. Administrators having an extensive understanding of the health issues of a community, and what they can do in response to such issues is essential (Mays, Morrow, & Novick, 2008). There is need for approaches to health that focuses on improving health and reducing health inequities of the entire population, which is the focus of population health (Phac-aspc.gc.ca, 2012). In order to understand the definition of population health, there is need to know what ‘population’ and ‘health’ entail. By looking at the vast range of factors that impact on health of the entire population, the public administration can handle the aspects surrounding the subject of population health (Young, 2004).
Population health focuses on multiple determinants, health outcomes, definition and measurement of health outcomes and the role of determinants. It can therefore be said that population health is a field that focuses on correlated factors that affect the health of communities over their life course, identifies systematic variations in the patterns of occurrence (Parrish, 2010). The approach also applies the resulting knowledge to develop and implement policies and actions to improve health and well-being of populations (Kindig and Stoddart, 2003). The field does not focus on the health of a population alone but extends to how health and its outcome are distributed within the population.
Population health is therefore not only focused on health issues and their distribution within a population but the determinants that influence such distribution, policies and intervention affect such determinants (Barbeau, Hartman, Krieger, Naishadham, & Smith, 2005). Population health, unlike public health, focuses on broad sets of concern explicitly tied to the health care delivery system than the government departments as the case of public health, informing public health strategies (Soto 2013). Therefore, population health ranges from health outcomes, the measurement of health, to health policy making with emphasis on the determinants.
In the past, the term population health has been used to refer merely to the health of a population bringing lack of clarity as to whether it is an approach of research or a field of study. Based on the concepts of its research, population health majorly focuses on maintaining and improving health of general population and reducing the gap in terms of health among community groups (Guest, 2013). The public administration, therefore, can focus on outcome of the efforts put in place for health and the impact attributed to effort put in place. Health of a population is measurable in terms of health status indicators and influenced by socioeconomic status, physical environment, individual health practices, personal health capacity, genetics, growth and development, together with the health services (Prevention, 2013). Public administrators can measure variations in terms of health occurrence and patterns and apply them in developing policies and interventions to improve health status of a population.
Despite the growing knowledge on population health, improving health within communities has proved to be a hard task with complexities within the practice. In order to effect the changes and improvements desired, public administration must understand the complexities of practice and determinants of health (Mays, Morrow & Novick, 2008). Different characteristics of population health policy have so far emerged in the United States and other countries, and is realized that population health encompasses a broader array of determinants than those addressed by public health. Population health still incorporates public health concerns, which still matter to them, but accords greater interest with those issues that affects the health status. Such issues range from the income levels, social status, population disparities and educational attainments (Mays, Morrow & Novick, 2008).
Population health addresses the changes effected in health status from individual, to the decision makers and business fraternity preferences. For instance, more than the public health sector does, the population and administration usually assign higher priority to maintaining and increase job and personal income (Peterson, 2011). A future challenge can be forecasted for the public administration will be maximizing positive effects of economic growth and productivity on community’s health status. In the United States, government and other sectors are responsible for the health of a defined population and purchases services for people within such communities to prevent any form of illness and resulting environmental effects (Shi & Singh, 2014).
Population Health Determinants
The fundamental challenge in population health is how to motivate individuals and organizations to address the determinants adequately to achieve a desired outcome. There are different factor that influence the activities of population health, ranging from urbanization. Health has multiple determinants such as the socioeconomic, genetic, individual health practice, infectious and environmental factors, which are essential in health, illness and injury (Guest, 2013). These determinants can be tied to the aspects of access, cost, quantity, and quality of health care services and personal choices on lifestyle. In this regard, we realize that determinants of health fall into three broad categories of social, genetic and environmental determinants (Pickett & Wilkinson, 2006). Determinants of health therefore cut across a wide range of social, economic and environmental factors, and as such, disparities result from the combination and interaction of health determinants of a population (Prevention, 2013).
Social status
The level of income often classifies social status and health status and normally improves with income and social hierarchy. Income levels dictate living conditions such as safe housing, access to food and personal lifestyle. The healthier populations exist in affluent societies whose wealth is distributed equitably (Pickett & Wilkinson, 2006). Of all the determinants, higher social and economic status seems to be the most important determinants of health. Each level on the social class ladder has different levels of sickness, life expectancies, and health status (Feldstein, 2011). Support from families, friends, and communities help achieve better health. Population health appreciates that the health effect of social relationships is an important factor on established risk factors of physical wellbeing (Hartley, 2004). The more social contacts people have may improve levels of life expectancies and lower their early mortality rates.
Education Levels
The Level of education influences the health status of a person, as it has a closer link to economic status. Evidently, education increases chances of job opportunities and income security, and also helping people improve their ability to access and understand information that promote and improve their health (Parrish, 2010). People are equipped with knowledge and problem-solving skills, sense of self-control and mastery over life circumstances through the attainment of education. Low literacy levels are likely to lead to unemployment and poverty, poor health and earlier death than in higher literacy levels (Hartley, 2004).
Environment
Exposure to contaminants in the environment can cause adverse health risks, including cancer, birth defects, respiratory illness and gastrointestinal ailments. Housing, quality of air, and the transportation systems significantly influence the physical and psychological well-being of a person putting their health at risk (Prevention, 2013). On the other hand, stressful or unsafe working environment is also more often associated health risks (Pickett, & Wilkinson, 2006). Employment affects physical, mental, and social health of a person significantly (Parrish, 2010). People with many controls over their working conditions and fewer stress-related demands of the job are likely to have longer life span than those in more stressful or riskier work environments.
Personal Health Practices and Coping Skills
Individuals often take actions and active roles to prevent diseases and promote self-care, cope with challenges, develop self-reliance, problem-solving skills and making choices to improve and maintain their health (Prevention, 2013). It is common that individual socioeconomic status and the environment in which people associate with influence personal choices considerably. Multiple risk-taking behaviors such as alcohol, drug use, and unsafe sex are still higher especially among young people (Parrish, 2010). Diet and eating habits are linked to some of the major causes of health risks.
Genetics and Development
Genetical predisposition is responsible for an inheritance to a wide range of individual responses that affect health status (Prevention, 2013). Active stimulation in early life of a child is the most significant influence, improving learning, behavior, and health into adulthood. Neglected children or those abused are at higher risk for injuries, numerous behavioral and mental problems that may result in death (Phac-aspc.gc.ca, 2012).
Health services
Health services designed to maintain and promote health, to prevent disease, and to restore health and function such as disease and injury prevention interventions are important in population health. Small and some medium income families have limited or no access to health care services and therefore making access to health care universal have significant implications for population health and controlling the cost of healthcare (Gruber & Long, 2011).
Population Health Outcomes
There are different outcomes expected because of interventions by different groups within population measured with the determinants. Disease and injury are some intermediate factors that influence the health of a person as positive outcomes revolve around complete well-being in social, economic and mental status and the equitable distribution of health services and not merely absence of a disease. The level and distribution of health outcomes in populations result from a complex cultural, environmental, political, social, economic, behavioral, and genetic factors (Prevention, 2013). Population health focuses on both the risk factor that represents an underlying vulnerability to particular condition or event and those that represent immediate weakness for a particular situation or event. Some of these factors do not predict the imminence of a situation or event, but only the risk of a person for a condition at some point in time. Others are risk factors that precipitate an event such as intensely stressful life experience.
According to Parish (2010), a measure of health, outcomes are combined to estimate the population healthy life expectancy, a standard often used to measure the population health. The measure of health outcomes and their distribution within a population define population health. According to Prevention (2013), there are different types of measurements used to measure the results of population health; the Health Utilities Index is commonly used in the Canadian National Population Health Survey, Years of Healthy Life used to healthy People. The outcomes generally can be said to be measured on the determinants that include health care and interventions, the social environment (income, education, employment, social support, and culture), the physical environment, genetics, and individual behavior and choices (Parish, 2010).
Global Population Health Concerns
Determining systematically the differences in health outcomes, determinants interaction complexities, biological pathways between determinants and health outcomes, and the impact the determinants are essential to population health (Parish, 2010). A society must establish conditions and equitable social and economic policies and institutions to achieve health status of a population, which encompasses complete social, mental and physical well-being. The United States invest much on global health issues that may in one way or another impact on their health. Contamination and infection outbreaks are capable of spreading from one country to another affecting trade and travel. The state commonly uses health experiences of other countries to compare with their own to identify ways of improving health status and outcomes (Prevention, 2013).
Role of Public Administration on Population Health Outcomes
Some roles having been discussed in the phrases above, the public administration plays a critical role in population health within their jurisdiction, and beyond. They take an active role in assessing health outcomes and evaluating interventions to understand complexities of health determinants, outcomes, distribution and disparities (Mays, Morrow, &Novick, 2008). By conducting the assessment, it is possible to effect changes and improvements on features pertaining to health. Evaluation aids in comparison to standards and the determination of gaps and discrepancies between the interventions and the desired outcomes (Sylvia & Sylvia, 2004). Depending on the interest of the public administration or policies, the evaluations may be conducted in early development or implementation stages to design modifications for improvements or at the end of the cycle to determine the next necessary move.
As assessment may focus on process, input and output population health focuses on the determinants, distribution and outcomes. In these essences, evaluation and assessment are critical in determining outcomes that may communicate changes and issues in population health because of interventions and distribution of health services to identify disparities. The concept of monitoring and evaluation is critical to informing public policies concerning population health, in terms of changes that must be undertaken and whether a program can be implemented or the modifications required (Patel, & Rushefsky, 2014). Assessment of outcomes informs the public administration on whether their funds are with the right use and whether more or fewer resources are required for a health intervention or program.
Assessment or evaluation mainly helps establish the direction or performance of interventions and programs to the desired outcomes. It is, therefore, important that for effectiveness, public administration must initiate and be committed to the effort of improvements and performance in population health (Peterson, 2011). There must be funds allocated for the same course, and any form of bump removed. It is realized that the public administration, therefore, plays a crucial role in population health by incorporating the aspects of organization and performance measurement, policy design and formulation to the course of the health of the general population.