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There has been
a recent interest in and focus on the concept of population
health, especially in countries such as Canada. This raises
the obvious point of describing or explaining what is meant
by population health and how it differs if at all, from public
health and health promotion.
Health promotion
is commonly defined as a process for enabling people to take
control over and improve their health. Population health could
be described as an approach that addresses the entire range
of factors that determine health and, by so doing, affects
the health of the entire population. It could also be argued
that population health is no different from public health
and community health. Others believe that it is a new paradigm,
while others believe that the concepts and principles of population
health and health promotion are essentially the same.
One way of looking
at this issue is to ask four questions, each of which related
to a different branch of health-related activity within policy.
Public health
asks: "What must we do to keep people healthy?"
Medicine asks: "How do we diagnose and treat people?"
Health promotion is concerned with the question: "How do we
improve the health of the population?" Finally, population
health poses a fourth question: "Why are some people healthier
than others?" (1)
Population
health: Why are some people healthier than others?
While health promotion recognised that there were many determinants
of health, it did not engage in the empirical research necessary
to identify and explain the correlation between social gradients
and health status. Population health amasses population-based
evidence in a systematic way in an attempt to understand how
and why different factors influence health. This body of research
suggests that social environments have a far stronger impact
on health than do individual behaviours; in addition, the
relative impact of health care, the physical environment and
genetics are far less critical to health than socioeconomic
factors. A central research focus of population health is
the attempt to understand these social-structural dimensions
of health. In this respect, however, it has been limited by
the available data.
The most important
observations to emerge from the population health perspective
derive from four related bodies of research relating to: early
childhood development, social and economic gradients, work
and working conditions, and social networks and supports.
Contributions from each area of research raise important considerations
for policy, as discussed in greater detail below. Together,
they have stimulated within the population health framework
the notion of a socio-biological translation, an attempt to
understand the links between material/perceptual conditions
of people's lives, and the biological responses these produce
within the body.
(1)
Population health, sustainable development, and policy
futures. Michael Hayes, Ph.D & Sholom Glouberman, Ph.D
Health Network. Canadian policy
research networks, Inc. October 1998.
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