How population, community health goals overlap

Distinguishing between population health and community health strategies can help health organizations define clear goals and earmark the right resources to accomplish them.

Within the healthcare industry, organizations have unclear definitions of community health and population health, and often create strategies with unclear or overlapping objectives, according to a June 2017 report published in the American Journal of Managed Care.

“Community and population health are two similar, yet distinct, approaches to promoting the public’s health through the use of upstream practice and prevention strategies,” the study’s authors said. “Recent discussion among the healthcare community has noted conceptual confusion in the means by which each term and their respective strategies are utilized in areas of patient care, public health and research.”

The study found that community health and population health differ in four key areas: how strategies are described, how populations are targeted, interventions used and how success is measured.

Community health strategies are described as “collaborative,” “initiatives,” and “empowerment,” to indicate multiple organizations working together. Community health strategies are usually developed for people who live in the same neighborhood or share other cultural commonalities, such as country of origin, language or religion.

When describing population health strategies, organizations discuss “outcomes,” “management,” and “accountability.” Population health strategies are usually developed for people who share the same health issue or are a part of the same health plan.

Though community health and population health strategies can target the same health issues, the approaches can differ. Community health programs often target ways to limit health inequities due to social determinates; while population health programs are more specific to at-risk patients.

“Examples of community health programs may include actions to improve education, reduce unemployment, or enhance a community’s built environment,” the study’s authors say. “Examples of population health programs may include efforts to increase the frequency of child vaccinations, reduce the rate of teen pregnancy, or enhance smoking cessation for adults with chronic obstructive pulmonary disease.”

Community and population health programs can have similarities. For example, people in a particular neighborhood could have the same health issue and health plans. This can cause people to be targeted for both population health and community health strategies. This is not a bad thing, says Panagis Galiatsatos, MD, fellow at the Pulmonary and Critical Care Medicine Johns Hopkins School of Medicine, and one of the study’s authors. He says the community can help healthcare organizations shape population health strategies.

“To make an impact with population health we have to involve the community, and not as a passive partner,” Galiatsatos says. “I can’t see community health initiatives working without population health. If you don’t get buy in from the community, you are not going to get the outcomes that really make an impact.”

Galiatsatos says that health care organizations can have a goal, but use both population health and community health strategies to achieve that goal.

“Population health is the grand scheme of the health outcome, community health is how it impacts people on a day to day basis,” Galiatsatos says. “A population health goal may be to decrease influenza. But the community’s goal is to not miss work or days of school.”

Ultimately, Galiatsatos says that healthcare organizations must invest time to build relationships with communities before rolling out these integrated strategies.

“The first goal is to define what it means to work with communities, and this isn’t classified by ZIP codes,” Galiatsatos says, who also launched Medicine for the Greater Good, a program where undergraduate and graduate student volunteers across Johns Hopkins help underserved city residents become advocates for their own health. “It took us five years to be out in the community, before we could even approach the subject of population health strategies.”