The Medicalization of Population Health: Who Will Stay Upstream?

• Published in: The Milbank quarterly Vol. 97; no. 1; pp. 36 - 39
• Main Author: LANTZ, PAULA M.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.03.2019; Blackwell Publishing Ltd; John Wiley and Sons Inc
• Subjects: GDP; Gross Domestic Product; Health care; Health care expenditures; Health care policy; Health disparities; Health research; Health services; Humans; Infant mortality; Level indicators; Life expectancy; Life span; Medicalization; Opinion; Opinions; Population; Population distribution; Population Health; Public health; Public Health Administration; Quality of care; Social determinants of health; Upstream
• ISSN: 0887-378X; 1468-0009; 1468-0009
• DOI: 10.1111/1468-0009.12363

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.