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Five levels in improving population health

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Tom Frieden, M.D.,  director of  the Centers for Disease Control and Prevention, writes in The New England Journal of Medicine that providers must deal with five levels of a “pyramid” model to optimize public health.

He lists:

  • The base: socioeconomic determinants — income, employment status, race and education,  followed by, in this order:
  • Such public-health interventions as expanded health coverage or contraception access.
  • Long-term preventive interventions, such as immunizations.
  • Clinical interventions such as blood-pressure management.
  • Public education and outreach efforts.

Dr. Frieden says that major long-term population-health improvement depends on preventive and clinical interventions.

Some key elements in successful population-health initiatives include, he says:

  • Team-based care.
  • Patient-centered care.
  • Consistency.
  • Continual improvement in delivery and treatment.
  • Registry-based information systems.

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