Sandro Galea, M.D., dean of the Boston University School of Public Health, discusses in the Harvard Business Review why measuring improved population health is so difficult. Dr. Galea notes that population health “is defined as the health outcomes of a group of individuals and how those outcomes are distributed within the group. But most discussions about measuring outcomes focus on the group as a whole and neglect distribution.”
“….If we simply measure overall population health, we can almost certainly improve it by focusing on low-hanging fruit — improving the health of groups that are easily accessible {such as affluent employees of big companies} and most amenable to changing their behavior. …But these efforts will inevitably widen health gaps, improving the health of some while leaving marginalized communities behind.
“Closing those gaps should be at the heart of efforts to measure and improve population health, even it means sacrificing some efficiency.”
He suggests:
“{W] e can make closing the health gaps between groups one of the prime objectives in health improvement.
And “{W}e can include relative indicators of health along with absolute indicators in metrics. This will require that health systems measure factors around which we may expect difference — like race, ethnicity, and income — and tabulate, report, and hold themselves accountable to relative achievement in health indicators across these groups.
{“W]e can include relative indicators of health along with absolute indicators in metrics. This will require that health systems measure factors around which we may expect difference — like race, ethnicity, and income — and tabulate, report, and hold themselves accountable to relative achievement in health indicators across these groups.
“Finally, we can establish incentives that promote both efficiency in improving the absolute numbers and equity in closing gaps. ”
