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.
