A recent article published in the Harvard Business Review (HBR) by Dr. Sandro Galea, M.D., Dean, Boston University School of Public Health, rightfully claims that measuring the value of population health programs is challenging. “Measures” are focused on groups of individuals within a given population as a whole. The issue comes in the gaps created in the socio-economic, life-style, health status and ethnic characteristics of those constituting the group. For example, diet behavioral modification programs to combat obesity using Smartphone and iPad technology will likely be more successful for “populations” within populations who have access to these technologies.
Ideally, these programs would target those who don’t have readily-available access to technology to produce improved results across the socio-economic spectrum. It’s widely documented that obesity levels are higher among people in lower-income brackets. Dr. Galeo suggests that the gap be closed by targeting the lower end of the spectrum among defined populations to level the success rate of healthy living programs. Doing so creates more equitable outcomes, higher rates of success and, thus, healthier populations.
This seems logical and easy, yet it requires a shift in our “values.” I tend to agree with Dr. Galea’s conclusions in that bridging health equity gaps closes social divides, defies the “Cadillac-care” notion and allows for greater, streamlined connectivity for everyone. Moving population health measures from absolute to inter-group differences may be a challenging shift, yet it would seem to create greater equity … achieving the larger goal in health and healthcare.
