ADVANCING THE SCIENCE
to IMPROVE
POPULATION HEALTH
PROCEEDINGS OF A WORKSHOP
Theresa Wizemann, Rapporteur
Roundtable on Population Health Improvement
Board on Population Health and Public Health Practice
Health and Medicine Division
THE NATIONAL ACADEMIES PRESS
Washington, DC
www.nap.edu
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This activity was supported by contracts between the National Academy of Sciences and the Aetna Foundation (#10001504), The California Endowment (20112338), Fannie E. Rippel Foundation, General Electric, HealthPartners, Kaiser East Bay Community Foundation (20131471), Missouri Foundation for Health (12-0879-SOF-12), National Association of County & City Health Officials, New York State Health Foundation (12-34 01708), Novo Nordisk, and the Robert Wood Johnson Foundation (70555). Any opinions, findings, conclusions, or recommendations expressed in this publication do not necessarily reflect the views of any organization or agency that provided support for the project.
International Standard Book Number-13: 978-0-309-44417-0
International Standard Book Number-10: 0-309-44417-9
Digital Object Identifier: https://doi.org/10.17226/23541
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Suggested citation: National Academies of Sciences, Engineering, and Medicine. 2017. Advancing the science to improve population health: Proceedings of a workshop. Washington, DC: The National Academies Press. doi: https://doi.org/10.17226/23541.
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PLANNING COMMITTEE FOR ADVANCING THE SCIENCE TO IMPROVE POPULATION HEALTH1
PAULA LANTZ (Chair), Professor and Associate Dean for Academic Affairs, Gerald R. Ford School of Public Policy, University of Michigan
LILA J. FINNEY RUTTEN, Associate Scientific Director for the Population Health Science Program, Department of Health Sciences Research, Mayo Clinic
MICHELLE FRISCO, Associate Director, Population Research Institute, Associate Professor of Sociology and Demography, The Pennsylvania State University
ROBERT KAPLAN, Chief Science Officer, Agency for Healthcare Research and Quality
PHYLLIS MEADOWS, Senior Fellow, Health Program, The Kresge Foundation
BOBBY MILSTEIN, Director, ReThink Health
KATHLEEN MULLAN HARRIS, James E. Harr Distinguished Professor, Department of Sociology, University of North Carolina at Chapel Hill
LISA SIMPSON, President and Chief Executive Officer, AcademyHealth
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s planning committees are solely responsible for organizing the workshop, identifying topics, and choosing speakers. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
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ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT1
GEORGE ISHAM (Co-Chair), Senior Advisor, HealthPartners, and Senior Fellow, HealthPartners Institute for Education and Research
DAVID A. KINDIG (Co-Chair), Professor Emeritus, University of Wisconsin School of Medicine and Public Health
TERRY ALLAN, Past President, National Association of County & City Health Officials, and Health Commissioner, Cuyahoga County Board of Health
CATHERINE BAASE, Chief Health Officer, The Dow Chemical Company
GILLIAN BARCLAY
RAYMOND J. BAXTER, Senior Vice President, Community Benefit, Research and Health Policy, and President, Kaiser Foundation International, Kaiser Foundation Health Plan, Inc.
RAPHAEL BOSTIC, Judith and John Bedrosian Chair in Governance and Public Enterprise, Sol Price School of Public Policy, University of Southern California
DEBBIE I. CHANG, Vice President, Policy and Prevention, Nemours
LILA J. FINNEY RUTTEN, Associate Scientific Director, Population Health Science Program, Department of Health Sciences Research, Mayo Clinic
GEORGE R. FLORES, Program Manager, The California Endowment
MARY LOU GOEKE, Executive Director, United Way of Santa Cruz County
MARTHE R. GOLD, Visiting Scholar, The New York Academy of Medicine
GARTH GRAHAM, President, Aetna Foundation
ROBERT HUGHES, President and Chief Executive Officer, Missouri Foundation for Health
ROBERT M. KAPLAN, Chief Science Officer, Agency for Healthcare Research and Quality
JAMES KNICKMAN, President and Chief Executive Officer, New York State Health Foundation
PAULA LANTZ, Professor and Associate Dean for Academic Affairs, Gerald R. Ford School of Public Policy, University of Michigan
MICHELLE LARKIN, Assistant Vice President, Health Group, Robert Wood Johnson Foundation
___________________
1 The National Academies of Sciences, Engineering, and Medicine’s forums and roundtables do not issue, review, or approve individual documents. The responsibility for the published Proceedings of a Workshop rests with the workshop rapporteur and the institution.
THOMAS A. LAVEIST, Professor and Director, Hopkins for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health
JEFFREY LEVI, Executive Director, Trust for America’s Health
SARAH R. LINDE, Rear Admiral, U.S. Public Health Service; Chief Public Health Officer, Health Resources and Services Administration
SANNE MAGNAN, President and Chief Executive Officer, Institute for Clinical Systems Improvement
JACQUELINE MARTINEZ GARCEL, Vice-President, New York State Health Foundation
PHYLLIS D. MEADOWS, Associate Dean for Practice, Office of Public Health Practice, School of Public Health, University of Michigan, and Senior Fellow, Health Program, The Kresge Foundation
JUDITH A. MONROE, Director, Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention
JOSÉ MONTERO, Vice President for Population Health and Health System Integration, Cheshire Medical Center/Dartmouth Hitchcock Keene
MARY PITTMAN, President and Chief Executive Officer, Public Health Institute
PAMELA RUSSO, Senior Program Officer, Robert Wood Johnson Foundation
BRIAN SAKURADA, Senior Director, Managed Markets and Integrated Health Systems
MARTÍN JOSÉ SEPÚLVEDA, Fellow and Vice President, Health Systems and Policy Research, International Business Machines Corporation
ANDREW WEBBER, Chief Executive Officer, Maine Health Management Coalition
National Academies of Sciences, Engineering, and Medicine Staff
ALINA B. BACIU, Roundtable Director
COLIN F. FINK, Senior Program Assistant (until January 2017)
AMY GELLER, Senior Program Officer
BETTINA RITTER, Research Assistant (until November 2015)
DARLA THOMPSON, Program Officer
ROSE MARIE MARTINEZ, Senior Director, Board on Population Health and Public Health Practice
Consultant
THERESA WIZEMANN, Rapporteur
Reviewers
This Proceedings of a Workshop was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise. The purpose of this independent review is to provide candid and critical comments that will assist the National Academies of Sciences, Engineering, and Medicine in making each published proceedings as sound as possible and to ensure that it meets the institutional standards for quality, objectivity, evidence, and responsiveness to the charge. The review comments and draft manuscript remain confidential to protect the integrity of the process.
We thank the following individuals for their review of this proceedings:
Ellen Beckjord, UPMC Health Plan
Elizabeth J. Mayer-Davis, University of North Carolina at Chapel Hill
Bobby Milstein, ReThink Health
Kelly Worden, U.S. Green Building Council
Although the reviewers listed above provided many constructive comments and suggestions, they were not asked to endorse the content of the proceedings nor did they see the final draft before its release. The review of this proceedings was overseen by Bruce N. Calonge, The Colorado Trust. He was responsible for making certain that an independent examination of this proceedings was carried out in accordance with standards of the National Academies and that all review comments were carefully considered. Responsibility for the final content rests entirely with the rapporteur and the National Academies.
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Acknowledgments
The sponsors of the Roundtable on Population Health Improvement have made it possible to plan and conduct the workshop Advancing the Science to Improve Population Health, which this publication summarizes. Nonfederal sponsorship was provided by the Aetna Foundation, The California Endowment, Fannie E. Rippel Foundation, General Electric, HealthPartners, Kaiser East Bay Community Foundation, Missouri Foundation for Health, National Association of County & City Health Officials, New York State Health Foundation, Novo Nordisk, and the Robert Wood Johnson Foundation.
The roundtable wishes to express its appreciation to the following speakers at the workshop for their informative and stimulating presentations: Maya Brennan, Urban Land Institute Terwilliger Center for Housing; Linda Elam, U.S. Department of Health and Human Services; LaMar Hasbrouck, National Association of County & City Health Officials; David Holtgrave, Johns Hopkins Bloomberg School of Public Health; Nancy Krieger, Harvard School of Public Health, Interdisciplinary Concentration on Women, Gender, and Health; Jenelle Krishnamoorthy, Merck & Co., Inc.; Paula Lantz, University of Michigan; Phyllis Meadows, The Kresge Foundation; Brendan Nyhan, Department of Government, Dartmouth College; Ron Pollack, Families USA; and Lisa Simpson, AcademyHealth.
The roundtable also wishes to express its thanks to the planning committee for this workshop for their knowledge and enthusiasm in arranging the workshop: Paula Lantz (Chair), University of Michigan; Lila
J. Finney Rutten, Mayo Clinic; Michelle Frisco, The Pennsylvania State University; Robert Kaplan, Agency for Healthcare Research and Quality; Phyllis Meadows, The Kresge Foundation; Bobby Milstein, ReThink Health; Kathleen Mullan Harris, University of North Carolina at Chapel Hill; and Lisa Simpson, AcademyHealth.
Contents
Organization of the Workshop and Proceedings
Embodied History, Structured Chance, and Flexible Phenotype as Contributors to Health
Research Designs and Frameworks for Population Health Improvement
Research Questions, Designs, and Methods
Current Debates and Challenges
Identifying Research Needs Versus Dissemination Needs
3 RESEARCH IN PRACTICE: OPPORTUNITIES AND CHALLENGES
Preventing HIV Transmission: A Brief History
Why Facts Do Not Always Change People’s Minds
Translating Population Health Research into Policy and Practice
4 BUILDING A POPULATION HEALTH RESEARCH AGENDA: VIEWS FROM THE FIELD
5 POPULATION HEALTH RESEARCH PRIORITIES: PERSPECTIVES FROM USERS OF RESEARCH
Local Health Department Perspective
Discussion: Framing the Message to Engage Policy Makers
6 TOWARD A RESEARCH AGENDA FOR POPULATION HEALTH
Understanding Population Health Problems and Issues
Understanding the Root Causes of Population Health Issues
The Effect of Policies, Practices, and Interventions That Aim to Improve Population Health
Improving the Dissemination and Translation of Population Health Research
C Suggested Readings for Krieger Presentation (Chapter 2)
D Results from a University of Michigan Survey Regarding Priorities for Population Health Research
Acronyms and Abbreviations
ACA |
Patient Protection and Affordable Care Act |
ASPE |
Office of the Assistant Secretary for Planning and Evaluation |
BIC |
Broader Impacts Criterion |
CBO |
Congressional Budget Office |
CDC |
Centers for Disease Control and Prevention |
CHIP |
Children’s Health Insurance Program |
HHS |
U.S. Department of Health and Human Services |
HIA |
health impact assessment |
HUD |
U.S. Department of Housing and Urban Development |
IOM |
Institute of Medicine |
MTO |
Moving to Opportunity |
NACCHO |
National Association of County & City Health Officials |
NSF |
National Science Foundation |
PAF |
population attributable fraction |
WMD |
weapon of mass destruction |
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