The United States’ Population Health
Introduction
Population health is an approach that focuses on improving the health of communities through effective collaborations. It attempts to describe the health of a particular group of people at the national or community level, such as nations, ethnic groups, prisoners, or pregnant women (Bor et al., 2017). This view considers health as a complex factor requiring an interdisciplinary input to improve its probability for success. Unlike public health, the population health strategy strives to promote the health of the communities by giving policy recommendations, health education, and research for evidence-based practice (Bor et al., 2017). It outlines the steps that communities can collectively undertake to improve their health outcomes. Population health comprises three mechanisms: health outcomes, health determinants, and health policies. This paper will look at the US country’s population health, health system, and recommendations for reducing health inequities by addressing the social determinants of health through five priority areas discussed at the Rio conference.
The Healthcare System of the United States
The United States healthcare system is managed at three levels of government: the national level, state level, and local level. At the national or federal level, health is governed by the Secretary of Health and Human Services appointed by the president-elect. The roles of the Secretary for health include overseeing the delivery of health in the country and conducting oversight of the social care policies (Bor et al., 2017). The actions of the Secretary are facilitated by a team of individuals and public health organizations. These bodies include the Food and Drug Administration, the National Institutes of Health, and the Centers for Disease Control (Richman et al., 2019). These entities assist the federal government in meeting certain activities to its citizens, including ensuring the quality of medications, enhancing research to improve practice, ensuring the provision of high quality and safe healthcare, and collecting information on the health status of the populations (Bor et al., 2017). Other significant roles of the national government are accomplished at the state level through funding and grants.
States are the chief protectors of the health status of their populations. Health programs are headed by the state secretary of health appointed by the governor or the health boards of the state. Despite differences in the goals and activities among the state’s health organizations, most of them are involved in planning and overseeing health at the state level. Furthermore, healthcare services are directly provided to the populations at the local level. They execute healthcare activities, including immunizations, health education, control of chronic diseases, and promote adequate sanitation. Additionally, other essential players in the US healthcare system comprise governmental and non-governmental organizations at the national, state, or local levels. Private organizations in the US healthcare system function as non-profit organizations to promote or lobby for policy changes, exchange information or fight for the welfare of the patients and the healthcare personnel.
The major financer of healthcare services in the United States of America is the federal government which contributes about half of the total expenditure on health. However, individuals also provide healthcare financing out of pocket costs, private organizations, and insurers (Bor et al., 2017). Medicare health insurance provides for insurance coverage for individuals above 65 years of age and the disabled. The employers mainly provide private insurance in compliance with the regulations of the Affordable Care Act. Heart disease and cancer are the leading causes of death. The life expectancy is at 78 years, according to a 2018 survey (Richman et al., 2019). This information is essential in population health planning.
The Population Health and The Austrian Health System
Austria is a democratic republic nation found in Central Europe consisting of nine provinces. According to a 2017 survey, the life expectancy of women was at 84 years and 79 years for men. Malignant tumors and cardiovascular conditions were the most common conditions (Richman et al., 2019). Austria has a statutory national health insurance cover of 99 percent of its inhabitants (Bachner et al., 2018). Social insurers primarily do healthcare financing of inpatient care, while inpatient care is financed by regional governments (through taxes), private insurers, and social insurance carriers. Healthcare is managed at the national government and the provincial level. The government and private institutions provide healthcare services.
Reducing Health Inequities
Improving Governance for Health and Development
Governance is an essential factor touching on healthcare as policymaking in the education, agriculture, and environment sectors affect populations’ health. Policymakers in other departments need to consider the health impacts of policies on health, including the health risks, benefits, or harms involved in their actions. More importantly, the healthcare system collaborates with the other sectors to plan, organize, and implement activities to ensure optimal health benefits. Good governance raises the responsibility of different sectors in reducing health inequities.
Governance in healthcare is primarily the role of the government through the Secretary of health. There are several strategies through which the government can conduct effective governance to reduce healthcare inequities. First, policymakers need to promote inter-sectoral collaborations to enhance the formulation of health-sensitive policies. Effective partnerships also involve including people in prioritizing healthcare goals to reduce inequities, enhancing their success (Barsanti et al., 2017). Second, proper governance enacts laws that remove the restrictions on inter-county movements to seek healthcare services (Pega et al., 2018). This will enhance the accessibility to healthcare services for populations with a poor provider to population ratio.
Promoting Participation in Policymaking
Effective participation of individuals and communities is crucial in policymaking in healthcare. Participation involves improving the capacity of persons to engage in the generation and the creation of policies that affect health. Public participation is imperative for forming relevant and practicable strategies for resolving the inequities in society (Pega et al., 2018). It also promotes the implementation of the plans at the community level. The government has a critical role in promoting the participation of communities in policymaking. There is a need to mobilize community members to engage in policymaking processes. Moreover, government officials need to be educated on the causes of health inequities. These ideas can be done by educating individuals on the healthcare policies of interest to reduce disparities. Furthermore, there is a need to enhance communities’ awareness of the importance of participating in policymaking forums. This can be achieved by using technological platforms, including mobile phone applications or government websites, to helps teach the community members.
Reorienting the Health Sector
Poorly performing healthcare sectors contributes to the burden of health inequities. Individuals from underserved populations, including ethnic and racial minorities, may find it challenging to afford the healthcare system’s cost. The high price of healthcare services reduces its accessibility, increasing healthcare inequities (Pega et al., 2018). Individuals’ economic status is significantly affected when they utilize many of their resources to cater to healthcare needs. Furthermore, healthcare services should be provided in high quality to enhance the resolution of the healthcare needs of the individuals in a community. Appropriate healthcare meets the holistic needs of patients, including the mental, physical, psychological, and social requirements. Care is also provided in an individualized manner by competent personnel that respects the autonomy of persons and the right to make informed consent.
The government of North Carolina can implement specific strategies to reorient the health sector towards promoting health and reducing health inequities. First, there is a need to reduce the rate of the uninsured in society. Individuals working in the mining, fishing, agriculture, and forestry departments are more prone to lacking insurance (Richman et al., 2019). Therefore, the government can enable their insurance by expanding the Medicaid eligibility criteria to cover these uninsured populations. This can be achieved through legislation to widen the scope of Medicaid cover. Second, there is a need to increase the number of primary care providers in North Carolina. Statistics show that only 62 of the 100 counties in this state meet the recommended 1:1500 ratio of providers to populations (Bor et al., 2017). This disparity in healthcare is acute in the rural settings where there is also a reduced enrollment of students to medical schools. Hence, the government should encourage the admissions of students to study medicine through the provision of scholarship programs.
Strengthening Global Governance and Collaboration
Global cooperation between states and nations helps tackle inequities in healthcare in the world. This strategy is also vital for states to support multinational organizations that strive to reduce social disparities. Cooperation between countries is essential to support and collaborate the international bodies, including the world health organization, international labor organization, and the united nations, fighting to end social disparities (Barsanti et al., 2017). Therefore, the state of North Carolina can strengthen global governance and collaboration through several strategies. First, the government needs to collaborate with other nations in tackling the inequities of health. The united states government needs to provide financial aids to developing countries to reduce inequities in health. Collaborations are critical in determining the priority areas for funding. Second, the government needs to advocate for technical support and agitate for government policies that prioritize resolving the health inequities (Pega et al., 2018). Optimal health is an inherent right of all human beings in the world.
Monitoring Progress
The continuous evaluation of the strides made in reducing the inequities in health is imperative for ensuring progress. Monitoring provides an avenue for determining the usefulness of the plans made for reducing the disparities in healthcare. It provides a basis for accountability in public institutions to direct the policymaking process. The practical strategies in this area include fostering the data collection of data on the social determinants of health. This can be accomplished through increased funding for the data collection on the state of environmental and social factors influencing health (Richman et al., 2019). Furthermore, there is a need to improve the accessibility for research findings to evaluate the policies made by other sectors that affect healthcare.
Conclusion
Population health strives to enhance the health of communities through improving multi-sectoral collaborations. It is an effective strategy for reducing health inequities. The Rio political declaration on social determinants of health is another plan of action for correcting the disparities in social health determinants. Governments worldwide should institute proper evidence-based techniques to promote the achievement of the recommendations of the Rio declaration. Additionally, there is a need to plan future goals to implement these recommendations and enhance their effectiveness through continuous collaborations.
References
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Barsanti, S., Salmi, L. R., Bourgueil, Y., Daponte, A., Pinzal, E., & Ménival, S. (2017). Strategies and governance to reduce health inequalities: Evidences from a Cross-European survey. Global Health Research and Policy, 2(1), 1-11.
Bor, J., Cohen, G. H., & Galea, S. (2017). Population health in an era of rising income inequality: USA, 1980–2015. The Lancet, 389(10077), 1475-1490.
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Richman, L., Pearson, J., Beasley, C., & Stanifer, J. (2019). Addressing health inequalities in diverse, rural communities: An unmet need. SSM – Population Health, 7, 100398.