Page 442 - Encyclopedia of Nursing Research

POPUlATION HeAlTH n 409

are defined as factors (events, characteristics) improve population health. Built on consen-
that affect health (Department of Health and sus and rooted in an operational framework,
Human Services, 2000; evans & Stoddart, these leading health indicators are identified P
1990; Kindig, 2007). “A clear conceptual as (1) physical activity, (2) overweight and
framework for the selection and use of indi- obesity, (3) tobacco use, (4) substance use,
cators may help point to the dimensions of (5) responsible sexual behavior, (6) mental
population health of import, and lead to health, (7) injury and violence, (8) environ-
more balanced discussions about what indi- mental quality, (9) immunization, and (10)
cators should be targeted . . . to impact pop- access to care.
ulation health” (etches, Frank, Di Ruggiero, In Canada, the document titled “The
& Manuel, 2006, p. 44). Ideal indicators are Population Health Template: Key elements
as follows: built on consensus, based on a and Actions that Define a Population Health
conceptual framework, valid, sensitive, spe- Approach” consolidates current understand-
cific, feasible, reliable, sustainable, under- ings of population health and outlines pro-
standable, timely, comparable, and flexible cedures and processes for implementing a
(etches et al., 2006). population health approach. In the Health
evans and Stoddart (1990) proposed a Canada (2001) template, population health
framework for the study of determinants of is defined as “the health of a population as
population health, incorporating this pre- measured by health status indicators and as
mise of ideal indicators and depicting the influenced by social, economic, and physi-
complex casual relationships between health cal environments, personal health practices,
and function, disease, well-being, health care, individual capacity and coping skills, human
individual behavior and biology, social envi- biology, early childhood development, and
ronment, physical environment, and genetic health services” (p. 2). Addressing the notion
environment. Purposed to promote under- that population health is both a concept of
standing of the determinants of population health and the study of determinants of
health and the discussion and formulation health, the population health template is a
of policy, the evans and Stoddart framework framework in which eight key elements of
has been foundational to shaping national a population health approach are identified:
health goals. In the United States, Healthy (1) focusing on the health of populations,
People 2010 outlines a systematic approach (2) addressing the determinants of health and
for improving the health of the nation based their interactions, (3) basing decisions on evi-
on two broad goals, increasing the quality dence, (4) increasing upstream investments,
and years of healthy life, and eliminating (5) applying multiple strategies, (6) collab-
health disparities (Department of Health and orating across sectors and levels, (7) using
Human Services, 2000). Incorporating both mechanisms for public involvement, and
ideal indicators and determinants of health (8) demonstrating accountability for health
into a plan for population health improve- outcomes (Health Canada, 2001).
ment, Healthy People 2010 underscores the Population health is focused on
necessity of monitoring and evaluating deter- improving the health status of populations,
minants (biology, behavior, social and phys- enhancing health care quality and access,
ical environment, policies and interventions, and decreasing costs. A population health
and access to quality care) in understanding approach targets entire populations; inter-
a population’s health status. leading health venes with families, communities, systems,
indicators are identified to facilitate under- and individuals; recognizes and emphasizes
standing of the importance of health promo- multiple determinants of health; incorpo-
tion and disease prevention and encourage rates primary, secondary, and tertiary pre-
participation in developing strategies to vention; and includes ongoing assessment,