Question

Compare ways in which the focus on ‘population’ health has improved the health status of certain groups.

Provide 2 (two) examples, explaining how these interventions have resulted in improved health outcomes.

Answer 1

As the most of people thinking about the health and health care is very personal issues .Assuring that the health of the public however that goes beyond the focusing on the health status of the individual as it requires a population health approach . As the Amercian's health status does not match with the nation's substantial health investments .The work of assuring the nation's health also faces the dramatic changes and systematic problems , challenging societal norms and influences .The committe belives that it is necessary to transform national health policy which traditionally has been grounded in a concern for the personal health services and the biomedical research that benefits the  individual .Such repositioning will affirm and expand existing commitments to reflect a border perspective .Approach the health from a population perspective commits the nation to understanding and acting on the full array of the factors that affects health . For the best address the social , economic and cultural environments at national , state and local levels , the nation 's efforts that must involve more than just the traditional sectors - the governmental public health agencies and the health care delivery system . Furthermore , the  efforts of the public health system that must be esupported by the political will - which comes from the elected official s who commit resources and influences based on evidence - and by healthy public policy - which comes from governmental agencies that consider the health effects in developing agriculture , education , , commerce , labor , transportation , and foreign policy .

Three realities are central to the development of effective population based prevention strategies , The first , is disease risk is concieved of as a continuum rather than a dichotomy . There is no clear division between risk for disease and no risk for disease with regard to levels of blood pressure , cholesterol , alcohol consumption , tobacco consumption , physical activity , diet and weight and lead exposure and other risk factors . In fact , recommended cut off points for the management or treatment of many of these risk factors have changed dramatically and in a downward direction over the time . ( for example guidelines for control of hypertension and cholesterol ) in acknowledgment of the increased risk associated with common moderately elevated levels of a given risk factor . The  second reality is that the most often only a small percentage of any population is at the extremes of high or low risk . The majority of people fall in the middle of the distribution of risk . The exposure of large number of people of group to a small risk that can yield a more absolute number of cases of a condition than exposure of a small number of people to a high risk . The third reality is that the population perspective is that an individual 's risk for the population to which he or she belongs , Thus someone in the United States is more likely to die prematurely from a heart attack than someone living in Japan , because the population distribution of high cholesterol in the United States as a whole is higher than the distribution in Japan . ( i.e on the graph of the distribution of cholesterol level in a population , The U.S mean is shifted to the right of teh Japanese mean )     

As these upper model assume the etiological links exist among all exposures and disease outcomes , that the effects of an intervention aimed at reducing teh risk of those in the highest risk category .  For example ;- the  people with the highest body mass index are at in teh increased risk for cardiovascular heart disease andd a plethora of chronic illnesses, Interventing medically for example to decrease risk ( by lowering levels of the obesity as measured by BMI ) ultimately decrease the proportion of the population with the highest BMIs. such measures among the very high risk individual may even be endorsed in cases where the intervention itself carries a substantial risk of poor outcome or the side effects However theuse of such an intervention would be acceptable only in those whose medical risk was very high risk groups and may have a limited effects on the population outcomes because the greater proportion of those with the moderate risk levels that may ultimately translate into more chronic disease or other poor health outcomes.

Because most of the  people are in categories of moderately elevated the risk as opposed to very high risk , this strategy offers the greatest benefit in terms of population attributable risk , assuming that the intervention itself carries little or no risk . For example if social policies or other population wide measures were adopted to promote small decrease in weight in the  general population,The committee embraces this kind of model of disease prevention in the case of policies such as seat belt regulation and the reduction of lead levels in gasoline .

The three different strategies for improving the health of the population . The nation has often endorsed the first strategy without a critical examination of the other two , especially the  second one .The American public has grown accustomed to seeing differences in exposures to risk , both environmental and behavioural and disparties in health outcomes . Acknowledging these gradients fullly will help develop true population based intervention straegies and help tehpartners who collaborate to assure the public's health move to take effective action and make effective policies .