Population Health Movement Gains Ground

Armed with improved demographics data, the nation's safety net providers are poised to take population health initiatives beyond the hospital walls to help patients overcome economic and social barriers to health.

There were a couple of new developments in the past week on the population health front that are worth noting.

For starters, the Essential Hospitals Institute, the research arm of America's Essential Hospitals, has been awarded an 18-month grant from the Robert Wood Johnson Foundation to begin the second phase of a coordinated effort to promote community-integrated healthcare.

Bruce Siegel, MD, president and CEO of America's Essential Hospitals, says safety net hospital administrators and clinicians have long understood the linkage between patient outcomes and social-economic challenges such as poverty and the ills that come with it, but have often lacked the resources to move beyond hospital walls and into the communities they serve.

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"Essential hospitals often are anchor institutions in their communities and serve patients for whom social determinants profoundly influence health," Siegel said in remarks accompanying this week's announcement.

"While this gives them a deep understanding of these nonclinical factors, applying that experience to improve community health often faces severe resource challenges."

During Phase One of the project, which was also funded by RWJF, the Essential Hospitals Institute late last year completed an assessment its members' capacity to improve population health and to find the support to deploy population health programs.

Using in-person summits, distance learning opportunities, and online resources, Phase 2 builds on those findings by

• Supporting population health partnerships among safety-net providers on the state and national level
   
• Compiling and sharing population health tools and resources designed for safety-net hospitals
   
• Convening "learning communities" to build safety-net hospitals' internal capacity to address population health

To mitigate funding restraints, the program looks to leverage safety-net hospitals' unique and leading role in the health of their communities to broker partnerships between essential hospitals, public health departments, and community organizations.

"Our work reflects the simple reality that to succeed as partners of the population health movement, hospitals need support to apply key tools and to develop core partnerships in population health," says Kalpana Ramiah, DrPH, Essential Hospitals Institute's research director.

"Support provided now will have a lasting impact on moving our nearly 300 member hospitals toward community-integrated care."

500 Cities Project
In a similar vein, public health data broken down to the neighborhood level for the largest 500 Cities in the nation will be available on an interactive website starting this week, thanks to a collaboration between RWJF, the Centers for Disease Control and Prevention, and the CDC Foundation.

This granular data source gives anyone living in these regions—from public health stakeholders to local residents—the ability to retrieve, visualize, and explore uniformly defined city and census tract-level data on 27 chronic disease measures, health outcomes, and clinical preventive service use.

RWJF says the data will empower anyone to better see how health varies by location and plan tailored interventions.

Until now, public health officials and other policy wonks were limited by health data available at only the state or county level. This new data source brings that down to the neighborhood level, where local policy makers will be able to identify risk behaviors associated with illness and early death, and health conditions and diseases that are the most common, costly, and in many cases preventable.

The 500 Cities webpage is the latest and most detailed of a number of data sources on public health that includes the annual County Health Rankings and America's Health Rankings, a nationwide public health and state-by-state ranking system that using 34 measures of behaviors, community and environment, policies, and clinical care data; and the VCU Life Expectancy Maps, which illustrate dramatic variances in life expectancy from neighborhood to neighborhood.

Local public health advocates need all the tools they can get to understand the public health threats that pose the greatest challenges to their service areas, especially at a time when the Affordable Care Act, Medicare and Medicaid are under consideration for fundamental redesign.

Data sources such as 500 Cities won't necessarily provide the answers, but they will help policy makers assess the challenges, and where best to steer scant resources.