The Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine hosted a public workshop on September 19, 2019 titled Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream. The term upstream refers to the higher levels of action to improve health. Medical services act downstream (i.e., at the patient level) in improving population health, while such activities as screening and referring to social and human services (e.g., for housing, food assistance) are situated midstream, and the work of changing laws, policies, and regulations (e.g., toward affordable housing, expanding healthy food access) to improve the community conditions for health represents upstream action. The workshop explored the growing attention on population health, from health care delivery and health insurance organizations to the social determinants of health and their individual-level manifestation as health-related social needs, such as patients' needs. The workshop showcased collaborative population health improvement efforts, each of which included one or more health systems. This publication summarizes the presentations and discussions from the workshop.

Contents

• The National Academies of SCIENCES • ENGINEERING • MEDICINE
• PLANNING COMMITTEE ON HEALTH CARE SYSTEM APPROACHES TO POPULATION HEALTH: TENSIONS AND PROGRESS
• ROUNDTABLE ON POPULATION HEALTH IMPROVEMENT
• Reviewers
• Acronyms and Abbreviations
• 1. Introduction¹
  • WORKSHOP OBJECTIVES
  • ORGANIZATION OF THE WORKSHOP AND PROCEEDINGS
  • A METAPHOR FOR FRAMING THE WORKSHOP
• 2. Overview of the Landscape: Tensions and Promise
  • ACTIVITIES IN THE HEALTH CARE SECTOR TO IMPROVE SOCIAL CARE AND STRENGTHEN SOCIAL RESOURCES
  • OPPORTUNITIES FOR HEALTH: ADDRESSING SOCIAL DETERMINANTS OF HEALTH
  • AUDIENCE DISCUSSION
• 3. How Leadership and Organizational Structure Can Address Health-Related Social Needs and Advance Health Equity
  • REDESIGNING A HEALTH SYSTEM TO CREATE WELL COMMUNITIES
  • ENTERPRISE-WIDE INFRASTRUCTURE TO ADVANCE HEALTH EQUITY
  • AUDIENCE DISCUSSION
• 4. Downstream: Addressing Patients' Health-Related Social Needs
  • RUSH SYSTEM FOR HEALTH: A CASE STUDY FOR HEALTH EQUITY
  • MANY VOICES: ONE WEST SIDE
  • AUDIENCE DISCUSSION
• 5. Midstream: Accountable Health Communities and Partnerships with Human Services Organizations
  • THE DENVER REGIONAL ACCOUNTABLE HEALTH COMMUNITY
  • PARTNERSHIPS WITH AREA AGENCIES ON AGING AND OTHER COMMUNITY-BASED ORGANIZATIONS
  • AUDIENCE DISCUSSION
• 6. Upstream: Changing Environments, Changing Policy
  • POLICY AND ENVIRONMENTAL CHANGES TO IMPROVE HEALTH IN KLAMATH COUNTY, OREGON
  • CHANGING THE ENVIRONMENT TO PROMOTE HEALTH OUTSIDE THE FOUR WALLS OF THE MD ANDERSON CANCER CENTER
  • AUDIENCE DISCUSSION
• 7. Small-Group Interactive Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity
  • INSTRUCTIONS
  • REPORT BACK
• 8. Final Reflections
• Appendix A. References
• Appendix B. Workshop Agenda
• Appendix C. Biographical Sketches of Presenters and Moderators
• Appendix D. Small-Group Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2022. Models for population health improvement by health care systems and partners: Tensions and promise on the path upstream: Proceedings of a workshop. Washington, DC: The National Academies Press. https://doi.org/10.17226/26059.

Digital Object Identifier: https://doi.org/10.17226/26059

Additional copies of this publication are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

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