Preventable death rates fall when communities expand population health, study shows
Unfortunately, the delivery and financing systems for public health and social services are highly fragmented, Health Affairs says.
Deaths due to cardiovascular disease, diabetes and influenza decline significantly over time among communities that expand their population health activities. According to a study published Wednesday in Health Affairs, that involves protecting water and food quality, addressing housing and income insecurity issues, and boosting education, which requires resources best tackled by multiple sectors.
The findings show that the delivery and financing systems for public health and social services are highly fragmented, reflecting a patchwork of federal, state, local and private funding streams. That poses challenges for deploying limited public health and social service resources in effective ways.
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Multisector networks help in this regard, the authors said. Gains in health status accrue over time among communities that take this approach, and in particular can improve the outlook for preventable deaths due to ailments such as cardiovascular disease, diabetes and influenza.
How access to capital leads to health improvements extends beyond the healthcare system. For example, communities that gained comprehensive system capital during the study period were significantly more likely than their counterparts to adopt comprehensive smoking bans, and they achieved lower rates of smoking, obesity and physical inactivity among low-income residents.
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As of 2014, almost 40 percent of U.S. metropolitan communities had attained levels of system capital that are associated with significant reductions in mortality due to those conditions. But less than half of the population now lives in a community with those kinds of resources.
These results, the authors said, underscore the importance of building strong incentives and sustainable infrastructure at the community level to support multisector work in population health. A lot of communities will need to draw on a combination of financing sources to build this capital, such as hospital community benefit spending, shared savings arrangements with healthcare delivery systems, allocations from the Affordable Care Act's Prevention and Public Health Fund, and investments from community development institutions.
Twitter: @JELagasse
