Population health: Why patient income matters

patient-centered care

Healthcare leaders who want a better way to explain population health and its goals should also take a look at the interconnected issue of income inequality.

Ian Morrison, Ph.D., an author, consultant and healthcare futurist, writes in Hospitals & Health Networks that people who have less money are likely to have poorer health regardless of their personal habits. He cites a study from Stanford and Harvard that correlates life expectancy and a number of socioeconomic characteristics, and that also noted variation in people with lower incomes based on the city they lived in.

Morrison contrasts that fact with two different definitions of population health. In the United States, the healthcare industry typically views the goal of population health as better managing the care of patients along the care continuum, with a focus on prevention and intervention for those who are at greatest risk. Outside of the U.S., health officials instead separate care goals and socioeconomic factors, and are more willing to intervene politically in education, public welfare and housing--all of which can play a role in public health, Morrison writes.

Because the American healthcare industry focuses on healthcare-related ways to improve population health, it does not address socioeconomic concerns, as it could, Morrison writes. Improving both income inequality and public health in tandem would require a significant investment to lift people at the low end of the spectrum to a place of more parity, he says, and such initiatives may come too late.

Morrison said initiatives as part of the Affordable Care Act have already begun some of this process and have helped redistribute wealth. “Expanding Medicaid and providing highly subsidized coverage to low-income folks has on balance effectively increased the minimum wage by as much as $2 an hour for those who receive the benefits,” he writes.

Morrison’s conclusion is that there is still much for healthcare officials to tackle on this issue, and that looking at income inequality as a potential factor in poor health outcomes can improve care for the impoverished and create stronger goals for population health initiatives.

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