Improving Population Health in US Cities

摘要

INTEREST IN POPULATION HEALTH AND THE PROMOTION OF greater collaboration between medical, public health, and social service institutions has surged in recent months. This approach adopts a comprehensive notion of health determinants that are spread across domains of behavioral risk, social and economic circumstances, environmental exposures, and medical care. The balance and effects of many of these determinants, eg, availability of healthy foods, parks and other safe places to play and exercise, exposure to environmental irritants, and safe housing, are specific to geographic locale. Although there is general enthusiasm for efforts to advance population health, strategies for tailoring approaches to specific locales are not well established. Of particular strategic interest is the need for developing population health approaches for the 80% of US residents who live in urban environments. While the diversity and fragmentation of services within cities pose formidable organizational challenges, there are several key attributes of urban settings, if harnessed strategically, that offer opportunities for potentially effective population health strategies.