Health Affairs: New framework to join public health, healthcare agencies afoot
Policy and administrative actions are needed to strengthen the incentives for partnerships among public health agencies and healthcare systems, according to an article published in this month's Health Affairs.
“These incentives are important because collaboration could facilitate a more community-based approach to reducing disparities in healthcare access and, ultimately, in health,” wrote Kathryn P. Derose, PhD, MPH, senior policy researcher at RAND in Santa Monica, Calif., and colleagues.
Attempts to explain disparities in access to healthcare faced by racial and ethnic minorities and other underserved populations often focus on individual-level factors such as demographics, personal health beliefs, and health insurance status. The authors proposed an examination of these disparities—and an effort to redress them—through the lens of public health.
“None of the healthcare access frameworks developed to date has conceptualized or discussed in any significant way how public health might affect healthcare access,” Derose and company purported. “[I]t is important to incorporate public health agencies and programs into conceptual understandings of access. By doing so, it is possible to identify concrete actions and policy levers to address disparities in healthcare access in ways that earlier frameworks did not. These actions and policy levers are related to public health’s three core functions—assurance, assessment and policy development—and 10 essential services.”
The authors proposed a new framework where public health agencies link people to needed services such as immunizations, testing and treatment; ensure the availability of healthcare; ensure the competency of the public health and personal healthcare workforce; and evaluate the effectiveness, accessibility, as well as quality of personal and population-based services.
“Public health can reduce disparities in healthcare access through its assurance, assessment, and policy development functions, which operate through health care services, public health policies and programs, and public health agencies’ role in mobilizing individual and collective action to improve health,” they wrote. They added that the framework conceptualizes the relationship between public health policies and programs and health and well-being more generally, which can then affect future use of health services.
The authors stated their framework could help support empirical studies of the effects of public health programs on disparities in healthcare access.
“Effectively addressing disparities in healthcare requires a collective effort that includes the full range of public health and healthcare system stakeholders,” the authors concluded. “Public health agencies can play an important convener role with other organizations and sectors such as communities and community-based organizations, the healthcare delivery system, academe, business and the media.”
“These incentives are important because collaboration could facilitate a more community-based approach to reducing disparities in healthcare access and, ultimately, in health,” wrote Kathryn P. Derose, PhD, MPH, senior policy researcher at RAND in Santa Monica, Calif., and colleagues.
Attempts to explain disparities in access to healthcare faced by racial and ethnic minorities and other underserved populations often focus on individual-level factors such as demographics, personal health beliefs, and health insurance status. The authors proposed an examination of these disparities—and an effort to redress them—through the lens of public health.
“None of the healthcare access frameworks developed to date has conceptualized or discussed in any significant way how public health might affect healthcare access,” Derose and company purported. “[I]t is important to incorporate public health agencies and programs into conceptual understandings of access. By doing so, it is possible to identify concrete actions and policy levers to address disparities in healthcare access in ways that earlier frameworks did not. These actions and policy levers are related to public health’s three core functions—assurance, assessment and policy development—and 10 essential services.”
The authors proposed a new framework where public health agencies link people to needed services such as immunizations, testing and treatment; ensure the availability of healthcare; ensure the competency of the public health and personal healthcare workforce; and evaluate the effectiveness, accessibility, as well as quality of personal and population-based services.
“Public health can reduce disparities in healthcare access through its assurance, assessment, and policy development functions, which operate through health care services, public health policies and programs, and public health agencies’ role in mobilizing individual and collective action to improve health,” they wrote. They added that the framework conceptualizes the relationship between public health policies and programs and health and well-being more generally, which can then affect future use of health services.
The authors stated their framework could help support empirical studies of the effects of public health programs on disparities in healthcare access.
“Effectively addressing disparities in healthcare requires a collective effort that includes the full range of public health and healthcare system stakeholders,” the authors concluded. “Public health agencies can play an important convener role with other organizations and sectors such as communities and community-based organizations, the healthcare delivery system, academe, business and the media.”