Guest Blog Post: Changing Health Along with Health Care by Gretchen Musicant, Commissioner, Minneapolis Health Department
Health care reform, implementation of the Affordable Care Act and concepts like Accountable Care Organizations are on our minds and in the news. The familiar Triple Aim of all this change is:
- Improving the patient experience of care (including quality and satisfaction).
- Improving the health of populations.
- Reducing the per capita cost of health care.
In honor of National Public Health Week this year, April 7-13, I’d like to reflect a bit on the second aim: improving the health of populations.
The Center for Disease Control and others recognize that between 10 percent and 20 percent of the population’s health is influenced by health care.* Other factors — including behavior and social conditions — make a larger contribution to whether a person is healthy or not.
It seems clear to me that if we want to make measurable changes in the health of the population, in addition to reforming the way we deliver health services we will need to address the other determinants of population health (including behavior and social conditions). So how do we collectively influence these powerful factors?
At The Action Group, we know that public health is critically important in ensuring the economic vitality of all Minnesota Communities, which is why we stay connected to public health initiatives. We thank Commissioner Musicant for sharing her viewpoint.
Local and state partners are tested and capable in public health work. Studies have shown that increased spending by local health departments can save lives otherwise lost to preventable diseases. Low-income communities make the largest health and economic gains in conjunction with local public health spending.**
In Minneapolis, steady creative investments and partnerships with community organizations have netted significant measurable gains for a number of health indicators. During my term as Commissioner of Health we have seen some remarkable improvements in population health as a result of such investments and partnerships.
- Teen pregnancy: Between 2006 and 2011 the pregnancy rate for girls age 15 to 17 in Minneapolis declined by half.
- Youth homicides; No homicides for those under 18 in 2013 – for the first time in my tenure.
- Youth violence: Since 2006, youth homicides have dropped 60 percent, and incidents with guns among youths have decreased 67 percent.
- Lead poisoning: more than an 80 percent reduction (from more than 500 in 2002 to 62 in 2013).
- 3-year-olds getting preschool developmental screening: nearly doubled (639 in 2005-2006 to 1,251 in 2012-2013).
A challenge before us is to assure that as health care reform takes shape in our communities, the second component of our triple aim is achieved in a significant way — that there are changes in HEALTH — not just health CARE. If we can invest in public health strategies, not only medical services, it will undoubtedly result in a healthier, more productive workforce and decrease the burden (and expense) we place on the health care system.
*Tarlov, A.R., Public Policy Frameworks for improving Population Health. Annals of the New York Academy of Sciences, 1999; 896:281-293.
**http://content.healthaffairs.org/content/early/2011/07/19/hlthaff.2011.0196.full.pdf+html and http://works.bepress.com/glen_mays/119/