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Policy Approaches to Health Equity: Fundamental Determinants and Increased Diversity
Kathryn Cardarelli, PhD, Kelly Ylitalo and Rachael Jackson


Health
Sustaining Healthy People & Communities


Population health has been defined by James R. Dunn and M. V. Hayes in the 1999 article titled Toward a lexicon of population health as “the health of a population as measured by health status indicators and as influenced by social, economic, and physical environments, personal health practices, individual capacity and coping skills, human biology, early childhood development, and health services” (S7-10).  The determinants of population health encompass factors that are measured at the individual level—such as personal behavior, coping resources, and genetic influences—and at the aggregate level.  Factors measured at the aggregate level include physical and social neighborhood characteristics, public policies such as funding for public health services, and residential proximity to hazardous environmental influences.  Another aggregate-level influence is access to health care resources, including the provision of physical health and mental health services for the recovery from injury and/or illness as well as for preventive health services.  However, it should be noted that although clinical interventions save lives and improve the quality of life at the individual level, they cannot fully explain why some populations are healthier than others.  Therefore, focusing on increasing investments in health care only is not an efficient way of improving population health, as noted in the 2005 book titled Reinventing Public Health: Policies and Practices for a Healthy Nation.

 

Population health can be measured quantitatively through the examination of birth and death rates, rates of morbidity from specific diseases, environmental and social risk factors, rates of adverse health behavior, use of community health care services and rates of hospitalization, and the health implications of public policy.  These data are available from public and private sources, including local, state, and national health and economic data bases.  Because the distribution of disease and premature death is not equitable among persons of different races and ethnicities, genders, and socioeconomic position, the issue of health disparities remains a compelling challenge.

 

Data presented in this compass point include the following:  

 

  • The Baylor College of Medicine ranked 13th and the University of Texas Southwestern Medical Center in Dallas ranked 17th of 64 schools in the 2004 U.S. News & World Report rankings for top medical schools in research.
  • Only 29% of eligible children received mental health services in Dallas County (4,671 of 16,129) in 2002, according to the Mental Health Association in Texas, an affiliate of the National Mental Health Association.
  • Between 2002 and 2003, the homicide rates in Collin, Dallas, Ellis, Kaufman, and Rockwall Counties declined, according to the Texas Department of State Health Services.
  • The top six leading causes of hospitalization for Dallas County residents were cardiology/vascular and thoracic surgery, obstetrics, general medicine, general surgery, pulmonary conditions, and orthopedic conditions, according to Parkland Hospital’s Our Community Checkup 2005 for Dallas County report, which reports the most recent health and hospital data from 2003.

 

Health: Sustaining a Healthy Community encompasses 8 aspirations and 25 indicators.


 


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