Foundational Principles of Population Health
Below are the
principles of population health presented by Katherine Keyes
and Sandro Galea in their new book on Population Health
Science. In a recent talk, Keyes explained how they identified these
principles and what they hope to accomplish by enumerating them in
this way. She said, “…
with guides from decades of theoretical writing from foundational
scholars like Mervyn and Ezra Susser, Geoffrey Rose,
Jerry Morris, George
[Davey-Smith]
and Shah [Ebrahim] and many others, we set out to start a
discussion about the foundational principles of population health
science, in an effort to energize discussion and research among
epidemiologists for whom there is a disquiet about the fundamental
assumptions and subsequent implications of our epidemiological
approaches for community-based medicine and prevention."
The Principles of Population Health
Sciences
1. Population
health manifests as a continuum.
2. The causes of
differences in health across populations are not necessarily an
aggregate of the causes of differences in health within populations.
3. Large benefits
to population health may not improve the lives of all individuals.
4. The causes of
population health are multilevel, accumulate through the life course,
and are embedded in dynamic interpersonal relationships.
5. Small changes in
ubiquitous causes may result in more substantial change in the health
of populations than larger changes in rarer causes.
6. The magnitude of
an effect of exposure on disease is dependent on the prevalence of the
factors that interact with that exposure.
7. Prevention of
disease often yields a greater return on investment than curing
disease after it has started.
8. Efforts to
improve overall population health may be a disadvantage to some
groups; whether equity or efficiency is preferable is a matter of
values.
9. We can predict
health in populations with much more certainty than we can predict
health in individuals.
■
|