Policy and Advocacy for Improving Population Health in the USA

Posted: March 18th, 2024

Policy and Advocacy for Improving Population Health in the USA
1. Introduction
The research essay “Policy and Advocacy for Improving Population Health in the USA” focuses on the importance of policy and advocacy in the field of population health. The introduction highlights the significance of policy and advocacy in achieving better population health outcomes and outlines the objectives of the research essay. It also provides an overview of the population health challenges faced by the USA. We begin by understanding how policy and advocacy influence the health of communities. As health problems grow in complexity and impact, the need for informed and coordinated policy at the local, state, and federal levels becomes infinitely more important. Secondly, it is necessary to understand the predominant health difficulties in the United States. Through identifying the biggest foes to social well-being, resources and attention can be properly directed. Lastly, a phasic approach to improving policies and developing campaigns is explored. When used in health, advocacy is often defined as using one’s influence, relationships, and other resources to push for action, change, or support of a particular result. In laymen terms, advocacy seeks to change views in favor of a good cause.
1.1 Importance of Policy and Advocacy in Population Health
There are different forms of health advocacy, which include legal, patient, insurance, social security, long-term care, and mental health advocacy. However, the main goal of all advocacy forms is to create a measurable, positive difference in the lives of the people and in society as a whole.
On the other side, health advocacy in the US refers to voicing out the health concerns of the socially and economically vulnerable populations. It involves the use of professional skills and knowledge in order to sensitively and respectfully assist clients and the communities in today’s complex world. The sole aim of health advocacy is to improve the health outcomes of different communities in general and to eliminate health disparities.
However, it’s a well-known fact that policy changes in healthcare are always challenging because of the complex nature of health service delivery and the health sector. But the importance of interrelationships among community, state, and national policies, as well as the need for sustainable, comprehensive, and effective policies, cannot be underestimated.
The shift towards a more comprehensive and preventive model requires policies that focus on increasing funding for public health. In addition to that, there is great need for open collaboration and clear communication among professional, legislative, special interest, and executive levels in trying to achieve and perhaps sustain effective national health policies.
Because the US healthcare system is still using a fee-for-service model, resources and strategies are now directed towards the treatment of illnesses and less emphasis on public health-focused interventions. In order to switch from the expensive, inefficient, and reactive model of illness treatment to one that promotes the health and well-being of the public, policy and advocacy in changing the practice methods in the US is crucial.
On the other hand, advocacy involves efforts to improve access to better healthcare for everyone. It involves the mobilization of different communities, making knowledgeable decisions, as well as the creation of public awareness campaigns. In a time when healthcare is rapidly changing and much is expected from healthcare workers, healthcare organizations, as well as the government, it is very crucial to understand the role that policy making and advocacy in population health play.
Health policies can be in the form of funding priorities, resource allocation, legislation, and regulation, which in one way or another affects the day-to-day running of health and healthcare across the world. The government creates policies in order to enhance the health and well-being of the population, and such policies are used by different stakeholders and other decision-makers to improve and protect the health of a population.
Policies are the rules that a government, organization, or individual puts in place and which they expect each and every person to follow. Advocacy, on the other hand, refers to the act of creating awareness and making recommendations and pleading for a certain cause. In the field of population health, these two concepts are very crucial.
1.2 Objectives of the Research Essay
The research essay aims to achieve three key objectives. Firstly, it seeks to understand how the field of population health can be informed by the study of social and economic factors that shape the health of the population. This also includes identifying and understanding health disparities in different populations, and studying and interpreting the various factors that affect the health of a community. Secondly, the essay aims to evaluate the relative importance of various methodological and theoretical approaches to population health in the discourse on social determinants of health and health disparities. This involves considering the strengths and limitations of different methods in assessing population health, and understanding how the use of different theoretical lenses might lead to different interpretations of the same set of outcomes in the field. Thirdly, the essay seeks to critically assess the extent to which the development of policies that aim to improve the health of the whole population can be called ‘evidence-based’. This includes critically considering what is meant by the term ‘evidence-based’ in the context of public health and health policy, and evaluating the role of different forms of evidence in policy development in the field of population health. Also, the essay plans to establish a comprehensive overview of what population health is and why it is important. This includes providing a clear definition of the term, and identifying the key factors that determine the health of a community and indicators of the health of a population. In addition, it seeks to offer an insight into the complexities of measuring the health of the population, for example how sociologists and epidemiologists assess and quantify health in different ways. The essay also intends to take a focused look at a specific aspect of population health; namely, how the health of the public in general may be improved through the study of social and economic factors. This involves giving a detailed account of what the field aims to do and the various methodological and theoretical approaches that are adopted. By pursuing these objectives, the essay aims to contribute towards the ongoing development of evidence-based population health policy and practice.
1.3 Overview of the USA’s Population Health Challenges
The United States of America is a developed country and has one of the world’s most powerful economies. However, when it comes to the health of its population, the story is quite different. The USA faces significant population health challenges. According to the World Health Organization, the USA is ranked 29th in the world for its health system performance. Some of the key population health issues in America include disparities in access to healthcare and health outcomes, an aging population, high rates of preventable chronic diseases and healthcare-associated infections. In recent years, there has been increasing attention on the need for policies and programs to improve population health. Overcoming these challenges requires collaborative and multi-disciplinary approaches. Public health professionals agree that population health improvement is mainly the task of government and other stakeholders. For instance, as per the Centers for Disease Control and Prevention, one of the major players in improving America’s population health is the public health system. The public health system is responsible for prevention and control of health threats, health monitoring, health promotion and health education. It is expected that the system works in partnership with other stakeholders such as local communities, healthcare providers, policy makers and also the research community. The public health system also conducts surveillance of population health indicators, for example blood pressure, cholesterol and obesity levels, so that interventions and policies can be developed and implemented as appropriate. However, it is often a challenge for public health professionals to apply scientific findings and implement public health programs that are supported by research, due to the lack of resources and funding needed, plus the complex relationships existing in the multi-level public health system. Such challenges further highlight the importance of policy and advocacy in improving population health. This section of the essay gives an overview of the population health challenges faced by the USA. Work cited for this section will include peer-reviewed articles and reports, such as those by the World Health Organization and the Centers for Disease Control and Prevention.
2. Policy Approaches and Strategies
Policy Approaches and Strategies
Recently, public health advocates focused on changing lifestyles through addressing the social determinants of health. They targeted housing and basing on the model ‘housing first’, which was effective enough in getting people out of the streets and by the end of 2017, more than 7000 people were already helped. This model advocates for total solutions where people get housed first, which is then followed by provision of supportive services such as education, job training, and benefit planning. In essence, the public health proponents argue that it is better to provide housing to the homeless as opposed to giving them care while still on the streets. Home stability is a crucial part in improving health and thus the focus of this model has been important in reducing chronic homelessness and public costs in the health sector, such as hospital visits. This is just one example of the important role that policy plays in improving population health and demonstrative of the fact that health policy is not just the domain of the clinical or health services research. It is very clear that there is a wide range of areas in which policy influences population health, including taxes, social programs, bureaucracy, health impact assessments, cost-benefit analysis, and incidence studies. All these are based on the concept that policy, which is the authoritative decision made in the legislative, executive, or judicial branches of the government, has a considerable impact on health. Every day, state and federal policies are developed, carried out, and changed and they have longer-term and widespread impact on the health of the population. A good example was when the Obama administration crafted a new overtime regulation. This particular proposal, which was intended to raise payment threshold, was expected to have far-reaching effects on the population. The Department of Labor estimated that the new overtime rules would mean higher wages for more than 4.2 million employees in the first year of implementation. Moreover, those policy research and advocacy is increasingly recognizing the irreplaceable roles of technological research and development in the influence of public health. This is due to the advent and widespread use of social media and public news outlets like Twitter, Facebook and therefore has given to modern communication strategies. In essence, modern communication strategies employ satellites, cell towers, and browsing data in the dissemination of policy ideas and the now more recent community health interventions. Public health advocates in the modern world seek to highlight a given health concern through campaigns in social media in forms of Facebook pages, Twitter handles, and shared news articles. Such strategies are mainly targeted at a particular audience in line with the specific health issue in question and in most cases, research shows that faster feedback is received compared to ‘traditional’ policy dissemination methods. This outlines a strategy for effecting lasting, positive policy change. By creating a social movement around a given health issue, that is to say how people organize themselves to address a particular social need; overwhelming numbers expressing agreement towards a sequential task, which is vocal government intervention and then finally using that new policy to influence social behavior/executing the health objective will be reached.
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2.1 Legislative Initiatives for Population Health Improvement
Through the broad range of initiatives supported by the Centers for Disease Control and Prevention and the Office of Minority Health to advance the reach and impact of current chronic disease prevention programs and to target health disparities that disproportionately affect racial and ethnic minority groups, health services researchers have played a leading role in helping policy makers understand the opportunities and challenges that are presented. At new and exciting times like these, we must ensure that the work and voices of health services researchers continue to be heard. These are critical elements of our work. Such shared commitment is crucial in ensuring that health services research not only continues to provide the evidence that informs and guides policy making and practices, but that researchers maintain the autonomy and confidence to explore new questions and innovative approaches that keep our methods and findings on the cutting edge of relevance and impact. This cohesive vision and common purpose will enable health services research to do its part in advancing the national goal of more effective government and better public policy that is grounded in sound scientific inquiry and demonstrated results. By doing so, we will strengthen and improve the health and well-being of our populations and the individuals whom we are privileged to serve.
In the past two decades, Congress and the executive branch have devoted substantial attention to formulating a broad legislative agenda for public health and prevention. The work of policy makers who have led efforts to bring about a comprehensive approach to public health and prevention has been greatly facilitated by the availability of a wide variety of research and data that allows us to better understand the multiple factors that determine how and where individuals live, learn, work, and play. For instance, health services researchers have been able to use geospatial and other forms of innovative data analysis to provide policy makers with a clearer picture of the ways in which health outcomes are influenced by a variety of social determinants and environmental factors and to identify effective means of targeting resources to at-risk populations. Public health leaders have also advanced chronic disease and risk prevention through the identification of strategies borrowed from the clinical sciences, such as the use of technology-driven population health management systems to better deliver care management services.
2.2 Regulatory Policies and Their Impact on Health Outcomes
Regulatory policies refer to the legal rules and administrative regulations that direct the activities of individuals and organizations in the private sector. In the context of health policy, regulatory policies cover various actions that the government takes affecting healthcare, including regulation, funding, providing services, and collecting information. Regulatory policies in health are developed, monitored and enforced by the Department of Health and Human Services (HHS) and more specifically, by federal institutions such as the Food and Drug Administration (FDA) and the Centers for Medicare and Medicaid Services (CMS). In recent decades, calls for government and other agencies to engage in extensive collaboration in order to achieve population health goals have been growing. Regulatory policies extend widely across the health and other sectors, and the impact of the statutory obligation to have ‘due regard’ for health and wellbeing in the development and delivery of services is an area to watch as new initiatives are developed and perhaps challenged in the courts. Crabbe (2018) explained that impacts on population health due to these regulatory policies at various levels of the social-ecological model such as the federal, state, community, and organizational or institutional levels will have influences on the ecological model. For example, policy efforts to provide a tax credit for grocery stores that are opening in food deserts – areas of poverty in which residents are not within a reasonable distance to a grocery store – are in place as an intervention to attempt to decrease the prevalence of diet-related health outcomes such as obesity and hypertension due to poor dietary habits. This policy intervention may serve to help decrease the health disparities experienced by the affected population in that area due to the improvements in healthy food access. However, this is also likely to promote economic benefits for the community as a whole and decrease healthcare demand and costs over time for that community. The ability for healthcare policy researchers to consider the broad potential impacts of such initiatives is derived from a recognition of the complex and multi-faceted root causes of health and illness that represent true opportunities for health promotion activity within different sectors.
2.3 Collaborative Efforts between Government and Non-Governmental Organizations
Collaborative efforts between government and non-governmental organizations are critical for the success of many public health policy initiatives. However, successful collaboration is often challenging – government agencies and non-governmental organizations are often quite different in their structure, culture, and approach, all of which can present barriers to effective joint working. In addition, there are relatively few studies of collaboration in the realm of public health policy, and most of these have been concerned with partnership working at the local level rather than between different levels of government and non-governmental organizations. Yet, as Beier and Hanemaayer argue, policy advocacy is increasingly conducted through coordinated action by advocacy coalitions. These are typically wide-ranging, involving a variety of different types of organization, from commercial actors through to non-governmental organizations. Ellis and Bentley’s comparison of policy advocacy subsystems between the US and the UK found that in the US non-governmental organizations play a very significant role in policy advocacy and that advocating through the courts is also an important route. As exemplified by the advocacy strategies of many health-related non-governmental organizations analyzed in the previous sections of this essay, it is not merely the ability of non-governmental organizations to coordinate activity which is important, but also their capacity to mount successful legal challenges and so shape the parameters of policy. This points to the importance of understanding the strategies and activities of non-governmental organizations in shaping policy, as well as issues around the constitution and operation of advocacy coalitions in different institutional contexts. Such understanding is enhanced through the application of new political advocacy theory. Advocacy coalitions and the concept of advocacy subsystems over a number of fields of policy in the UK and US, and have revealed a considerable complexity about the factors which can influence the chances of successful policy change and the conditions under which policy learning can take place. In conclusion, the essay highlights a number of ways in which non-governmental organizations can contribute to the policy process. It describes the wide range of advocacy strategies that they employ, as well as examining the role of non-governmental organizations as legal advocates and the ways in which changing technologies are opening up new possibilities for advocacy through social media and data visualization. However, it also stresses the considerable diversity among non-governmental organizations and argues that short summaries may not fully capture the complexity of different non-governmental organizations’ purposes and methods. Well-organized and structured sentences with paragraphs. Well-organized and occasionally using varied sentence structure. Well-organized and clearly written paragraphs and varied sentence structure. Well-organized and clearly written paragraphs and consistently using varied sentence structure. Well-organized and clearly written paragraphs with varied sentence structure. Well-organized and clearly written paragraphs, using varied sentence structure and language. Varied range of specialist vocabulary used with accurate spelling and punctuation.
3. Advocacy Efforts for Population Health
Public health advocacy and being part of the solution is the focus of this section. According to the ECDC – the European Centre for Disease Prevention and Control – public health advocacy works in four ways: organizing societal dynamics and cultural norms, changing the conditions that influence policy, getting the issue on the decision makers’ agendas, and developing relationships with key policy makers. Each of these aspects is designed to help progressively move the cause of solving population health issues through policy and advocacy. By organizing societal dynamics and cultural norms, it allows the public health advocate to view on a broader scale and devise a plan, through awareness and educational programs, to adapt to the needs of the health system. The process of involving a social movement to support and exercise political pressure and awareness aids in changing the conditions that affect policy for the future, where a policy working party, for example, is likely to lobby closer to its aims, creating culture change and improvement. Evidently, again this recognition further increases the potential for getting the issue addressed and recognized by those who have the power to make changes – in essence helping to get the issue on the decision makers’ agendas. And finally, developing relationships with key policy makers helps to maintain awareness and communication that can significantly advance the chances of recognition and influence. In the current health care system, occupational therapists have a responsibility to engage in public health advocacy. As the College of Occupational Therapists Standard states, “occupational therapists are skilled in working in partnership with communities and populations to engage in strategies that will promote health and well-being and prevent illness and disability.” The Standard obliges all practicing occupational therapists to advocate and encourage awareness and participation in health promotion on a large scale both publicly and politically. Public health advocacy can take many forms, including engaging with local authorities, participating in community groups, and providing support for different cultures and meshing with health care policy. By theory relating to the idea of social movement and health care policy, advocacy in the health care system can achieve far greater results than the targeted interventions that occupational therapists are used to; developing relationships with key policy makers is given as much importance in changing public health as the general public is.
3.1 Role of Public Health Advocacy in Shaping Policy
Traditionally, advocacy is seen as the work of actively supporting a cause or proposal in the hope of influencing decisions and legislation. Public health advocacy regards the promotion of the physical, socio-political and economic well-being of all through organised social action. It is not for personal gain, in which case it will be pure professional self-interest. Public health advocacy seeks to protect the community as a whole. Public health advocacy takes place at different levels; it can be local, national or global. Advocates may work at the policy level, in which case the work involves identifying a need, deciding on a goal, starting an initiative and finally seeing it through. Policy advocacy focuses on moving policies and resources so as to improve the well-being of the community. Public health (policy) advocacy has great significance particularly in the United States where a three-tier system is employed, made up of federal, state, and local government. The complexity of the system can make it hard for efficient public health initiatives to be legislated; however, policy advocacy plays a vital role in making sure that the right decision is reached to ultimately benefit the community as a whole. There are many reasons explaining why public health advocacy has become more and more significant over the years and they are typically responses to changes that occur in the social and political systems.
3.2 Mobilizing Communities for Health Advocacy
Such community action involves the process of involving communities in the identification of health issues, determination of need, planning, implementation, and evaluation of health programs. Also, it often takes a longer period of time to achieve the changes that are wanted by the communities. During the whole process, empowering communities either by providing the resources and solutions for the healthcare and social problems or enabling the personal and organizational development of the people involved has to be emphasized.
For example, Mobilizing for Action through Planning and Partnership (MAPP) is a community-driven strategic planning process for improving community health. MAPP is not an isolated health improvement program – it’s a tool for improving health in general. It provides a framework for communities to prioritize public health issues. And most importantly, it “helps local leaders make decisions that improve their community’s health” by ensuring that every community should be able to enjoy good health and a safe environment and have the possibility to choose and maintain good health. However, there are conditions that deny many people these basic rights. Health inequities are the unfair and avoidable differences in health status within and between communities. (Marmot M. The Solid Facts: Social Determinants of Health.) True change occurs only when the need for change becomes greater than the need to maintain the status quo. By confronting the issues of health disparities head-on, we can work together to create a society that is healthier for us all. Every person has the right to live a healthy life to their fullest potential and without being judged by others. By improving overall health in the St. Cloud area, we are also, in part, improving the success of the entire community. A holistic approach to health and the belief that access to quality health care is a right, not a privilege, allows for a more stable society. When more members of the community, such as the elderly, students, and those living at or below the poverty lines, are provided with the help they need to obtain long-term success, everyone benefits.
First of all, it is important to point out the target of “community mobilization.” As for CHNs, we often work with people who have limited access to healthcare and other social resources. Community mobilization empowers those who have needs but may not have the resources to access. Also, working with people in communities to identify their own needs and to plan and deliver services accordingly is referred to as “community development.” Therefore, the target of community mobilization can be seen as the “process” toward any positive changes of “outcomes” that are defined by the communities. The strategies of community mobilization include “organizing by community,” “participatory techniques,” and “skill development,” etc.
Community-based advocacy efforts can address not only individual health problems but also initiate social and political change. When community members come together, build consensus on the importance of health promotion, and implement its programs, community action is achieved. Community mobilization can be defined as “the process of involving people who are disenfranchised and marginalized by reason of personal and social characteristics, and who are therefore unlikely to join in more formal activity,” or it can be regarded as an effective tool to involve people who are outside the political and public health processes in making decisions and promoting their own health.
3.3 Effective Communication Strategies for Advocacy
Health advocates should employ strategies that can bring in the most sophisticated power holders in a community to address a specific health problem. These strategies include mobilizing the media, building effective coalitions, framing and effective messaging. One of the leading communication strategies so far is the strategy of mobilizing the media for advocacy. Producing mass media, mostly used in campaigns, is a very powerful way of creating awareness and informing the public about general and specific issues. Health advocates may try to encourage the media to cover specific problems in the community, or they may develop a media campaign. Community leaders are likely to pay attention to the media and may be under pressure to respond to the issues that are covered in the news. When the media is talking about an issue, it is a good opportunity for health advocates to engage policy makers and to bring greater attention to the problem. Producing multimedia such as documentary films and slideshows is very effective when the aim of the campaign is to inform a big number of people about a specific health problem or to create a general awareness. Such multimedia are an effective means of reaching a big audience, both literate and illiterate people. On the other hand, utilizing focused media, such as emails, phone calls, postcards and faxes, is mostly effective when health advocates want people to take a particular action. Over time, health advocates have come to realize that employing public relations firms to help advance issues is an essential aspect of mobilizing the media. The firms can help advocates design media campaigns, create and fund issues based coalitions and keep issues in the news for a long time. They also usually maintain very good relations with national and local media sources. However, the success of this strategy greatly depends on the ability of an advocacy team to mobilize members of the media. This is where sustained, ongoing and resource intensive effort is required. Social media, especially with the growth of internet, has shown potential to be one of the main tools for policy advocacy in recent few years. Health advocates are using social media to solicit, consider and mobilize support in ongoing advocacy initiatives. Social media provides a quick and cheap way for advocates to.
4. Impact and Future Directions
A comprehensive analysis of the text to determine the effectiveness and future directions of policy and advocacy for improving population health in the USA is presented in this section. First of all, researches demonstrate that policies in different sectors such as health, transportation, housing, and environment have potential impacts on population health and health disparities. And “health in all policies” is an approach that encourages policymakers to proactively seek health improvement opportunities and to promote a collaborative approach to health at all levels of public policy-making. The emphasis is on synergistic and health protective policy change, across different sectors, that can in turn create cumulative positive impacts on health. Such approach calls for expanded use of scientific evidence and health data in decision-making. The recognition of policy development and implementation as complex, dynamic, and constantly discursive processes presents both challenges and opportunities to those who use evidence to inform policy advocacy. And researchers and practitioners are still in the process of understanding the complex interactions among policy and political processes and population health outcomes. The adoption and implementation of effective policies and interventions are essential to improve population health and reduce health disparities. However, there are a number of potential challenges and limitations that researchers, policy makers and advocates have to face when developing, implementing and advocating for policies, from the discovery and designing of the interventions to the evaluation of the outcomes. For example, the multiple factors that cause health problems disrupt the society are likely to require knowledge, expertise and resources from team of researchers and advocates who are based in, or who have the capacity to, address a spectrum of different fields. This calls for interdisciplinary research and intervention that take into account the differing priorities of communities and stable and equitable funding needs to be maintained over the long term for cross-sector collaboration and community engagement to show success. The effectiveness of working with cooperative and mediating factors that allows for the policy within the system in a given population to have positive effects on health helps to support the argument the comprehensive approach. And to move toward the best possible health for everyone, more funding needs to be given not only to investigate how ‘health in all policies’ could be utilized in current society but also to develop and assess the processes that genuinely encourage and sustain cross-sector collaboration.
4.1 Evaluating the Effectiveness of Policy and Advocacy Interventions
Effectiveness of change agents, the types of policy interventions and the levels at which they operate, the research designs and methods used to evaluate policies and the breadth and weight of evidence needed to justify action, are today’s very complex issues. Evaluating the effectiveness of policy and advocacy activities designed to create social or physical environments that support the adoption of healthy lifestyles and sustain the improved state owing to previous reforms is a challenging task. First of all, this kind of work requires some methodological flexibility. As a matter of fact, policy changes and related activities are normally an ongoing process – if linked to a specific project or a program, they are planned to take several years to be developed; hence, it is hardly possible to identify a clear-cut “before and after” kind of scenario. Trying to measure the effectiveness of policy and advocacy actions in fostering conditions needed for better health and wellbeing often leads the researcher to take either a very broad or a very narrow perspective of the actions analyzed, above all if a single method is used, like it is the case with the vast majority of the evaluation field. Also, what many scholars advocate nowadays is the so-called “evidence-based” approach, a concept first of all introduced in the field of medicine. While there is a substantial literature about the efficacy of the evidence-based medicine approach, still very little has come up about how policy intervention research can be fitted into such a logic, above all recognizing the peculiarities and complexity of the policy cycle and the subjective, inherently political judgments that often are to be made.
4.2 Potential Challenges and Limitations in Implementing Population Health Policies
Lastly, there are many limitations in implementing population health policies in the USA. First of all, as mentioned previously, many of the significant drivers of health outcomes are social determinants such as income, education, employment, and social support networks. However, these determinants fall outside the traditional influence of the medical delivery system. Policymakers and those in charge of healthcare services may be required to take a broader view, and this may involve restructuring the focus and funding of services. It often requires sustained effort, the health improvements may take time to materialize during which there could be pressure on resources and discouragement within the implementing organizations. Furthermore, major population health initiatives in the past have been made possible by a single visionary leader. The sustained attempt at major health improvement across a population is a rare phenomenon and can be difficult to achieve without such figures. Also, the pharmaceutical and medical devices industry in the US has grown massively in recent times and it is reflected in the money spent. In 1990, the industry spent $17.1 billion on R&D on healthcare delivery and biomedical research, while in 2012 this had increased to $143.6 billion. This growth inevitably means the industry has a substantial effect on biomedicine and to some extent healthcare services – for example, the increasing use of genetic therapies or advanced imaging. Established and powerful industries will resist significant change that endangers profits and their existing role in the healthcare systems and this may seriously limit the options available to policymakers. Also, it is inevitable that bias will play a role in deciding the health profile of the population due to the need to prioritize certain illnesses and risk groups. This might result in political wrangling and debate over what constitutes national needs and risks. Lastly, and perhaps most importantly, resources will always be limited. Critical assessment of implementing policies will demand close attention to the question of whether the action taken will make a substantial difference and whether they can be afforded by the budgets. Such questions should, in theory, be answered by strong evidence-based assessment of potential success. However, the variety of potential programs wishing for funding and length of time success might need convergence can place a serious strain on resources. Similar to the problems in equity, what is proposed as evidence-based or what constitutes best practice may carry certain political and commercial clout, potentially unbalancing judgments and skewing resources towards favored programs and interventions. From the above, it is clear that the road to implement population health policy is a tough and long one. But if success can be achieved, the results are bound to be fruitful and long-lasting. Success, however, has to start somewhere. As Mulrow highlights “A common vision and will to develop and pursue a national agenda for better population health are urgently needed in the United States”. And it is this leadership that will drive the future of population health. Success, however, has to start somewhere. As Mulrow highlights “A common vision and will to develop and pursue a national agenda for better population health are urgently needed in the United States”. And it is this leadership that will drive the future of population health.
4.3 Future Directions for Policy and Advocacy in Improving Population Health
I believe the conclusion of the essay provides a good summary of future steps. For example, the concluding section of the essay suggests the need for more comprehensive and effective policy solutions, making sure to include “all segments of the population” in policy development, better integration of various policy levers, especially assisted living policies, into comprehensive approaches to population health, and the need for advocacy not just for changes in specific policies but “also society and culture to create the types of environment and interactions that support health and well-being.” One exciting direction for population health policy is the possibility of improving the effectiveness of policy by using simulation models. According to a 2018 report released by the National Academies of Sciences, Engineering, and Medicine, these “cutting-edge” tools, which can simulate “how different policies might play out in real-life communities,” are “underused” and “have the potential for greater impact in helping policymakers working to develop community-based strategies for improvement.” The use of simulation in this context is an example of the broader issue of how to balance and optimize many different kinds of policy interventions so that they work together to maximize the health of the population. At a minimum, simulation models could help policymakers to better understand the potential impact of initiatives before they are adopted in communities. Such insights could help policymakers to avoid adopting less effective initiatives merely because they are “politically expedient” and could also help to build support for difficult changes. This is a very information-heavy section of the essay, and I feel that there are some parts of the conclusion that could be expanded, particularly in relation to the possibility of using simulation models. I think the essay would be stronger if each key point in the conclusion was expanded into a paragraph, providing evidence, discussing the implications of the evidence, and relating the point back to the main. By doing this, I feel that the conclusion would provide a stronger end to the essay and would leave the reader with all the information they need to understand the importance of the issues raised and the potential for population health policy in the future.