Population health is a phrase bandied about quite a bit these days. But, what exactly does it mean? Population health is defined as the “health outcomes of a group of individuals, including the distribution of such outcomes within the group.” Groups are sometimes geographic populations, such as residents of Plainview or college students in Lubbock, but can also be groups such as employees of Lubbock County, ethnic groups, disabled persons, prisoners or any other defined cohort. When considering population health, the overall health of a population might be good, but within that population (or group) there can be subsets that are less healthy. The idea is to help those that are less healthy join in the good health of the larger population.



For example, let’s say the larger group is comprised of college students in Lubbock, but within that population there are subsets. In this example, there is a group of pre-diabetic individuals and diabetic individuals. We know from the literature that college students tend to gain weight during their first year of school and often have poor nutritional habits. We also know that there is an association between elevated BMI and diabetes.

Hypothetically, if Texas Tech Physicians had responsibility for the health of this population, or were getting paid a per member/per month fixed fee for taking care of the health of this population, we would want to help these subsets with diabetes education and treatment. A clear goal would be to prevent or delay the onset of diabetes in the pre-diabetic subset. With the subset of diabetic patients, we would want to assist them in keeping the disease under control by monitoring and even lowering the hemoglobin A1C test, which measures long-term glucose control.

A key concept in population health is that we are concerned about the health of people who are not yet patients in the traditional sense. I am currently involved in a project, led by Dr. Alan Peiris of our faculty, in which we are developing predictive analytics to determine the subsets that will be most intensive in terms of effort needed.

If we wanted to categorize all these individuals in a population, it might, in a very broad sense, look like this:

· Those who are currently healthy and likely to stay that way, as they have healthy behaviors and they have no identified genetic or other risk factors
· Those who are currently healthy, but have risk factors that place them at risk of becoming patients
· Those who are currently in need of acute care due to “episodic” events, which can happen to anyone
· Those who are currently chronically ill, which is group that consumes much of the resources

Think for a minute of the different things that each of these subsets would need and of how Texas Tech Physicians could address those needs. Population health is always concerned about the individual, but also how that person fits in the larger group and in keeping all in the group healthy to manage the increased financial risk shifted to us.