The Population Health Template Tool
The ‘Population Health Template working tool’ was published in draft form by the Strategic Health Directorate of Health Canada in 2001. The document (which sadly appears to have been archived) gave an excellent overview of the logic of using a population health approach.
"The population health approach builds on a long tradition of public health, community health and health promotion, and reflects the evolution of our thinking related to health. Health is understood to be a capacity or resource for everyday living, that enables us to pursue our goals, acquire skills and education, grow and satisfy our aspirations. The population health approach recognizes that many interrelated factors and conditions contribute to health … (it) aims to maintain and improve the health of the entire population and to reduce inequities in health status among population groups. To reach these objectives, it considers the entire range of factors and conditions (commonly referred to as the determinants of health) – and their interactions – that have been shown to influence health over the life course. The resulting knowledge is used to develop and implement policies and actions that will achieve health gains."
The report notes that "A healthier population makes more productive contributions to overall societal development, requires less support in the form of health care and social benefits, and is better able to support and sustain itself over the long term. Actions that result in good health also bring wider social, economic and environmental benefits for the population at large. These benefits include a sustainable and equitable health care system, strengthened social cohesion and citizen engagement, increased national growth and productivity and improved quality of life."
The template tool suggests how actions may be coordinated to achieve these goals. Working from the left of the diagram, the series of dark red shapes identify key stages in implementing a population health approach, while the orange boxes remind us of the normal iterative planning loop (here circling counter-clockwise). The key elements begin with identifying priorities for action (based on indicators of health status in the population) and an analysis of determinants. The next box makes the point that the choice of actions to take should be based on evidence of effectiveness of the intervention. The next box reminds us to lean toward the 'upstream' determinants to address root causes of health and illness, while not neglecting immediate causes. Next, interventions should use multiple approaches (care, prevention, health protection, health promotion) involve multiple sectors working in collaboration and with public engagement. The final box, on accoutability, reminds us that routine evaluation of effectiveness should be included, and that knowledge should be disseminated.
This model is so clear that it is truly a shame that (as of January 2014) it has somewhat disappeared from view.