Suggested Citation:
"Appendix D: Small-Group Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity." National Academies of Sciences, Engineering, and Medicine. 2022. Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop. Washington, DC: The National Academies Press.
doi: 10.17226/26059.
Suggested Citation:
"Appendix D: Small-Group Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity." National Academies of Sciences, Engineering, and Medicine. 2022. Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop. Washington, DC: The National Academies Press.
doi: 10.17226/26059.
***WORKING DRAFT – prepared by Marc Gourevitch with assistance from Alina Baciu to inform discussion at the September 19 workshop Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream
Suggested Citation:
"Appendix D: Small-Group Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity." National Academies of Sciences, Engineering, and Medicine. 2022. Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop. Washington, DC: The National Academies Press.
doi: 10.17226/26059.
WORKSHEET FOR THE PRACTICAL EXERCISE Toward Co-Creating Shared Language to Understand and Advance Population Health and Health Equity
Identify a rapporteur and a note-taker; annotate the large format version of the diagram, to report group feedback and leave behind for NASEM staff; Keep the handout for your reference, and to continue the conversation after today.
Reflect on the presentations and discussion of the day, and the tensions and promise of upstream approaches to advance population health. Considering the Cross Cutting Needs: Workforce, Organizational Structures & Policies, Data & Technology, Metrics and any other considerations, review the diagram and answer the following questions.
What information does the diagram seem designed to convey?
How does this diagram help describe the role of my organization & work?
What are its possible uses?
How can I use this in my organization, my work?
What changes are needed to make it more useful for specific audiences?
How can I adapt this to describe in my organization, my work?
References:
Castrucci, B, and J Auerbach. 2019. Meeting Individual Social Needs Falls Short of Addressing Social Determinants of Health. Health Affairs Blog.
Kindig, DA, and G Isham. 2014. Population Health Improvement: A Community Health Business Model That Engages Partners in All Sectors. Frontiers of Health Services Management.
Auerbach, J. 2016. The 3 Buckets of Prevention. Journal of Public Health Management and Practice.
Alderwick, H, and LM Gottlieb. 2019. Meanings and Misunderstandings: A Social Determinants of Health Lexicon for Health Care Systems. Milbank Quarterly.
Suggested Citation:
"Appendix D: Small-Group Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity." National Academies of Sciences, Engineering, and Medicine. 2022. Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop. Washington, DC: The National Academies Press.
doi: 10.17226/26059.
Suggested Citation:
"Appendix D: Small-Group Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity." National Academies of Sciences, Engineering, and Medicine. 2022. Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop. Washington, DC: The National Academies Press.
doi: 10.17226/26059.
Suggested Citation:
"Appendix D: Small-Group Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity." National Academies of Sciences, Engineering, and Medicine. 2022. Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop. Washington, DC: The National Academies Press.
doi: 10.17226/26059.
Suggested Citation:
"Appendix D: Small-Group Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity." National Academies of Sciences, Engineering, and Medicine. 2022. Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop. Washington, DC: The National Academies Press.
doi: 10.17226/26059.
Suggested Citation:
"Appendix D: Small-Group Exercise: Up/Mid/Downstream Paradigms in Advancing Population Health and Health Equity." National Academies of Sciences, Engineering, and Medicine. 2022. Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop. Washington, DC: The National Academies Press.
doi: 10.17226/26059.
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Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop
2022
The Roundtable on Population Health Improvement of the National Academies of Sciences, Engineering, and Medicine hosted a public workshop on September 19, 2019 titled Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream. The term upstream refers to the higher levels of action to improve health. Medical services act downstream (i.e., at the patient level) in improving population health, while such activities as screening and referring to social and human services (e.g., for housing, food assistance) are situated midstream, and the work of changing laws, policies, and regulations (e.g., toward affordable housing, expanding healthy food access) to improve the community conditions for health represents upstream action.
The workshop explored the growing attention on population health, from health care delivery and health insurance organizations to the social determinants of health and their individual-level manifestation as health-related social needs, such as patients' needs. The workshop showcased collaborative population health improvement efforts, each of which included one or more health systems. This publication summarizes the presentations and discussions from the workshop.
National Academies of Sciences, Engineering, and Medicine. 2022. Models for Population Health Improvement by Health Care Systems and Partners: Tensions and Promise on the Path Upstream: Proceedings of a Workshop. Washington, DC: The National Academies Press.
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