Population Health in Challenging Times: Insights from Key Domains: Proceedings of a Workshop (2023)
Chapter: 1 Introduction
1
Introduction
The year 2020 presented extraordinary challenges to organizations working to improve population health—from public health agencies at all levels of government to health systems to community-based nonprofit organizations working to respond to health-related social needs. Between September 21 and 24, 2020, the Roundtable on Population Health Improvement held a workshop in six online sessions titled Population Health in Challenging Times: Insights from Key Domains. The concept for the workshop arose from a growing need to understand how the different domains in the population health field are responding to and being changed by the two major crises that they are confronting—racial injustice and the COVID-19 pandemic—within the societal context that also includes the national opioid overdose “epidemic” and other challenges. The workshop was organized by a planning committee composed of members of the Roundtable on Population Health Improvement: Sanne Magnan (Chair), John Auerbach, Bobby Milstein, and Lourdes Rodriguez. The charge to the planning committee is described in Box 1-1, and the workshop sessions were organized around five key domains:
- Academic public health and population health,
- The social sector,
- Health care,
- Governmental public health, and
- Philanthropy.
A sixth session showcased high-level themes in cross-sector work. Each panel was designed to bring together several individuals with deep knowledge of that domain who were able to clearly articulate difficulties and opportunities, both internal and external, to their organizations.
Since February 2013, the Roundtable on Population Health Improvement has provided a trusted venue for leaders from the public and private sectors to meet and discuss leverage points and opportunities arising from changes in the social and political environment for achieving better population health. Population health is defined by Kindig and Stoddart (2003) as the health outcomes of a population, the patterns of determinants that shape those outcomes, and the interventions, including policies and investments, that link outcomes and determinants.
The roundtable’s vision is of a thriving, healthful, and equitable society. The roundtable describes its mission as follows:
In recognition that health and quality of life for all are shaped by interdependent historical and contemporary social, political, economic, environmental, genetic, behavioral, and health care factors, the roundtable exists to provoke and catalyze urgently needed multisector community-engaged collaborative action.1
In his introductory remarks orienting viewers to the week’s sessions, Joshua Sharfstein, vice dean at the Johns Hopkins University Bloomberg School of Public Health, roundtable co-chair, and moderator of the first session and panel, noted that each of the conversations expected to take place throughout the workshop would be “anchored in the incredible moment in time we are finding ourselves in.” He went on to note how the pandemic has “revealed profound inequities in our society and societies all around the world, most recently with the startling statistic” that more
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1 See http://nas.edu/pophealthrt (accessed June 23, 2021).
than 75 percent of children who have died from COVID-19 are from communities of color. The pandemic is intertwined, he noted, with
the crisis that reflects the exposure of racism in our society, the murder of [George] Floyd, the protest that followed, and the recognition that it is not just law enforcement that has a reckoning with race but many other fields including health and population health as well.
Sharfstein then enumerated the other crises affecting the health of American communities, from the overdose crisis, which is likely worsening during the pandemic, to the growing food insecurity affecting so many families around the country. Sharfstein stated that
This is an extraordinary time for the country and an extraordinary time for our field … and the discussions that will happen this week are going to be about what each of these domains can do to rise to the moment, to respond to the crises, and to provide greater vision and support for the country and the world moving forward.
This Proceedings of a Workshop summarizes remarks and conversations from the six distinct panels listed above from Chapters 2 to 7: academia, the social sector, health care, (governmental) public health, philanthropy, and cross-sector partnerships. Each panel offered a compelling mix of introspection and ideas to further the role and influence of its sector in nurturing the conditions for equitable health and well-being in communities during the pandemic, recovery, and into the future. Highlights from the remarks and discussions are summarized in Box 1-2.
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