Understanding individual, population, & public health
I recently shared a post about 10 evidence-based tips for good health from public health researchers at the University of Bristol. The list includes common-sense health tips at a societal level; things like “don’t be poor” and “don’t be disabled.”
Of course, the writing style points to the necessities of combating the social determinants of health, and the fact that individual and public health, while interconnected, are distinct fields of study.
One tip jumped off the screen for a commenter: Be able to afford your own car.
This comment was in good faith, as there was a robust back and forth on the topic. And they are correct: driving is not healthy on an individual level. It’s not like walking or lifting weights or eating a whole foods diet. But these practices are different than population health and public health behaviors.
The differences between individual, population, and public health are not just semantic.
These distinct fields of study require varying approaches and policies. While always interconnected, a lot of online discourse confuses these three fields.
Let’s take a look at the differences. It’s relevant to driving a car (and much else), which I’ll return to near the end.
Population health vs individual health
Essentially, population health provides the contextual framework within which individual health is understood and addressed, while individual health contributes to the overall health profile of populations.
Here’s how they differ:
Scope: Individual health focuses on a single person’s well-being, while population health examines the health outcomes of groups sharing specific characteristics.
Determinants: Population health considers broader factors like socioeconomic circumstances, environmental conditions, and collective behaviors that shape health outcomes across groups. Individual health primarily concerns personal factors such as genetics, lifestyle choices, and immediate medical needs.
Context: An individual’s health is relative and must be understood within the broader population context. Conversely, population health is shaped by the collective health experiences of its individual members.
Measurement: Population health requires multidimensional measures to capture the complex interplay of factors affecting group health outcomes. Individual health assessments typically focus on specific medical indicators and personal health status.
Interventions: Population health strategies often target policies and higher-level interventions that impact entire communities. Individual health interventions usually involve personalized medical treatments and lifestyle modifications.
Data analysis: Population health relies heavily on data analytics to identify trends, disparities, and opportunities for targeted interventions across groups. Individual health data is primarily used for personal diagnosis and treatment.
Population health vs public health
Now let’s broaden out and look at the differences between population health and public health. Despite their differences, these fields are even more interconnected, with population health insights often informing and driving public health policies and programs.
Scope: Population health focuses on specific groups or communities sharing certain characteristics, while public health addresses the health of the entire population.
Focus: Population health emphasizes understanding and improving health outcomes within defined groups, considering various determinants of health. Public health concentrates on disease prevention, health promotion, and protecting the overall health of communities.
Approach: Population health relies heavily on data analytics and insights to identify health trends and tailor interventions for specific populations. Public health implements broader policies, education programs, and preventive measures for the general public.
Interventions: Population health strategies often target specific health disparities or needs within a group. Public health initiatives typically involve large-scale efforts like vaccination campaigns or tobacco control policies.
Data utilization: Population health leverages detailed data analytics to create personalized care plans and identify health trends within specific groups. Public health uses population-wide data to track and respond to broader health issues and disease outbreaks.
Policy focus: While both fields influence policy, public health has a stronger emphasis on developing and implementing health-related laws and regulations at various governmental levels.
Why this matters
A number of wellness influencers and health-conscious folk believe Robert F Kennedy, Jr is going to fix America’s health system. His MAHA movement has galvanized a coalition that thinks massive, systemic change is about to occur.
Here’s the problem: most every idea emerging from MAHA is about individual health. The sovereignty of the body is a primary focus of this campaign. None of the solutions being offered are at a population health or public health level.
Then, the other problem: successful public health solutions that already exist, like vaccination programs, are in danger under a Kennedy-run HHS.
So far, MAHA has focused on “problems” like seed oils and food dyes. They’ve minimized the complex interconnections between individual, population, and public health to make it appear like a few food ingredients are what’s really driving chronic disease and obesity in America. Forcing companies to remove those ingredients from their products make for great marketing but horrible public health policies. A better approach would be to look upstream at why so many people can only afford processed foods in the first place, which requires an investigation into numerous socioeconomic and cultural factors.
Meanwhile, actual upstream solutions Kennedy has proposed, such as ending the pharmaceutical lobby in DC and banning DTC pharma advertising, are unlikely to pass a GOP-controlled Congress, when that party has greatly benefited from the nation’s largest lobbying group.
MAHA has been successful due to the same confusion the commenter above expressed: people mistaking individual health with public health. To their point: driving is not a healthy behavior when compared to exercising. If the list shared above was about individual health practices, driving should be excluded.
But that’s not what the list is about. From a public health perspective, the poorest members of society (often immigrants and minorities) have the least access to cars. They rely on public transportation to earn a living, which means long wait times, irregular and unreliable service (depending on where they live), enduring extremely cold and/or hot temperatures, and the stress of additional hours per day devoted to commuting.
These stresses often result in negative health outcomes, including anxiety, depression, exposure to pollutants, physical strain, increased risk of infectious diseases, sleep deprivation, and reduced access to healthcare. Public health researchers have weighed the evidence and concluded that these tradeoffs to any physical issues with driving are worth it.
Understanding the differences—and connections—between these three forms of health are essential if we want to improve health outcomes. Anyone obscuring those differences is either ignorant that they exist or intentionally blurring the lines for their own agenda.
No one guilty of either should ever be in charge of public health.
