What is population health?

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Last updated: June 26, 2025View editorial policy

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From the Guidelines

Population health is defined as the health outcomes of a group of individuals, including the distribution of health outcomes within the group, and can be measured in terms of health indicators, disease epidemiology, and behavioral and metabolic factors. This definition is based on the most recent and highest quality study available, which emphasizes the importance of addressing social determinants of health and implementing preventive strategies to reduce disease burden 1.

Key Components of Population Health

  • Health indicators, such as mortality, morbidity, and functional status
  • Disease epidemiology, including incidence and prevalence
  • Behavioral and metabolic factors, such as physical activity, nutrition, and A1C levels
  • Social determinants of health, including education, income, and environment

Importance of Addressing Social Determinants of Health

Addressing social determinants of health is crucial to improving health outcomes and eliminating disparities, particularly for individuals from racial and ethnic minority communities, underserved geographic areas, and those facing socioeconomic barriers to care and health 1.

Role of Healthcare Organizations

Healthcare organizations practicing population health often use data analytics to identify high-risk groups, coordinate care across providers, and measure outcomes systematically 1. The ultimate goal is to achieve better health outcomes for all community members while reducing healthcare costs through prevention and more efficient care delivery.

Effective Approaches to Population Health

Effective approaches to population health include implementing evidence-based interventions, such as the Chronic Care Model, which integrates self-management support, delivery system design, decision support, and clinical information systems to promote better prepared, proactive healthcare teams and better informed and activated patients 1.

From the Research

Definition of Population Health

  • Population health refers to the health outcomes of a group of individuals, including the distribution of such outcomes within the group 2.
  • It encompasses health outcomes, patterns of health determinants, and policies and interventions that link these two 2, 3.
  • Population health includes attention to social and environmental, as well as medical, determinants of health 2.

Key Concepts

  • Health outcomes: the results of health care and other factors that affect the health of a population 2, 4.
  • Health determinants: the factors that influence health outcomes, including social, environmental, and medical factors 2, 4.
  • Policies and interventions: the actions taken to improve health outcomes and reduce health disparities 2, 3.

Relationship to Public Health

  • There is debate about whether population health and public health are identical or different 5.
  • Population health can be used to inform public health policy and practice 5, 6.
  • Clarifying the definition of population health is important for public health research, practice, and policy 6.

Measurement and Analysis

  • Valid, reliable, and comparable measures of health states and health status are critical components of the evidence base for health policy 4.
  • Population health measurement strategies should address the relationships between epidemiological measures and multi-domain measures of population health status 4.
  • Electronic health records and registries can be used to capture population health data and identify areas for improvement 3.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

What Is Population Health?

Primary care, 2019

Research

Population Health Management and Cancer Screening.

South Dakota medicine : the journal of the South Dakota State Medical Association, 2017

Research

Understanding population health terminology.

The Milbank quarterly, 2007

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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