In 2000, the Institute of Medicine (IOM)-the health policy arm of the National Academy of Sciences-held a one-day symposium of experts in behavioral and social science, epidemiology, grantmaking, health and social policy, and population health to discuss and develop strategies for community- or population-wide health improvement beyond clinical care.
The symposium was prompted by evidence that interventions focused on non-medical factors can play a major role in promoting the health of communities.
Marketing campaigns to change behaviors (such as smoking cessation), economic policies (such as efforts to provide job opportunities) and legislation (such as gun control or mandating bicycle helmets) are among the opportunities to enhance the health of a population.
Project staff at IOM convened a five-member steering committee to guide the selection of workshop participants and to develop the agenda. (See the Appendix for a list of members.)
The symposium, "Population-Based Strategies for Improving Health: Charting a Field," took place on September 28, 2000, in Washington with approximately 35 participants. The interactive workshop focused on three main areas:
- The areas of endeavor that support the use of population-based interventions to improve health. These include epidemiological assessment, analysis of cost-effectiveness, communication technologies, marketing expertise and approaches that help determine appropriate interventions.
- The variety of approaches that have been used to integrate efforts in diverse fields. In order to develop innovative policies and broad-based approaches to population health, collaborations among experts in multiple fields are likely to be necessary.
- Institutional arrangements that have been effective in bringing appropriate expertise to the issue. Although models of successful funding are few, participants discussed the issues involved with creating new programs and possible mechanisms for their implementation.
The symposium included three presentations:
- The goals of the Robert Wood Johnson Foundation in population health (J. Michael McGinnis, M.D.).
- The breadth of scientific areas that should be encompassed by population-based health (Leonard Syme).
- The challenge of establishing interdisciplinary centers (Daniel Stokols).
A five-member panel discussed a variety of approaches to population health, including a grassroots perspective and an economic perspective that focuses on the incentives and constraints affecting individuals in their behavior choices.
The group as a whole discussed how to integrate multiple disciplines into a cohesive unit to study population health.
The Center for Social Epidemiology and Population Health at the University of Michigan was cited as an example of a university setting that brings together several disciplines. There was agreement that more study was needed on "catalytic factors" that create widespread change.
Three breakout working groups were each assigned one of the following hypothetical tasks:
- Design a center to address population health.
- Develop a broad plan to advance research in population health.
- Develop approaches to stimulate the interdisciplinary efforts and the integration of fields in the study of population health.
Among the areas explored by the working groups were:
- How to integrate multiple perspectives with similar or complementary themes at research centers.
- The importance of institutional commitment to overcome obstacles and provide incentives to participate.
- The role of community participation in enhancing population health.
- The importance of training to advance the field.
- The challenge of funding for long-term studies in population health research.
Project staff transcribed the seminar proceedings and distributed approximately 150 copies to all participants, to those unable to attend and to other interested parties.
The Robert Wood Johnson Foundation (RWJF) supported the project with a grant of $82,819 to the National Academy of Sciences - Institute of Medicine between June and November 2000.