September 2002

Grant Results

SUMMARY

In 2000, staff at the University of Wisconsin-Madison Center for Health Policy and Program Evaluation organized a conference on strategies to improve population health through the reallocation of national spending on health, education, and other concerns.

Some investigators increasingly advocate a broader population-based view of health, which uses measures of quality of life and daily functioning to define the health status of a group of people. The availability of health care services, social and economic conditions, and the general environment are among the factors that can influence population health.

Key Results

  • The conference, entitled "Practical Strategies for Cross-Sectoral Allocation of Resources to Improve Health," was held June 14–16, 2000, in New York, N.Y. The conference was attended by 22 academic and health care policymakers from the United States, Canada, the United Kingdom, and New Zealand (see the Appendix for a list of participants).

    The meeting's title, "Cross-Sectoral Allocation of Resources to Improve Health," refers to the idea that spending on the health care sector alone may not be sufficient to improve population health.

    In this view, targeted investments across many different sectors of society — including education, employment, and housing — may have more profound effects on population health as a whole.

    During the conference, attendees heard case studies of this approach as it has been applied in Oregon; on Prince Edward Island in Canada; and in New Zealand. These talks were followed by panel presentations and discussions of the issues, current policy, and research experience (see the Bibliography for more details).
  • In a conference report submitted to the Robert Wood Johnson Foundation (RWJF), conference organizers noted that in the United States, where spending on medical care now consumes 14 percent of the gross domestic product, it is not unreasonable to wonder if a more balanced investment among the other determinants of population health might yield a greater return in the future.

    They noted that although the empirical evidence remains incomplete, there is a strong association between education and income and health outcomes, leading many to believe that enhanced investments in education would yield greater returns to population health. Similarly, investments in child health may be more cost-effective than many expenditures made at the end of life.

    According to the report, meeting participants identified a number of next steps that could be made toward promoting cross-sectoral allocation of resources to improve health, including:
    • Document the best and the worst examples of existing cross-sectoral approaches to improving population health. Develop a list of politically feasible opportunities.
    • Identify reasons why other sectors should be concerned about health. Create a common language for academics, practitioners, and policymakers.
    • Assess the health impact of non-health activities. Explore the readiness for an alternative use of resources.
    • Market the concept of population health through articles, journal supplements, or meetings convened by an authoritative source, such as the Institute of Medicine of the National Academy of Sciences of the United States.

Although this grant originally was designed to fund meeting planning, with RWJF approval, grant funds were applied to convening the conference itself. The Milbank Memorial Fund, a New York City-based foundation supporting analysis, research, and communications on health policy issues, cosponsored the conference.

After the Grant
Milbank also sponsored a follow-up conference in Portland, Ore., in January 2001. "In Portland, Ore., in January 2001," a draft manuscript from that meeting, tentatively entitled "What New Knowledge Would Help Policy Makers Better Balance Investments for Optimal Health Outcomes," is being prepared.

Funding
RWJF supported the conference with a grant of $60,617 between June 1998 and August 2000.

 See Grant Detail & Contact Information
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GRANT DETAILS & CONTACT INFORMATION

Project

Planning for a Population Health Improvement Leadership Conference

Grantee

The University of Wisconsin-Madison Center for Health Policy and Program Evaluation (Madison,  WI)

  • Amount: $ 60,617
    Dates: June 1998 to August 2000
    ID#:  030887

Contact

David A. Kindig, M.D., Ph.D.
(608) 263-6294
dakindig@facstaff.wisc.edu

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APPENDICES


Appendix 1

(Current as of the time of the grant; provided by the grantee organization; not verified by RWJF.)

Conference Participants

Yukiko Asada
Research Assistant
The Department of Preventive Medicine
The University of Wisconsin at Madison
Madison, Wis.

Brian K. Atchinson
Vice President and Managing Counsel
UNUMProvident
Portland, Maine

Deborah Bohr
Vice President
The Health Research and Educational Trust
Brooklyn, N.Y.

Jo Ivey Boufford
Dean
The Robert F. Wagner Graduate School of Public Service
New York University
New York, N.Y.

Philip Davies
Deputy Director — General (Policy)
The Ministry of Health
Wellington, New Zealand

Patricia Day
Senior Research Fellow
The Department of Social and Policy Sciences
The University of Bath
Bath, England

Tim Evans
Team Director
Health Equity
The Rockefeller Foundation
New York, N.Y.

Daniel M. Fox
President
The Milbank Memorial Fund
New York, N.Y.

Mark Gibson
Policy Advisor for Health Care,
Human Services, and Labor
The Office of the Governor of Oregon
Salem, Ore.

Nancy J. Kaufman
Vice President
The Robert Wood Johnson Foundation
Princeton, N.J.

David A. Kindig
Program Officer, the Milbank Memorial Fund
Professor of Preventive Medicine
Director, the Wisconsin Network for Health Policy Research
The University of Wisconsin at Madison
Madison, Wis.

David Lifts
Special Assistant to the Assistant Secretary
for Health
The US Department of Health and Human Services
Washington, D.C.

Ambassador Thomas Loftus
Special Advisor to the Director-General
The World Health Organization
Washington, D.C.

Jonathan Lomas
Executive Director
The Canadian Health Services
Research Foundation
Ottawa, Ontario, Canada

Rick Roger
Chief Executive Officer
Vancouver/Richmond Health Board
Vancouver, British Columbia, Canada

Tim Sands
Head of Health Action Zone Development
NHS Executive
Leeds, England

Stephen M. Shortell
Professor of Health Policy and Management
The School of Public Health
The University of California at Berkeley
Berkeley, Calif.

Gregory L. Stoddart
Professor of Clinical Epidemiology and BioStatistics
Associate Member, the Center for Health
Economics and Policy Analysis
McMaster University
West Hamilton, Ontario, Canada

Maris Vinovskis
H.P. Bentley Professor of History
The University of Michigan Institute for Social Research
Ann Arbor, Mich.

Hong Wang
Doctoral Candidate in Population Health
School of Medicine
The University of Wisconsin at Madison
Madison, Wis.

David Wiener
Executive Assistant to the Mayor of Lansing
The Mayor's Office, City Hall
Lansing, Mich.

Wendy Youens
Executive on Contract
Toronto, Ontario, Canada

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BIBLIOGRAPHY

(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)

Reports

Practical Strategies for Cross-Sectoral Allocation of Resources to Improve Health. Madison, Wis.: The University of Wisconsin-Madison Center for Health Policy and Program Evaluation, 2000. A conference report was submitted to the Robert Wood Johnson Foundation.

Articles

Kindig DA. "Public Health vs. Population Health: A Conversation." Unpublished.

Sponsored Conferences

"Practical Strategies for Cross-Sectoral Allocation of Resources to Improve Health," June 14–16, 2000, New York, N.Y. Attended by 22 academics and health care policymakers from the United States, Canada, the United Kingdom, and New Zealand. Examples of organizations represented include the Canadian Health Services Research Foundation, the World Health Organization, the US Department of Health and Human Services, and the School of Public Health at the University of California at Berkeley. Six presentations and six panels.

Presentations

  • Wendy Youens, executive on contract (Toronto, Ontario, Canada), "The Prince Edward Island Experience."
  • Tim Sands, head of Health Action Zone Development (Leeds, U.K.), "British Health Action Zones and Social Care Boundaries."
  • Phillip Davies, deputy director-general, the Ministry of Health (Wellington, New Zealand), "New Zealand Integration."
  • David Wiener, executive assistant to the mayor of Lansing (Lansing, Mich.), "Healthy Cities."
  • Mark Gibson, policy advisor for Health Care, Human Services, and Labor, the Office of the Governor of Oregon (Salem, Ore.), "Cross-Sectoral Approaches in Oregon."
  • David A. Kindig, program officer, the Milbank Memorial Fund (New York, N.Y.), "What Does Research Tell Us?"

Panels

  • "Employment," Tim Evans, team director, Health Equity, The Rockefeller Foundation (New York, N.Y.).
  • "Housing," Rich Roger, chief executive officer, the Vancouver/Richmond Health Board (Vancouver, British Columbia, Canada).
  • "Suicide," David Litts, special assistant to the assistant secretary for health, the US Department of Health and Human Services (Washington, D.C.).
  • "Disability," Brian Atchinson, vice president and managing counsel, UNUMProvident (Portland, Maine).
  • "Economic Development," Thomas Loftus, special advisor to the director-general of the World Health Organization (Washington, D.C.).
  • "Education," David Kindig, program officer, the Milbank Memorial Fund (New York, N.Y.), and Maris Vinolvskis, professor of history, the University of Michigan Institute for Social Research (Ann Arbor, Mich.).

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Report prepared by: David Kales
Reviewed by: James Wood
Reviewed by: Richard Camer
Program Officer: C. Tracy Orleans

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