The life expectancy of American citizens is significantly
shorter when compared to other high-income countries, suggested a new study. The United States spends more on health care than any other country
in the world.
at the University of Missouri School of Medicine are suggesting that an
innovative systems-thinking approach to population health could improve
the country's current health disadvantage.
"Our country's inability to define, monitor and improve on
preventable deaths has complicated our progress in managing the health
of our communities and population," said Julie Kapp, associate
professor in the Department of Health Management and Informatics at the
MU School of Medicine and lead author of the study. "This goes beyond
collective impact. A national systems-thinking approach could be a step
in the right direction toward improving the health and health care of
the U.S. population."
‘A national systems-thinking approach could be a step in the right direction toward improving the health and health care of the U.S. population.’
A national systems-thinking approach considers how components within
a larger structure operate and interact, and how to optimize the
design, implementation and evaluation of that system. This approach can
be applied to various health concerns, including obesity, infant
mortality and disparities to elder care, so long as the ultimate goal is
improving quality and quantity of life. Kapp used the Malcolm Baldridge
Framework for Performance Excellence as a model of which to apply
systems thinking to population health improvement.
"We consider U.S. population health a supra-system, which means it
contains many subsystems at federal, state and local levels," Kapp said.
"This approach requires all health and health care organizations to
Kapp said this approach could be implemented by creating an
evidence-based national reporting dashboard and offering incentives to
health care organizations that agree to use a shared measuring system.
She also recommended that community-based nonprofit organizations be
required to use shared outcomes-focused metrics when applying for
federal funds and accreditation.
"To improve the effectiveness of how community-based organizations
address health and health-related issues, we must change their funding
requirements," Kapp said. "Changing their funding requirements on a
broad scale requires change at the federal level. Therefore, a systems
approach is required."
Kapp's recommendations are conceptual and are intended to provide a
theoretical framework for implementing a systems-thinking approach to
U.S. population health. Applying the Baldrige framework in this way
would be innovative, Kapp said, but she also acknowledged that
implementing a systems approach in the U.S. would probably take many
years to accomplish.
"However, given our country's current health outcomes compared to
other peer countries, and our failure to make progress on improving the
proportion of citizens dying from preventable deaths after 100 years of
awareness, we cannot afford to not consider an aligned and integrated
systems thinking perspective for improving U.S. population health," Kapp