Healthcare provision forms a significant portion of every government’s annual budget, and the global expenditure has been increasing steadily. Several factors determine the approach taken in healthcare policing including the income of the people, the prevalent diseases and the prices of services, among numerous others. Healthcare policies are specific to different populations. The appropriate policies and approaches can be determined by analyzing the correlation between factors affecting the health of the people as indicated by outcomes.
Section 1 - Demand for Health and Medical Care
The demand for a good or service refers to the willingness and ability of consumers to purchase them. Numerous stakeholders are involved in a healthcare system such as the insurers, healthcare providers, government and consumers. Several factors differentiate healthcare demand from the demand of other services as illustrated in roles of various stakeholders and their compounded effect on healthcare.
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prices/cost
The prices of goods and services determine demand in that when they are high, the demand is likely to decrease while low cost of healthcare encourages demand. The application of this principle in healthcare is however marred by various other factors (Hood et al., 2016). For example, the demand of health may be deemed inelastic in some circumstances which negate choice such as emergency services provision.
income
Consumers with high incomes translate to high demand for health because they have the propensity and capacity to spend. Whenever income is low, the demand for health is low. However, the inelasticity of demand may also negate income as a factor because healthcare is needed to preserve life and wellness, hence, consumers will be forced to spend irrespective of their income (Hood et al., 2016).
knowledge/education
The level of knowledge among consumers translates to awareness and consciousness regarding their health. Populations that are more educated tend to be more aware of their health and may have better lifestyles that preserve their health such as avoidance of junk foods and regular exercise. They also view their health as an investment through such habits as going for regular checkups and taking insurance covers. Populations that are ignorant about their health may be prone to lifestyles that undermine their health; hence demand for healthcare within such populations may be high (Hood et al., 2016). Knowledge in healthcare is however disproportionate in that consumers must depend on healthcare professionals with whom a bulk of the knowledge resides.
government influence
Governments often regulate the healthcare sector and maximize access of healthcare services to citizens through such measures as price subsidies leading to increase in healthcare demand.
Section 2 - Production and Consumption of Health
The factors that constitute the health production function may vary among populations because healthcare is dependent on the people's specific needs. The health production function depicts the relationship between the overall health (as indicated by measures such as morbidity, mortality and quality of life) and inputs (determined by environmental factors, lifestyle, education, income, and genetics).
Health Production = ∫[overall health, inputs]
Morbidity and mortality are the most common measures in determining overall health since they are easily quantifiable, while the quality of life is a qualitative variable. Morbidity is the rate of disease or the suffering caused by such a disease in an individual or population. Some of the metrics used in indicating morbidity levels include number of lost working days and chronic illness incidence in a population (Hood et al, 2016). Mortality refers to the deaths due to a specific cause in a population. It may be indicated as a number of deaths per a number of people e.g. 25 per 1000 people or it may be specific within different demographics such as age groups, sex, race and other factors to draw more meaning. Mortality rates are only useful in absence of excess mortality due to factors such as war or pandemics. The quality of life is measured by tools such as the CDC HRQOL–14 questionnaire that go beyond physical health to evaluate emotional health, cognitive status, and aspects of spiritual being. The quality of life aims to determine how much an individual is able to not only function but also enjoy a level of satisfaction from their daily living.
Inputs are also referred to as determinants because they are causative factors to the state of health. There are genes that leave carriers susceptible to diseases or conditions such as cancer, heart disease, Alzheimer’s, obesity and numerous others, causing risk and prevalence to be significantly higher among such populations.
Income and education affect the prevalence of disease and access to treatment in that people with higher incomes have higher access than those with lower incomes. Individuals who attain lower levels of education are also exposed to more risk factors that may cause poor health or disability. Individuals with higher education are also likely to access benefits that have a positive effect on health such as health insurance, more rest due to increased number of leave days etc. (Magnan, 2017).
Environmental and lifestyle factors are also important factors in health. Environmental factors include pollution, poor infrastructure, and exposure to disease causing organisms among numerous others. Some of these factors intersect and compound the severity of each other. For instance, water pollution reduces access to clean drinking water and also increases the number of disease causing microbes contributing to poor health (Magnan, 2017). Air pollution also increases the risk and incidence and severity of respiratory tract illnesses such as asthma. Lifestyle factors include physical exercise and food intake. Some of the diseases affected by lifestyle factors include diabetes, cardiovascular disorders, and obesity.
The aggregate change in health status decreases with positive movement in inputs, that is, as the inputs are adjusted to favor good health in a population. Hence, the law of diminishing returns is applicable whereby the rate of increase of health status reduces as healthcare increases, if all other inputs remain constant. The importance of this trend is illustrated when making a decision in healthcare investment versus the investment in alleviating all other inputs or related determinants to overall health status.
Section 3 - Population Health
Population health refers to studies conducted and approaches employed to ensure that policies and practice produce the required effect on a certain group of people. As indicated by the CDC, it is an interdisciplinary approach that facilitates collaboration between different organizations and agencies in producing the targeted health outcomes (Centers for Disease Control and Prevention). The scholarly aspect of population health is crucial because it reveals trends and patterns of health outcomes within certain populations due to certain factors such as social environments, healthcare, and genetics. Policies can then be formulated to resolve specific challenges being experienced by the population.
Population health data and research is important for policymakers because it determines the policies formulated to deal with the specific conditions affecting the health of the population. Such factors are often localized and may not be mitigated using the general policies operating within a larger domain such as an entire nation (Magnan, 2017). Population health data also helps economists evaluate the impact of different measures in terms of the utility of the resources invested in a population health approach. Economic models reveal the correlation between different non-medical factors that affect the health of a population. For instance, economists may reveal that poor infrastructure may be the main factor that contributes to a certain population's poor health, thus the most appropriate mitigative policies for such a population should consider it (Magnan, 2017). Population health economics also reveal the impact that healthcare is having on productivity and the resultant loss from poor health. Healthcare professionals use population health data to formulate health delivery mechanisms that are most effective in addressing the prevailing health problems in a certain population such as disease incidence and common emergencies (Taylor et al., 2016). For instance, a population in which cardiovascular disease is prevalent due to sedentary living and lack of exercise require different healthcare approaches compared to one in which a similar prevalence is mainly caused by poor dietary culture.
Section 4 - Global Metrics and Disparities
International population health metrics are used to compare the relationship between health outcomes and trends and population characteristics. In a study designed to compare the health of Americans to countries at a similar level of economic strength, Wolf surmised that US citizens have poorer health and a lower length and quality of life. Some of the metrics that were used in this study include Adverse birth outcomes, HIV and AIDS infections, drug related mortality, obesity and diabetes prevalence, cardiovascular disease risk, and chronic lung disease (Woolf, 2013). These metrics are compared and evaluated with respect to all factors that affect them.
Wolf found several factors that contributed to the statistical outcomes exemplified in the study (Woolf, 2013). For instance, a correlation was drawn between the physical/social environments in American communities and adverse health outcomes (Woolf, 2013). These outcomes include a high number of deaths and injuries due to road accidents, obesity and asthma. The American urban environment was more suited for automobiles than for pedestrians which may result in a high prevalence of traffic accidents (Woolf, 2013). Moreover, even Americans who engaged in healthy behaviors such as nonsmokers appear to have significantly poorer health than a similar cohort in peer countries (Taylor et al., 2016). Numerous other factors could also contribute to poorer health and high mortality among Americans than in peer countries, including access to firearms, food consumption patterns and existence of high stress environments, among others. Of note is that none of these factors is exclusively responsible for a certain health disadvantage (Taylor et al., 2016). Economists, healthcare professionals, economists and professionals in other relevant disciplines use this data to determine the most appropriate approaches required to improve the health of Americans.
Section 5 - Policy Issues
The California Tobacco Control Program is a policy intervention that was designed to reduce cigarette smoking and other uses of tobacco in the state of California, United States. This program was funded using a portion of a new 25 cent tax that was charged per cigarette pack. The program's objectives included reducing the rates of tobacco addiction among residents in California, reducing environmental waste resulting from tobacco products, and reducing second-hand smoke exposure and enlightening society on the dangers of tobacco use (Lightwood & Anderson, 2020). The program was instituted to combat a prevalent culture that normalized and encouraged tobacco use hence leading to a high prevalence of resultant health consequences. The program has resulted in an approximate $215 billion in health expenditure savings incurred by the savings in the state as of 2008 since 1988 when the program was established (Lightwood & Anderson, 2020). Moreover, the incidence of lung cancer is decreasing thrice as fast in California as other US states. Despite the relative success of the program, tobacco use remains a health concern in California.
Conclusion
The creation of effective healthcare provision systems is dependent on various factors and requires the collaboration of healthcare professionals, economists, policymakers and other relevant stakeholders. The demand function indicates the relationship between several of these factors such as environment, lifestyle, education, income, and genetics; and the outcomes such as morbidity and mortality levels. Population health metrics are used to determine the needs of each population and facilitate formulation of the commensurate measures and policies. The California Tobacco Control Program of 1988 is one such program established to reduce the impact of Tobacco use in California.
References
Centers for Disease Control and Prevention. (n.d.). CDC HRQOL-14 healthy days measure. Centers for Disease Control and Prevention. https://www.cdc.gov/hrqol/hrqol14_measure.htm
Centers for Disease Control and Prevention. (n.d.) What is Population Health? Centers for Disease Control and Prevention. https ://www.cdc.gov/pophealthtraining/whatis.html
Hood, C. M., Gennuso, K. P., Swain, G. R., & Catlin, B. B. (2016). County health rankings: relationships between determinant factors and health outcomes. American journal of preventive medicine, 50(2), 129-135.
Lightwood, J., & Anderson, S. (2020). Health Care Cost Savings Attributable to the California Tobacco Control Program, 1989 to 2018.
Magnan, S. (2017). Social determinants of health 101 for health care: five plus five. NAM Perspectives. National Academy of Medicine. https://nam.edu/social-determinants-of-health-101-for-health-care-five-plus-five/
Taylor, L. A., Tan, A. X., Coyle, C. E., Ndumele, C., Rogan, E., Canavan, M., ... & Bradley, E. H. (2016). Leveraging the social determinants of health: what works?. PloS one, 11(8), e0160217.
Woolf, S. H., & Aron, L. (2013). US Health in International Perspective: Shorter Lives, Poorer Health
