Spotting Trends in Population Health Management

This is the final blog in a continuing series based on the findings from the Sodexo 2016 Healthcare Compendium, a compilation of research that examines the increasing trend toward a focus on value in the healthcare sector. Read the full article: Trends in Population Health Management

Did you know that 40 percent of an individual’s well-being is determined by healthy behaviors, while medical care determines just 10 percent? It’s true, and it makes the point that you are what you eat. Eighty-six percent of U.S. healthcare dollars are spent on the treatment of chronic, often preventable health issues linked to an unhealthy diet such as heart disease, diabetes and stroke.

Too many carbohydrates, too much fat and far too few fruits and vegetables characterize many American’s diets, contributing to widespread obesity. To promote wellness effectively, the healthcare industry is realizing that it needs to go beyond treating individuals with chronic conditions and address the risks of different population segments by reducing the root causes. Avoiding illness by focusing on prevention is the objective of Population Health Management (PHM), a widespread effort to improve the health of entire groups or populations by tackling the social, economic, environmental and behavioral factors that contribute to health disparities and continuum of care through different behavioral strategies.

Sounds simple, but the reality is complicated. Millions of low-income adults and children live in neighborhoods that lack convenient access to healthy foods. Long distances and lack of transportation to supermarkets means residents usually shop at local convenience stores that lack an adequate selection of nutritious foods leading to unhealthy choices, obesity and other health issues. Food insecurity is another problem, defined as access by all household members at all times to enough food for an active, healthy life. In 2013, more than 14% of American households were food insecure due to a lack of resources. Fortunately, there are numerous programs that advance the PHM strategy:

Worksite Nutrition Programs: The CDC’s National Healthy Worksite Program (NHWP) offers nutrition programs for small and medium-sized companies that are consistent with NHWP guidelines. These encourage healthy eating by emphasizing fruits, vegetables and whole-grain products; low-fat dairy products, lean meats, poultry, fish, and legumes and small amounts of salt, sugar and saturated fat. Making these foods accessible, appealing, and affordable to workers is an important step in the improvement of worker health.

School Lunch Programs: Government programs administered by the Food and Nutrition Service (FNS) focus on providing healthy food to children before, during and after school, as well as in the summer. The Healthy, Hunger- Free Kids Act of 2010 set new standards for better, more nutritious school lunches and lunchroom solutions endorsed by the Smarter Lunchrooms Movement have proven to be effective. Cornell’s B.E.N. Center research results revealed some easy-to-follow best practices – and great results:

• Moving and highlighting fruit choices increased sales by up to 102%
• Naming vegetables and displaying new names increased their selection from 40% – 70%
• Placing white milk first in lunchroom coolers increased sales up to 46%
• The first entrée highlighted on the lunch line has an 11% advantage over the second option
• The percentage of students consuming “healthy items” increased by 35% when a “healthy choices only” convenience line was introduced

The Supplemental Nutrition Assistance Program (SNAP) administered by the U.S. Department of Agriculture has more than 47.5 million participants. To encourage healthy eating and lifestyle behaviors, participants are offered nutrition education through SNAP-Ed. While states develop their own educational programs, the plan follows federal nutrition guidelines with a focus on a healthy diet, physical activity and balanced caloric intake.

Access to Farmers’ Markets Increased by 150%: Community farmers’ markets are one of the best ways to make healthy foods accessible to large numbers of people at one locale. Farmers’ markets produce usually costs the same or less than seasonal produce at supermarkets. Happily, over the past decade the number of markets across the United States has grown to over 8,000, providing an opportunity to bring affordable, locally grown fruits and vegetables to low-income and urban communities, particularly as the markets increasingly accept food assistance programs, the Special Supplemental Program for Women, Infants, and Children (WIC), the Farmers’ Market Nutrition Program (FMNP) and SNAP. Additionally, low-income seniors can participate in a Senior Farmers’ Market Nutrition Program (SFMNP) which provides coupons for use at farmers’ markets and roadside stands in participating states.

Other successful programs include Meals on Wheels, providing over 1 million meals to seniors every day while numerous community resource programs fund community and urban programs that focus on healthy food access. For example, New York City uses a combination of incentives and restrictions to get green produce carts in areas of the city with the least access to fruits and vegetables. Detroit and Cleveland have reclaimed vacant land and lots for community gardens while vendors in Kansas City who sell healthy foods pay a reduced permit fee.

Taking a more proactive and broader approach to improving America’s health through a variety of initiatives focused on specific groups, Population Health Management aims promote healthier behaviors that will ultimately reduce healthcare costs — while improving quality of life — by preventing obesity-related chronic diseases.

Nebeyou Abebe, MA, PMP, is Senior Director of Health & Well-Being for Sodexo North America where he is responsible for developing Sodexo’s enterprise-wide health & well-being strategy, advising clients on their employee (and community) health and well-being goals, creating and empowering an organized community of practice for wellness. His work has been published in national public health and healthcare publications including Modern Healthcare, Diabetes Spectrum, and Employee Business Plan Review.