A Population Health Impact Pyramid for Health Care

Centennial Issue
Population Health US Health Care Reform

Policy Points:

  • To meaningfully impact population health and health equity, health care organizations must take a multipronged approach that ranges from education to advocacy, recognizing that more impactful efforts are often more complex or resource intensive.
  • Given that population health is advanced in communities and not doctors’ offices, health care organizations must use their advocacy voices in service of population health policy, not just health care policy.
  • Foundational to all population health and health equity efforts are authentic community partnerships and a commitment to demonstrating health care organizations are worthy of their communities’ trust.

Though there is no definitive history of the “population health approach,”1 relevant methods and practice have been deployed for centuries. Although a common population health lexicon is still in development,2 in their seminal 2003 paper “What Is Population Health?,” Kindig and Stoddart define the “relatively new term” as “the health outcomes of a group of individuals, including the distribution of such outcomes within the group.”3

More recently, the Interdisciplinary Association for Population Health Science (IAPHS) has firmly placed health equity as a central focus of the field and on the development of a health-in-all-policies agenda to advance equitable health opportunity for all communities. IAPHS notes that population health involves:

an interdisciplinary and multi-method approach to producing knowledge about: population health levels & disparities; the intertwined & multi-level causes of health and disease, from genes, to behavior, to social and physical environments; the mechanisms through which health and health disparities are produced; and what policies and practices will improve population health and ameliorate health disparities.4

According to these definitions health care is but one of the “mechanisms” across many levels that contribute to population health, giving it a necessary yet insufficient role to play in developing (and being part of) the multisector and multilevel solutions that improve the health of populations generally and eliminate unjust, systematic, avoidable inequities in health between groups.

Open Access


1. Szreter S. The population health approach in historical perspective. Am J Public Health. 2003;93(3):421-431.
2. Peek CJ, Westfall JM, Stange KC, et al. Shared language for shared work in population health. Ann Fam Med. 2021;19(5):450-457. https://doi.org/10.1370/afm.2708.
3. Kindig D, Stoddart G. What is population health? Am J Public Health. 2003;93(3):380-383. https://doi.org/10.2105/ajph.93.3.380.
4. What is population health. Interdisciplinary Association for Population Health Science website. https://iaphs.org/what-ispopulation-health/. Accessed September 9, 2022.

Alberti PM and Pierce HH. Population Health Impact Pyramid for Health Care. Milbank Q. 2023;101(S1):770-794.