Population Health

What is Population Health?

Population Health focuses on identifying and understanding the needs of various groups within the community. Population groups can include people in a certain ethnic group, in the same age bracket, individuals of the same gender, or people with a certain disability or disorder. Once these needs are understood, the work of building solutions begins. This is accomplished with input from those affected along with community partners whose missions support service to people in need.


Examples include:

  • Holding diabetes prevention classes for a group of pre-diabetics at a large industrial plant during the regularly scheduled lunch hour -- providing lunch.
  • Engaging a group of concerned citizens fearful of lack of access to healthcare once their only hospital closed in planning that results in a unique and workable solution.
  • Embedding community health workers in the communities of vaccine hesitators to help them understand the purpose of the vaccine and why they should be vaccinated -- and then removing barriers (like transportation) so that they can get to the vaccine appointment.

This is just a sample of the ways Population Health meets people where they area and designs programs or policies to reduce barriers to optimum health.

Data Collection, Analysis and Use

In order to understand the very specific needs of various groups of people, Population Health organizes community health needs assessments and improvement planning. This is a huge community effort involving medical and social services partners as well as citizens. The process, which usually takes at least a year, provides a comprehensive look at where health needs exists and puts forth evidence-based solutions to address them.

Links to the Most Recently Completed Community Health Assessment & Improvement plans follow:

Franklin County Community Needs Assessment & Improvement Plan
Patrick County Community Needs Assessment & Improvement Plan
Henry/Martinsville - Underway

Funding Interventions, Piloting New Ideas

Population Health in the WPHD takes the work a step further by identifying funding sources and facilitating grant submissions for promising programs aimed at improving community health outcomes. For example, a grant from the Appalachian Regional Commission was secured for Patrick County to obtain expert guidance in looking how health care access could be improved.  A companion grant provided funding to pilot the project.

Keeping Current; Providing Expertise

Population Health requires that health department personnel are out in the field, bringing services to people where they are. This means health department staff are active in causes like substance user disorder (Opioids Taskforce), lifestyle health (community gardens), and community building (United Way and other nonprofit organizational boards).