Does Place Matter for Policy? The Effect of Local Characteristics on Intervention Priorities in the ReThink Health Dynamics Model

Research points to the importance of place as it affects population health and longevity (Mohney 2013; Wenger 2012), as well as health care utilization and costs (Fisher etal. 2009; Wennberg 2010). Population health differences by geography are closely related to health disparities that exist among different socioeconomic, racial, and ethnic groups, underlining the importance of social determinants of health (Braveman et al. 2010; Braveman et al. 2011; Marmot et al. 2008; Smedley et al. 2002). Cost differences by geography, in contrast, reflect not only health disparities but also the local habits and practice styles of providers (Gawande 2009). Although all may agree that these place-based differences exist, the policy implications are not obvious. For example, should a city or county with a large fraction of disadvantaged people have different priorities for improving its health system than one with a smaller fraction, even though both have the same aims of improving health and reducing costs?

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Homer J, ReThink Health Dynamics. Does Place Matter for Policy? The Effect of Local Characteristics on Intervention Priorities in the ReThink Health Dynamics Model. 2013 August.