Wednesday, December 14, 2016

A Framework for Public Health Action: The Health Impact Pyramid

The Health Impact Pyramid

Abstract

A 5-tier pyramid best describes the impact of different types of public health interventions and provides a framework to improve health. At the base of this pyramid, indicating interventions with the greatest potential impact, are efforts to address socioeconomic determinants of health. In ascending order are interventions that change the context to make individuals' default decisions healthy, clinical interventions that require limited contact but confer long-term protection, ongoing direct clinical care, and health education and counseling.
Interventions focusing on lower levels of the pyramid tend to be more effective because they reach broader segments of society and require less individual effort. Implementing interventions at each of the levels can achieve the maximum possible sustained public health benefit.

LIFE EXPECTANCY IN DEVELoped countries has increased from less than 50 years in 1900 to nearly 80 years today. The greatest improvement occurred in the first half of the 20th century, when life expectancy in the United States and many parts of Europe increased by an average of 20 years, largely because of universal availability of clean water and rapid declines in infectious disease, as well as broad economic growth, rising living standards, and improved nutritional status. Smaller gains in the latter half of the 20th century resulted primarily from advances in treatment of cardiovascular disease and control of its risk factors (i.e., smoking, high blood pressure, and high cholesterol).

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