Population health and public health: Commonalities and differences

Abstract

Objective

To explore the synergy between population health and public health by initiating a discourse about their interconnected roles, responsibilities, and approaches in achieving optimal health outcomes.

Overview

Population health and public health, although distinct, are interconnected disciplines critical for enhancing health outcomes. Population health focuses on analyzing health determinants and outcomes within specific groups, employing data to guide targeted interventions and policies. Public health, on the other hand, prioritizes broader preventive measures and community‐wide interventions to safeguard health. Both fields benefit from a transdisciplinary approach that integrates strategies to address and improve health.

Such integration is essential for addressing health disparities and improving the efficiency of health systems. By combining the analytical strengths of population health with the implementation capabilities of public health, a more comprehensive framework can be developed. These collaborations will not only enhance the effectiveness of health programs but also promote health equity by leveraging collective expertise and resources. They will facilitate the development of interventions that are both preventive and responsive, capable of addressing the upstream determinants of health and the immediate needs of communities. Such transdisciplinary efforts were demonstrated within the oral health field during the COVID‐19 pandemic.

Conclusions

The synergy between population and public health can lead to robust health outcomes, fostering comprehensive health promotion and disease prevention strategies. By aligning research, practices, and policies, these integrated approaches will transcend traditional boundaries within the healthcare sector to build efficient health systems.

INTRODUCTION

The terms “population health” and “public health” have long been a part of the healthcare lexicon, often used interchangeably without a clear distinction [1, 2]. While population health is primarily concerned with identifying risk factors, social determinants of health (SDoH), and measuring health outcomes to improve health and well‐being in specific populations [3, 4]; public health refers to dedicated efforts to promote healthy living and safeguard the lives of the individuals in the community [3]. Within the broader healthcare systems, these terms represent two interconnected fields [5]. Delineating the scope and objectives of population and public health offers several advantages. For instance, understanding the distinct goals and boundaries of population and public health can facilitate defining roles and tasks, and developing directives and educational curricula, ultimately shaping the healthcare workforce [1]. Additionally, recognizing the similarities and differences between population and public health will enable researchers, practitioners, and policymakers to communicate and tailor their strategies when collaborating across disciplines [6]. By harmonizing and adopting standardized terminology between these fields, stakeholders can better align and integrate approaches across disciplines, leading to more coherent and impactful health outcomes.

This article aims to initiate a discourse about the roles, responsibilities, and approaches employed in population and public health towards achieving optimal health outcomes.

A COMPARATIVE EXPLORATION OF POPULATION AND PUBLIC HEALTH

Understanding the relationship between population and public health brings clarity in defining goals, strategies, workforce, and training within each field. Such clarity aids in guiding resource allocation and program planning and tailoring these efforts to the appropriate level of interventions (individual, community, or policy).

During the COVID‐19 pandemic, the oral health sector was significantly impacted due to restrictions on dental services, heightened infection control requirements, and patient hesitancy in seeking routine dental care. The roles and responsibilities of population and public health disciplines to navigate through the pandemic were not clearly defined. Understanding how these disciplines worked in response to these challenges highlights their synergies and roles. Parallels between population health and public health can be explained through an illustration of the process of building a house (Figure 1). A longside, expanding on these concepts with an oral health example of the oral health workforce during the COVID‐19 pandemic. Population health professionals are akin to civil engineers; they lay the groundwork by gathering population‐level data and identifying key risk factors and other threats to health outcomes. Government approvals and political will are necessary for implementing construction plans, akin to the critical role of policymakers in healthcare systems in utilizing population‐level data to spearhead healthcare and public health initiatives, guidelines, and policies (Figure 1: Stage 1). During the pandemic, population health researchers focused on gathering and analyzing foundational data to assess how the pandemic influenced oral health practice to devise safety protocols for dental offices and personnel—Personal Protective Equipment (PPE) requirements, masking regulations, and sterilization and disinfection protocols at a community and population level. Public health entities like the World Health Organization (WHO) [7], Centers for Disease Control and Prevention (CDC) [8, 9], and American Dental Association (ADA) [10, 11, 12] issued reports and guidelines on safe practices for dental offices based on this foundational research, ensuring that essential services could continue while mitigating the risk of transmission.

FIGURE 1.

Architecture for a healthy population. [Color figure can be viewed at wileyonlinelibrary.com]

In the next stage, public health professionals execute and turn plans into tangible reality, much like managers and construction workers do in executing house blueprints [13]. In this analogy, structural and contextual factors are some of the materials used to build the house. Structural factors are the health system building blocks (bricks), which include elements such as service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance [14]. Contextual factors crucial for improving and maintaining health are like cement that cohesively bonds all of these elements together. They encompass socioeconomic status, cultural influences, environmental conditions, sustainability, demographics, political climate, and prevailing public health trends (Figure 1: Stage 2). As the population health researchers aided in collecting the foundational data and formulating strategies, public health professionals took into consideration the structural and contextual factors to build upon and implement these strategies on the ground. During the COVID‐19 pandemic, there was a deficit in the structural components of the healthcare system—namely healthcare infrastructure, workforce availability, healthcare access, and financing. The contextual factors were highlighted by an evidence brief published by WHO [15] focusing on the inequities in SDoH that were exacerbated during the COVID‐19 pandemic which limited certain vulnerable groups' access to preventive dental care and routine check‐ups.

In the face of these setbacks, public health played a crucial role in educating the public and professionals about the importance and ways of maintaining oral health during lockdowns and promoting safe ways to access care, such as through tele‐dentistry platforms, mobile dental clinics, and triaging of patients. They coordinated efforts to formulate relevant communication strategies and disseminate public health policies and recommendations to the public and dental professionals. Public and population health professionals utilized data‐driven approaches informing targeted interventions to advocate for policy changes, such as expanding insurance coverage for tele‐dentistry [16].

The transdisciplinary (The transfer of conceptual frameworks across disciplines, wherein, along with the goals, the skills are shared among the disciplines [17].) interactions between various sectors—including health policy, social sciences, biomedical sciences, medical care systems, housing, urban planning, transportation, and environmental agencies—are similar to city planning, which is integral in laying a good foundation. These transdisciplinary contributions from outside the basic civil engineering framework executed by city planners include installing solar panels, building fences around the house, gardening, alarm systems, garbage disposal systems, etc. Finally, population health professionals, public health officials, and other disciplines strive to ensure the outcome is a well‐built house—symbolically a healthier population. These two fields are inseparable and integral, working together to construct a robust and healthy society, much like the essential roles in building a sturdy house (Figure 1: Stage 3). The intersection of public and population health was evident as both fields aligned their efforts to optimize oral health outcomes during the pandemic. For example, population health data highlighted the effective methodologies to treat oral health conditions and preventive care, while public health professionals disseminated prevention protocols, vaccine information, and safety maneuvers, which led dental practitioners to prioritize reopening dental services for urgent cases while maintaining strict safety protocols. As the safety protocols were being continuously updated, the pharmaceutical industry, manufacturing companies, transportation, urban planning, information technology (IT) systems, and others worked to supplement the efforts of the healthcare professionals, an example of transdisciplinary efforts. They ensured the production and delivery of protective gear, sterilization and disinfection materials, oxygen equipment, and building healthcare infrastructure (both in terms of healthcare facilities and IT to expand the scope of treatment during the pandemic).

For a deeper understanding, the population and public health features are delineated in Table 1. The rationale for delineation is to focus on learning about specific characteristics described in the literature about population and public health. In Table 1, central characteristics of population and public health are categorized by (i) scope and focus, (ii) approaches and strategies, and (iii) goals and objectives, further subdivided into different specific domains to elucidate the overlaps and divergence between these disciplines.

TABLE 1.

Central characteristics of population and public health.

	Population health	Public health
Scope and focus
Theme	“How healthcare systems, healthcare agencies, and organizations work together to improve health outcomes.” [5] “Brings an emphasis on structural and contextual factors.” [3, 23]	“What the society and the government does to assure the conditions in which people live can be healthy.” [5] “Emphasis on the conditions in which people can be healthy.” [24]
Definition	“The health outcomes of a group of individuals, including the distribution of such outcomes within the group.” [25]	“The science and art of preventing disease, prolonging life, and promoting health through the organized efforts and informed choices of society, organizations, public and private communities, and individuals.” [26]
Focus (populations)	Focus on specific population groups. Focuses on attributable risk (AR) of population‐level metrics [6].	Focus on cultivating healthier individuals and communities [3]. This approach is mainly based on geographical locations and is broad, inclusive, and diverse. Focus on relative risk (RR) among communities.
	Invested in the population causes of “incidence” [27]. Help improve the health and maintain well‐being across the lifespan of individuals in the populations [28].	With the view of upstream effects within the communities, it focuses on individual factors making someone more “susceptible” to certain conditions [27]. Help promote health and well‐being in the communities.
Intervention	Designing interventions based on population‐level health assessments, understanding health patterns, disparities, and social determinants of health.	Implementing policies, programs, and interventions to prevent disease and promote health based on the current trends and needs of the communities.
Concerns	Population‐level health outcome measures: Along with individual‐level clinical/biological factors like age, sex, genetic predisposition, etc., it considers (non‐clinical) factors like income, education, and social determinants of health.	Developing and implementing strategies for targeted preventive interventions and services.
Principle	Health equity [3, 4]—“Health equity is achieved when everyone can attain their full potential for health and well‐being.” [29]	Social justice [5]—ensures everyone has a fair and just opportunity to be as healthy as possible, addressing disparities in health and healthcare access.
Approaches and strategies
Approach	Transdisciplinary approach	Intervention‐focused approach
	Multi‐sectoral—mostly horizontal (resource‐sharing) collaborations but also vertical	Disease/context‐specific—mostly vertical (condition/disease‐focused) collaborations
Research perspective	Research in population health shapes health outcomes for populations that take an upstream perspective, examining the social, economic, and environmental factors.	Research in public health tends to be behavior/disease‐specific and follows an intervention‐based approach, also taking into consideration the upstream factors.
Professionals	Population health professionals have more analytical skills and include: population health scientists, population health researchers (including epidemiologists, biostatisticians, and data analysts), environmental health scientists population health managers, social workers, community coordinators, health policy analysts and advocates, etc.	Public health professionals have more program management skills and include: public health scientists, public health researchers (epidemiologists, biostatisticians, evaluators), environmental health specialists, public health nurses, dentists, community health workers, health policy advocates, health educators, among others.
Collaborations	Diverse collaborations and partnerships [30]—among the healthcare sector, public health sector, policymakers, social services, community organizations, academic institutions, housing departments, transportation sectors, environmental organizations, and economists.	Focused on working with healthcare providers, government agencies—Ministries of Health, Public health departments, non‐profit organizations, and community health centers.
Targets/Level of Intervention	Policies/recommendations: Population‐wide efforts (e.g., reducing air pollution, improving access to healthcare, addressing social inequalities).	Prevention/early detection: Community‐level interventions/programs (e.g., controlling infectious diseases, responding to public health emergencies, implementing immunization programs).
Interventions	Targeted and population‐specific.	Comprehensive and wide‐ranging.
Outcome measures (example—Smoking rates)	Focus primarily on “health outcomes.” [3] For example, Smoking rates are perceived as a risk factor by the population health experts, while cases of lung cancer incidence/prevalence/mortality rates are the ultimate outcomes.	Focus on “behavioral and wellbeing‐related outcomes.” For example, reducing smoking rates can be seen as an outcome of a public health intervention.
Denominator	The denominator is defined by the population of interest.	The denominator is usually the community as a whole.
Goals and objectives
Policies/guidelines	Help provide evidence for and inform political judgments [3]; address health and social determinants of health through health policy change [4].	Advocate for and help implement health policies (Occasionally tend to overrule scientific basis over community needs).
Social determinants of health	Seeks to address upstream drivers of health inequities addressing factors of social cohesion and social capital within the socio‐economic and political contexts [29].	Strives to achieve social justice while mitigating the effects of health disparities and broadly promoting health care access, improving quality, and reducing costs.
Deliverables	Facilitate the development of strategies and public health programs and interventions based on preventive research, data analytics, and evidence‐based practices [31].	Practice intervention strategies, services, and programs within the communities and conduct developmental and evaluation research to support the interventions.

OPPORTUNITIES FOR INTEGRATION BY POPULATION AND PUBLIC HEALTH WORKFORCES TO ACHIEVE COMMON GOALS

The United Nations (UN) adopted 17 Sustainable Development Goals (SDGs) in 2015, opening a window of opportunity to promote transdisciplinary efforts [18]. In these efforts to promote health across all goals, SDGs provide a roadmap of commitment towards all aspects of health, moving away from treating diseases to promoting health and well‐being across the life course. Through such efforts, meeting at the crossroads of population and public health to achieve sustainable health outcomes is even more appealing. The vertical and horizontal approaches mentioned in Table 1 must be integrated with diagonal approaches. A diagonal approach “provides a comprehensive framework that addresses requirements for targeted approaches that correspond to specific diseases or populations, but also provides opportunities for strengthening health systems and other health‐related sectors.” [19] This approach helps to tackle the specific disease/condition (vertical programs) while addressing the gaps within the system with resource allocation (horizontal purview) through transdisciplinary collaborations. The underlying principle is the amalgamation of disease‐oriented interventions with initiatives to strengthen the health systems.

Population health models are instrumental in identifying critical areas for public health engagement and collaboration to enhance the population's overall health [6]. Utilizing these transdisciplinary collaborations in public health practices can shift the focus from isolated and categorical methods to holistic and integrated approaches. These models and analytics can help guide public health research as well as prioritize population health outcomes. This perspective expands the outcomes of interest to encompass not only disease status, but also functional status and well‐being, including physical, mental, social, and environmental aspects.

Collaboration at community‐level interventions is critical to initiating widespread health promotion initiatives. Together, population and public health experts can conduct research to identify, model, and address health disparities within specific populations/communities by considering the upstream population‐level factors, community‐level determinants, and individual needs.

Data sharing and analysis form a cornerstone of effective partnerships. By jointly designing, collecting, analyzing, and disseminating data on health outcomes, determinants, and disparities, both fields can gain a deeper, more comprehensive understanding of health needs. This collaborative approach informs evidence‐based interventions and policies, bridging the gap to achieve a more effective healthcare system sensitive to population‐level data and analytics [6].

In essence, population health prescribes strategies to improve health outcomes and public health helps in implementing and scaling up of these prescribed strategies.

CHALLENGES AND LIMITATIONS OF INTEGRATING POPULATION AND PUBLIC HEALTH APPROACHES

As we delve deeper into the concepts of population and public health, we find that unclear waters may still muddle collaborative actions. First, to foster collaborations, we need a robust transdisciplinary approach. This can be challenging as it puts an extra burden on the discipline that is foreign to the conceptual frameworks of population and public health. However, once such connections are built, they will result in holistic collaborations.

Second, harmonizing public and population health priorities must focus on the multiple factors affecting health outcomes. These domains fail to achieve such integration due to the siloed approaches they undertake, which often consider their practices to be the sole effective means to enhance health strategies and initiatives. This situation is further complicated by the blurred lines between reality and rationality amidst the narrow beliefs held within these domains. Additionally, there is chronic underfunding of public and population health efforts compared to biomedical trials and treatments [20]. Converging efforts will aid in prioritizing and presenting health issues to public and private research funders and various health departments to support collaborative initiatives. It has been decades since we have heard that prevention is better than cure; it is our time to prioritize prevention in action by advocating for it.

Third, coordination between public and population health professionals and stakeholders is essential. Aligning expertise for initiatives and policies and garnering support from stakeholders across various sectors can be challenging due to complexities in working styles and the absence of a central coordinating agency for making the final call. Integrating available population health‐level data within public health actions must consider real‐world factors influencing health measures and outcomes [21, 22]. When these disciplines coordinate, specific tasks can be assigned to the professionals based on their knowledge, resources, training, and the nature of the organization.

We can overcome these challenges and limitations of integration; this can be achieved by maneuvering through these divergences between population and public health.

CONCLUSION

A public health milestone timeline was published in 2023 to mark the occasion of WHO's 75th anniversary. Although we have surmounted significant challenges such as epidemics, pandemics, and other public health emergencies and have set goals towards achieving health equity and social justice; a gap still exists, a disjunction in our efforts to attain overall health. Dr. Julio Frenk et al. have aptly discussed the necessity of moving beyond the dichotomies we have constructed differentiating population and public health and advocating for integrative efforts to provide comprehensive care [19].

The response to COVID‐19 in the context of oral health exemplifies how public and population health can collaboratively address a health crisis. Population health provided the analytical foundation, identifying gaps and disparities, while public health ensured the practical application of interventions, guidelines, and policies. Together, they synergized effectively to navigate the challenges posed in the face of unprecedented challenges by the COVID‐19 pandemic, promoting equity and resilience in oral healthcare delivery.

Population health should embrace public health and vice versa, as the intricate relationship between them is fundamental for improving healthcare systems. Public health plays a significant role in implementing programs to maintain the overall health and well‐being of communities. Some domains, such as education, income, transportation, etc., fall out of the reach of public health professionals. Herein, population health is the quantitative underpinning that functions holistically to collaborate with various disciplines and support public health initiatives by addressing the major determinants that influence health.

Collaboration between population and public health is key to addressing health inequities and designing interventions to meet the populations' needs at individual, community, and policy levels. However, maintaining focus on equity can be challenging in practice. As the nuances between these domains are outlined, there is a hope that upstream efforts are made to integrate and strategize to leverage contributions from both domains to improve and maintain the health of the populations. Ongoing discussions and highlighting of the scope of each domain will initiate a conversation to allow us to build an efficient and effective healthcare system. Such health‐enhancing endeavors will help us combine the strengths of both fields, illustrating the power of synergy between population and public health to achieve better health for all.

CONFLICT OF INTEREST STATEMENT

The authors have no conflicts of interest to disclose.

Bhosale AS, Urquhart O, Carrasco‐Labra A, Mathur MR, Rafia K, Glick M. Population health and public health: Commonalities and differences. J Public Health Dent. 2025;85(1):40–46. 10.1111/jphd.12651