Health programs aim to reduce the number of people who suffer from certain diseases and conditions by promoting healthy behaviors and reducing risk factors. These health improvement programs include education, screening, and treatment. They also help communities address the complex determinants of health, including social, economic, and environmental conditions that impact individuals’ ability to make positive choices about their own well-being.
According to a McKinsey analysis, community-based interventions have been associated with modest changes in population-level health outcomes, such as a decrease in smoking rates and an increase in the proportion of people who report being in good or fair health.
Often, these changes occur over time and are difficult to measure because they affect large numbers of people and are not always measured with high accuracy. As such, a program that produces small reductions in the rate of an outcome—such as a drop in smoking or the percentage of people who are obese—will need to be in place for years before the “needle moves” on the health indicators.
To be successful, health programs must be implemented with clear strategies for measuring performance, collecting data, and evaluating the results. They must be tailored to the size and characteristics of the local population to be reached, and their cost must be appropriate to their potential impact. Moreover, they should have limited technical components because more strategies in the package decreases the likelihood that one or more will have broad population impact.
A key challenge for health improvement programs is overcoming the resistance of people and organizations to change. To do this, it is important to communicate a compelling story that includes a credible rationale for the initiative and examples of its impact on health and equity. It is also important to build partnerships with stakeholders who can help deliver and support the initiative.
Another challenge for health improvement programs is the “prevention paradox”—the idea that even if a preventive measure is shown to reduce the incidence of disease, it may offer little benefit to individual participants. To overcome this resistance, it is helpful for community leaders to frame the health benefits of an initiative with information that shows how many people will be affected. It is also useful for them to share stories about the impact of a previous program that changed behavior and lives, with an emphasis on the individuals who benefited from it.
Finally, it is important to understand the local context and culture of the people a health initiative is intended to serve. As the COVID-19 pandemic has demonstrated, even the most rigorous and data-driven effort can fail if it does not take into account the unique needs of the population it is trying to reach. This requires a strong commitment from top leadership and a broader cultural shift in the way that public health agencies think about their work. To do this, they will need to hire a diverse staff and engage experts and community partners early on in the process.