Population Health Science Program

Population health science involves looking at health outcomes among groups, such as communities, regions, states, countries and the world. This includes examining how outcomes vary between different groups and finding ways to eliminate such disparities.

The Population Health Science Program aims to improve health and well-being in southeastern Minnesota by studying, delivering and evaluating a wide range of high-quality, evidence-based health services. These efforts take place at all levels — within communities and organizations as well as among health care providers and individuals — with a focus on long-lasting changes that protect and promote health outside of traditional doctor-and-patient visits.

One priority of the Population Health Science Program's work is developing a collaborative program of research and increasing expertise in population health science among Mayo Clinic primary care physicians and staff, including conducting population-level descriptive, interventional, evaluative and surveillance research.

Other program priorities are to:

  • Identify community health priorities and build strong partnerships across Mayo Clinic and in the community, including with southeastern Minnesota health care organizations, school districts and public health entities
  • Leverage public health data resources in southeastern Minnesota to track community health and inform efforts to improve community health
  • Create educational opportunities and resources to promote an understanding of population health and the specific population health needs of our community
  • Evaluate the impact of primary care on patient experience, access to care, cost of care and practice efficiencies

Areas of focus

Population Health Science Program staff, collaborators and scholars are focusing their research efforts on improving health and health care among residents of southeastern Minnesota, including Mayo Clinic patients, employees and their dependents.

Three approaches are being taken to improve health in these groups:

  • Proactive, team-based primary care. This involves improving the management and outcomes of patients who seek health care at Mayo Clinic locations, which can be done through traditional clinical trials, practice-modification trials or practice re-engineering experiments.
  • Connect people with preventive care. Our community includes many people who would benefit from preventive health care, such as vaccinations and cancer screenings, but who are not currently seeking this type of care. The Population Health Science Program is identifying these members of our community, including Mayo Clinic employees, and designing and evaluating interventions to ensure that they access preventive health care on a routine, ongoing basis.
  • Prevent disease through lifestyle changes. There are well-established nonmedical strategies, such as healthy eating and increased exercise, for preventing disease and improving quality of life. The program is promoting wider use of these strategies in our community, as well as designing and evaluating methods to encourage people to adopt and stick to such lifestyle changes.

Broad research themes for the program have been identified in conjunction with the Mayo Clinic primary care practices and the community-wide Community Health Needs Assessment for Olmsted County, Minnesota. These include:

  • Cancer prevention and control
  • Chronic disease management
  • Diabetes
  • Healthy lifestyle promotion
  • Mental health
  • Obesity prevention and management
  • Palliative care
  • Vaccine-preventable diseases

Projects

Population Health Scholars Program

The Population Health Scholars Program provides training and mentoring in community and population health research at Mayo Clinic. It also contributes to ongoing efforts at Mayo to develop and identify population health indicators, including patient-reported outcomes, to evaluate the quality and value of care, as well as facilitate adoption and integration of best practices in population health in diverse clinical and community environments.

The three-year program, which welcomed six Mayo clinicians as scholars for 2014, provides a unique training opportunity to learn how to obtain grants, conduct research and publish study findings that advance population health science.

Factors associated with completion of the HPV vaccine series

This project is identifying HPV vaccination rates by age, sex and race in Olmsted County, Minn., which is home to Mayo Clinic in Rochester. Researchers hypothesize that children who start the vaccination series at ages 9 to 11 have higher completion rates than children who start at age 12 or older.

Findings from this project will help determine which children are at a high risk of failing to complete the vaccination series and aid in appropriately targeting interventions that encourage completion.

Causes and consequences of multimorbidity

The rate of multimorbidity, which is the presence of two or more chronic health conditions, is increasing rapidly in the U.S. population. Yet, current preventive and treatment efforts tend to focus on one disease at a time — and only after the conditions are diagnosed. There is a critical need to earlier identify groups of people at risk and develop interventions to prevent multimorbidity and other adverse health outcomes.

This project is looking at the incidence, causes and consequences of multimorbidity. Data and outcomes from this study are important for developing earlier and more-integrated interventions to prevent multimorbidity and improve patients' long-term outcomes.

Mayo Clinic primary care practice evolution

Health care delivery at Mayo Clinic is moving toward a model that makes subspecialty expertise available within the primary care practice. The Population Health Science Program is evaluating the impact of this transformation on patient and provider satisfaction and the cost of health care.

Contact

Lila J. Rutten, Ph.D.

Jon O. Ebbert, M.D.