Health Impact in 5 Years
Achieving lasting impact on health outcomes requires a focus not just on patient care, but on community wide-approaches aimed at improving population health.[1-6] Interventions that address the conditions in the places where we live, learn, work, and play have the greatest potential impact on our health.[7-11] By focusing on these “social determinants of health” (SDOH) and on “changing the context to make healthy choices easier," we can help improve the health of everyone living in a community.
The Health Impact in 5 Years (HI-5) initiative highlights non-clinical, community-wide approaches that have evidence reporting 1) positive health impacts, 2) results within five years, and 3) cost effectiveness and/or cost savings over the lifetime of the population or earlier.
The public health impact pyramid visually depicts the potential impact of different types of public health interventions. At the base of the pyramid are those interventions that have the greatest potential for impact on health because they reach entire populations of people at once and require less individual effort. The HI-5 Initiative maps directly to the two lowest tiers of public health pyramid with the greatest potential for impact.
Health conditions that the HI-5 interventions address
Community-wide approaches can have broad health impact, often addressing several health conditions at once. Below is a list of the health outcomes that HI-5 interventions can prevent or reduce:
- Anxiety and Depression
- Blood Pressure
- Cardiovascular Disease
- Child Abuse and Neglect
- Cognitive Development
- Infant Mortality
- Liver Cirrhosis
- Motor Vehicle Injuries
- Dental Caries
- Sexually Transmittable Infections
- Sexual Violence
- Teenage Pregnancy
- Traumatic Brain Injury
- Type II Diabetes
- Youth Violence
- Auerbach, J., The 3 Buckets of Prevention. J Public Health Manag Pract, 2016. 22(3): p. 215-8. doi: 10.1097/PHH.0000000000000381 Available from: The 3 Buckets of Prevention. J Public Health Manag Pract, 2016
- Robert Wood Johnson Foundation, P. Braveman, and S. Egerter, Overcoming obstacles to health: report from the Robert Wood Johnson Foundation to the Commission to Build a Healthier America. 2008: Robert Wood Johnson Foundation.
- Dow, W.H., et al., Evaluating the evidence base: Policies and interventions to address socioeconomic status gradients in healtha. Annals of the New York Academy of Sciences, 2010. 1186(1): p. 240-251.
- Stoto, M.A., Population health in the Affordable Care Act era. Vol. 1. 2013: AcademyHealth Washington, DC.
- Williams, D.R., et al., Moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities. Journal of public health management and practice: JPHMP, 2008. 14(Suppl): p. S8.
- Braveman, P., S. Egerter, and D.R. Williams, The social determinants of health: coming of age. Annual Review of Public Health, 2011. 32: p. 381-398.
- Frieden, T.R., A framework for public health action: the health impact pyramid. American Journal of Public Health, 2010. 100(4): p. 590-595. Available from: A framework for public health action: the health impact pyramid
- Hood, C.M., et al., County Health Rankings: Relationships Between Determinant Factors and Health Outcomes. American Journal of Preventive Medicine, 2016. 50(2): p. 129-135.
- Booske, B., et al., County Health Rankings Working Paper: Different perspectives for assigning weights to determinants of health. 2010, University of Wisconsin Population Health Institute (UWPHI). Retrieved from County Health Rankings Working Paper: Different perspectives for assigning weights to determinants of health.
- McGinnis, J.M., P. Williams-Russo, and J.R. Knickman, The case for more active policy attention to health promotion. Health affairs, 2002. 21(2): p. 78-93.
- Secretary’s Advisory Committee on Health Promotion and Disease Prevention Objectives for 2020, Healthy People 2020: An Opportunity to Address Societal Determinants of Health in the United States, Office of Disease Prevention & Health Promotion, U.S. Department of Health and Human Services. 2010. Available from: Healthy People 2020: An Opportunity to Address Societal Determinants of Health in the United States