Identifying population health needs to reduce health inequality

Health inequalities can lead to poorer health outcomes for patients in disadvantaged areas across the UK; can identifying population health needs help to tackle this problem?

Tackling health inequalities is a core part of improving access to GP services and creating better health outcomes for the population. Health inequalities can be driven by:

• Different experiences of wider health influences, such as environment, income or housing.
• Differences in health behaviours and other risk factors, such as smoking, diet and physical activity levels.
• Psychosocial factors, such as social networks and self-esteem.
• Unequal access to, or experience of, health services.

To better mitigate health inequalities, practices can complete a health needs assessment (HNA). This assessment will measure and prioritise local population needs. It should consider the social, economic, cultural and behavioural factors that influence health and makes sure that the most effective support is being provided for patients in the greatest need. To complete a HNA successfully, practices can follow these five steps.

Pinpoint what you need                   

To encourage engagement with the assessment, and identify who will carry out each part, it is crucial that practices involve the key stakeholders at the beginning of the process:

• Identify the population of interest in the assessment – for example, is it defined by geography, illness, social experience or setting?
• Identify the key stakeholders.
• Identify which resources are available, and which of these are best suited to your assessment.

Identify health priorities

Your practice can use data to give a detailed picture of the health needs and priorities of your population of interest. This data can be collected through surveys, questionnaires, focus groups, public meetings, direct observations and interviews. Secondary data sources – such as demographic data, vital statistics, hospital records, morbidity and mortality reports and literature reviews – are also a great way to gather valuable information for your assessment.

This step should identify which of the issues identified are most important, helping practices identify leading priorities for action. Priorities may be decided on the basis of:

• size and severity impact;
• availability of effective and acceptable interventions and actions;
• local commissioning priorities and partnership arrangements.

Implementation

Once the priorities for action have been identified, practices should implement the HNA. During this process, a monitoring strategy should be put in place to measure the impact of any changes in services.

Reporting

Following the HNA, the results should be reported and presented to all the participants in the assessment. This report should be concise, accessible, informative and tailored to its intended audience.

Reflection

Reflection and evaluation is the final step in the HNA process. Practices should consider:

• Whether the objectives set at the start of the process were met.
• The impact of the HNA.
• How diverse the range of stakeholders was, and how involved they were in the process.
• How the barriers identified at the start of the process were overcome.
• New opportunities for tackling health inequalities that were discovered through the HNA process.
• Who will respond to the HNA and how they will do this (for example, planning changes or implementing a new intervention).