Shared Language for Shared Work in Population Health

C. J. Peek, John M. Westfall, Kurt C. Stange, Winston Liaw, Bernard Ewigman, Jennifer E. Devoe, Larry A. Green, Molly E. Polverento, Nirali Bora, Frank V. Degruy, Peter G. Harper, Nancy J. Baker

Research output: Contribution to journalArticlepeer-review


People working on behalf of population health, community health, or public health often experience confusion or ambiguity in the meaning of these and other common terms—the similarities and differences and how they bear on the tasks and division of labor for care delivery and public health. Shared language must be clear enough to help, not hinder people working together as they ultimately come to mutual understanding of roles, responsibilities, and actions in their joint work. Based on an iterative lexicon development process, the authors developed and propose a definitional framework as an aid to navigating among related population and community health terms. These terms are defined, similarities and differences clarified, and then organized into 3 categories that reflect goals, realities, and ways to get the job done. Goals include (a) health as well-being for persons, (b) population health as that goal expressed in measurable terms for groups, and (c) community health as population health for particular communities of interest, geography, or other defining characteristic—groups with shared identity and particular systemic influences on health. Realities are social determinants as influences, health disparities as effects, and health equity as both a goal and a design prin-ciple. Ways to get the job done include health care delivery systems for enrollees and public health in population-based civic activities—with a broad zone of collaboration where streams of effort converge in partnership with served communities. This map of terms can enable people to move forward together in a broad zone of collaboration for health with less confusion, ambiguity, and conflict.

Original languageEnglish (US)
Pages (from-to)450-457
Number of pages8
JournalAnnals of Family Medicine
Issue number5
StatePublished - Sep 22 2021

Bibliographical note

Funding Information:
The authors thank Annals of Family Medicine and the Robert Graham Center for co-sponsoring the interactive process to develop this paper and its figure. More specifically, Ellen McCarthy and John Holkeboer of the Annals of Family Medicine editorial team and Jack Westfall of the Robert Graham Center, who is a co-author. We thank Glen Mays of the University of Colorado for his contributions at the initial live interactive session. Thanks also goes to Nancy Baker, who felt a strong need for shared language in resident and medical student curricula on population and community health. She instigated this work by pulling together her University of Minnesota colleagues (with thanks to Christopher Reif) to develop the first iteration of the figure, took the lead in writing the ini-tial submission for publication, and wisely helped shape article content and editorial choices at every stage.

Publisher Copyright:
© 2021, Annals of Family Medicine, Inc. All rights reserved.


  • Definitions
  • Lexicon
  • Population health
  • Primary care public health integration

PubMed: MeSH publication types

  • Journal Article


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