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Med Health Care and Philos (2009) 12:235244 DOI 10.1007/s11019-008-9173-8
SCIENTIFIC CONTRIBUTION
On the relationship between individual and population health
Onyebuchi A. Arah
Published online: 24 December 2008 The Author(s) 2008. This article is published with open access at Springerlink.com
Abstract The relationship between individual and population health is partially built on the broad dichotomization of medicine into clinical medicine and public health. Potential drawbacks of current views include seeing both individual and population health as absolute and independent concepts. I will argue that the relationship between individual and population health is largely relative and dynamic. Their interrelated dynamism derives from a causally dened life course perspective on health determination starting from an individuals conception through growth, development and participation in the collective till death, all seen within the context of an adaptive society. Indeed, it will become clear that neither individual nor population health is identiable or even denable without informative contextualization within the other. For instance, a persons health cannot be seen in isolation but must be placed in the rich contextual web such as the socioeconomic circumstances and other health determinants of where they were conceived, born, bred, and how they shaped and were shaped by their environment and communities, especially given the prevailing population health exposures over their lifetime. We cannot discuss the what and how much of individual and population health until we know the cumulative trajectories of both, using appropriate causal language.
Keywords Causality Context Ethics Individual
health Life course Population health Theory of health
Introduction
Population health is a relatively new, rather fashionable term in the medical eld.1 From its probable origins in Canada to its current use in the literature (Kindig and Stoddart 2003; Arah and Westert 2005), population health calls up images of non-individual health, at least in its literal meaning. Unsurprisingly, there is also individual health which is often seen as the complement of population health. Is population health merely the opposite of individual health? Do both represent core descriptions of health with respect to the individuals and societies? Both forms of health are, however, rarely analyzed together in the same papers,2 probably due to the prevailing dichotomy of medicine into clinical medicine (with its personal or
O. A. Arah (&)
Department of Social Medicine,...