population health planning

Commentary: Assessing population (baseline) risk is a cornerstone of population health planning—looking forward to address new challenges

Douglas G Manuel^1,2,3,4,5,* and Laura C Rosella^4,51The Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada, ²The Departments of Family Medicine and Epidemiology and Community Medicine, University of Ottawa, Ottawa, Ontario, Canada, ³Statistics Canada, Ottawa, Ontario, Canada, ⁴The Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada and ⁵Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
*Corresponding author. Ottawa Hospital Research Institute, Room 1-008 Administrative Services Building, 1053 Carling Avenue, Ottawa, ON K1Y 4E9, Canada. E-mail:dmanuel@ohri.ca
Accepted 23 November 2009


McLaren et al.¹ review two developments in critical thinking about the continued relevance of Rose’s seminal population health strategy and concluded that Rose’s original ideas, now over 25 years old, hold firm. Our commentary will focus on their critique of the suggestion to more widely use multivariate risk algorithms in the population setting.² We also draw connections between the use of risk algorithms and the authors’ central concerns about the role of social inequalities in relation to intervention or policy coverage. We argue that understanding a population’s baseline risk is a cornerstone of population health planning as articulated by Rose, and therefore it is inexcusable not to use improved methods of baseline risk assessment. Rather than be complacent with Rose’s original method of assessing population risk, we should look forward and further develop multivariate risk algorithms in the population setting./.../