4b. Ecological Models of Population Health: An Overview

Arguably the most important learning emerging from the limitations of the “lifestyle”-oriented approach to addressing population health issues is that we need to do a better job of designing and implementing interventions addressing multiple levels of influence. Specifically, we need to move beyond just considering individual knowledge, attitudes, and beliefs influencing health-related behaviours to addressing the social, environmental, and political determinants that enable or hinder health-related decision making.

For lack of better terminology, this broader perspective can be defined as a “society and health” view or an ecological view that emphasizes the constant interactions of cultural, social, economic, political, and biological influences on health across the lifespan. This suggests a need to understand ways in which social structures affect differential risks at different developmental points.

Drawing upon the work of Sorensen et al (1998)¹, the following table summarizes the key principles of a social ecological model of population health and associated operating guidelines for interview design and implementation.

**Key Dimensions of an Ecological Model of Population Health and Implications for Practice** (from Sorensen et al, 1998¹)
Core Principles of an Ecological Approach	Implications for Practice
Health and well-being are influenced by a wide variety of environmental factors.	Encompass multiple settings and life domains Reinforce health-promoting social norms through existing social networks
Personal characteristics and environmental conditions have direct and interactive effects on health and well-being.	Target changes in the community or organizational environments, as well as individual behaviour changes
The degree of fit between people's biological, behavioural, and socio-cultural needs and the environmental resources available is a key determinant of change.	Tailor programs to fit the setting through participation of the intended audience Empower people to make changes
Within the context of structured community settings, certain behaviours and roles exert pivotal influences on well-being.	Identify influential points in the community for promoting health
Examine links between physical and social conditions within particular settings, and the joint influences of multiple settings and life domains on health over extended periods.	Utilize multiple delivery points and methods over extended periods Address social conditions and recognize social context Implement coordinated interventions across multiple life domains
Interdisciplinary research linking public health, medicine, social science, and policy is essential.	Establish multi-disciplinary teams Link research, evaluation, and practice/policy

The following video provides additional information about the key principles and concepts underlying the ecological approach to population health:

Randy Miller. (2013, June 27). An Introduction to the Ecological Model in Public Health. [Video]. YouTube. https://www.youtube.com/watch?v=xhUxOZRn_4E

Please return to Module 4. Environment-Oriented Theories for Population Health Interventions to complete any readings associated with this content.

References

Sorensen, G., Emmons, K., Hunt, M.K., & Johnston, D. (1998). Implications of the results of community intervention trials. Annual Review of Public Health, 19, 379–416.