So You Need to Understand Population Health

A Review of Population Health: Creating a Culture of Wellness (3rd Edition)

Synopsis and Evaluation

Nash, Skoufaols, Fabius, and Oglesby (2021) provide an in-depth, easy to understand overview of population health. The third edition divides the book into three sections including population health in the United States, the health ecosystem, and culture change. Overall, the book does a good job of providing the reader with understandable objectives and information to meet basic learning outcomes.

The book lays the foundation for understanding population health concepts. It provides the learner with guidance on the definitions of population health and its current state. For those without a background in the field, it highlights basic knowledge around epidemiology and its role in population health. The author’s use of call-out boxes to provide relevant information connecting the topic to current events is helpful. For example, they describe hot-spotting as a method to assist in identifying the neediest patients. The last chapter discusses health equity. From a learning standpoint, the authors could provide more information on health equity and its relation to population health. As with many books, the chapter focuses on the basics of cultural competency. It briefly mentions the role of structural racism and bias in our healthcare system. The American Public Health Association recommends Racism: Science & Tools for the Public Health Professional as an option for further understanding of health equity. This book provides information on the topic and also actionable steps for healthcare professions.

The second section of the book reviews the healthcare ecosystem. This is a complex topic; however, the authors take time to ensure the reader understands stakeholders and payment systems. One highlight of the section is the time spent on developing the workforce. In the midst of the Covid-19 pandemic, our healthcare workforce is on the front line. The CDC (2020) estimates over 10000 healthcare providers from Feb -June 2020 have a Covid-19 infection. Covid-19 highlights the need to address our workforce shortages. This book is different from some publications that divulge more information on the definitions of population health and our healthcare systems and spend little time discussing the development of the workforce. Now more than ever the human capital that exists within the healthcare ecosystem is our greatest asset.

The last section of the book is the longest and focuses on the culture of change. Change is hard, especially within such a complex system. The authors provide a refreshing take on topics including health promotion, metrics/outcomes, and advocacy. Interestingly the book discusses creating a culture of health and wellness within organizations. Change always starts from within. If as professionals, we demonstrate the changes we “preach to others” they are more likely to come along on this journey.

Reviewer’s Opinion

If you are not here to stand on the sidelines but are instead lead changes in our system this is a must-read textbook. Two successes from the book is including information on health behavior change and the simplistic use of language to help with understanding. My only suggestion is to include more information on health equity.

First, the inclusion of information on health promotion is not something I usually in other population health books. As someone who began their career studying community health, it is refreshing to see evidence-based theory on health behaviors. As professionals, we must understand the fundamentals of behavior change prior to designing population health initiatives. Second, the author’s use of language that is easy to understand to teach about complex issues is amazing. It is easy to get caught on the formal definitions of concepts, but the authors did not. Instead, to their advantage, the book includes visuals, case studies, call-out boxes, and other supplemental learning objects. Any reader should walk away with an understanding of the topic.

The current state of our country is one in which the inequities that exist are front and center. We cannot stand by and continue to duplicate the same efforts over and over again. This book had an opportunity to expound on the role of systemic racism and bias in healthcare. My suggestion for the authors to is include more information on this topic in all future editions. Additionally, the next editions must include not only information on addressing racism as a public health concern but also evidence-based actionable solutions for the healthcare professional. We cannot begin to push the needle on population health initiatives without first having an in-depth understanding of the role structural racism plays in our society.


Advanced Solutions International, I. (n.d.). APHA Store. Retrieved November 25, 2020, from

Fabius, R. J., Nash, D. B., Oglesby, W. H., & Skoufalos, A. (2021). Population health: Creating a culture of wellness. Burlington, MA: Jones & Bartlett Learning.

Racial Equity Tools. (n.d.). Retrieved November 25, 2020, from

Update: Characteristics of Health Care Personnel with COVID-19 - United States, February 12–July 16, 2020. (2020, September 24). Retrieved November 24, 2020, from

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