A population's health status and factors determining it are vital to producing
health of the citizens therein. The evidence is overwhelming that people in the United
States have worse health outcomes than those in other rich nations. Yet this fact is little
appreciated in the United States. U.S. public health practice remains rooted in the 20th
century with efforts to change personal behaviors, access health care, and ensure
satisfactory sanitation outcomes. Professional public health education remains similarly
stuck in the last century's paradigms. The population health block of the MPH in
Community-Oriented Public Health Practice attempts to orient students to 21st century
public health with a focus on creating appropriate structures in societies to make a
population healthy. Such an approach is inherently political, which is a challenge in the
United States because we tend to view health through an apolitical lens. This chapter
explains the population health approach, which requires students to look at other
countries to learn about health production. The goal: for people in the United States to
not be dead first but to live longer healthier lives.
Keywords: Barker hypothesis, Early life, First thousand days, Health, Inequality,
Inequities, Life expectancy, Medical harm, Morbidity, Mortality, Population
health, Socioeconomic gradient, U.S. mortality.
