The Two Challenges to Addressing The Upstream Risk and Protective Determinants of Health In Current Health Policies and Programs In The U.S. and/or In Other Countries

Many quality improvement techniques—including the promotion of evidence-based treatments and well-coordinated care—can improve health outcomes. Their influence is often limited by factors beyond clinicians’ control, such as patients’ education, employment, and social support. To address the social and economic factors that affect health, quality improvement initiatives must reach beyond the traditional boundaries of the health care system of United States. One promising approach is the use of community-based partnerships that bring a wide range of stakeholders—health care providers, educators, business leaders, social service providers, community organizations, and clergy—together to promote healthy behavior, improve access to primary and preventive care, and reduce health disparities. Societies can think about early life when we can achieve all and appreciate all–because “we are all born equal.” Disparities in U.S. health care often result from a complex mixture of systemic quality and access problems intertwined with historic injury. Healthcare management research overlooks the role of collective leadership actions in alleviating health disparities. However, exploring the strategic actions of collective leaders can provide the field with a different viewpoint of how individuals and organizations partner to solve complex problems such as health disparities. The many dimensions of health disparities include race, ethnicity, socioeconomic status, and geography. It is critically important for policymakers to define the problem correctly so that our solutions address their intended goal—health security for all regardless of socioeconomic characteristics. A body of literature exists in organizational theory and management research that examines how leaders strategically and collectively word with stakeholders to solve complex problems– and create change in their organizations.