Organizational and Institutional Compartmentalization as a Barrier to Population Health

Abstract

The Centers for Disease Control and Prevention (CDC 2019e) define population health as “an approach that allows health departments to connect practice to policy.” One intention of the approach is that institutions from several different sectors, including academia, non-profits, public health, and local governments, should collaborate towards a holistic view of local health outcomes. In principal, the holistic view should allow for the recognition of substantial health concerns, such that resources can be re-allocated to address them. In reality, each institution is still bound by unique financial and personnel constraints, and there is little incentive to motivate actions that extend beyond institutional missions. The “Health Disparities in Jail Populations” project required the development of complex inter-organizational memoranda of agreements (MOAs), as well as complex and secure data processing resources to accomplish its secondary data analysis goals. The purpose of this article is to highlight barriers we encountered and the mechanisms we used in overcoming those barriers, while attempting to integrate data across several institutions that “own” different forms of data on health care to individuals who have entered the criminal justice system.