Shifts in the Use of Population Health, Health Promotion, and Public Health: A Bibliometric Analysis

Article excerpt


Objective: Bibliometric analysis can be used to objectively compare the usage of terms over time. The purpose of this research was to compare the use of population health, health promotion, and public health using bibliometric indicators of the published literature.

Methods: Bibliometric indicators, such as scientific productivity and the overlap between the terms, were analyzed in the Web of Science. Indexing of population health, health promotion, and public health was explored in MEDLINE, CINAHL, and EMBASE.

Results: The most productive country in population health was Canada, while the most productive country in health promotion and public health was the United States. The number of published articles using the public health term was surpassed by health promotion around 1990. Both were surpassed by population health around 2000. Population health was the only concept which lacked an index term in all three databases.

Discussion: There has been a shift in the usage of public health, health promotion, and population health concepts over time. Country analysis revealed that Canadian researchers are leaders in population health, while researchers based in the United States are leaders in public health and health promotion. This may indicate differences rooted in the social, historical and economic traditions.

Although the publication rate of articles described as 'population health' research is increasing, it is lacking an index term across major electronic databases. We suggest that without timely acceptance of terms, new concepts that represent different ways of thinking about health may be limited, delayed or glossed over.

Key words: Bibliometric analysis; public health; health promotion; population health

Mots clés : analyses bibliométriques; santé des populations; promotion de la santé; santé publique

Numerous definitions have been proposed for population health, health promotion, and public health. Population health has been defined as "the health of a population as measured by health status indicators and as influenced by social, economic, physical environments, personal health practices, individual capacity and coping skills, human biology, early childhood development, and health services".1 The 1974 Lalonde Report acknowledged that health should be broader than biomedical interventions2 and was followed shortly by the Ottawa Charter, which defined health promotion as "the process of enabling people to increase control over and to improve their health".3 Public health is "one of the efforts organized by society to protect, promote, and restore people's health".4

These definitions indicate that population health, health promotion, and public health are inter-related. All pertain to the health of individuals, as well as to the population's health status and the reduction of health disparities or inequalities to various degrees, yet subtle differences are apparent.5 For example, public health focuses on governments' responsibilities for health protection and includes disease surveillance and communicable disease control.4 In Canada, public health policymakers work with public health workers including practitioners and administrators at the local, provincial, and national level. Most major Canadian universities have public health programs at the graduate level. Health promotion aims to empower individuals and communities to gain control over their environment and better overall health through community-based partnerships.3,6 In Canada, health promoters work at the community, provincial, national, and international levels and a few graduate-level programs are available. Population health focuses on measuring and changing the health of a population either at the societal level or group level and includes discussions of the social (i.e., non-medical) determinants of health to address health inequalities.7 In Canada, population health is largely focused 'upstream' (i. …