Introduction: A Call for Transformation in Population Health Science
The field of population health science is at a crossroads. Despite advancements in medical research and technology, health disparities persist, and life expectancy in the United States continues to decline. The COVID-19 pandemic has further highlighted the limitations of the current biomedical model, which focuses on individual-level interventions and causal determinism. A recent study, "Beyond the Biomedical, Towards the Agentic: A Paradigm Shift for Population Health Science," by Acolin and Fishman (2023), advocates for a shift towards an agentic paradigm that emphasizes structural resilience and interconnectedness within populations.
Understanding the Paradigm Shift
The biomedical model, rooted in germ theory, has long dominated population health science. It views health as a function of risk factors, symptoms, diagnoses, and treatments. However, this model falls short in addressing the complex social and structural determinants of health. The agentic paradigm proposed by Acolin and Fishman shifts the focus from individual risk factors to the structural environment that supports individual resilience.
The Agentic Paradigm: A New Framework
The agentic paradigm views individuals as proactive and reflective actors who navigate their environments to achieve personal goals. This perspective recognizes that health outcomes are not solely determined by individual behaviors but are influenced by the structural environment. The agentic paradigm emphasizes the importance of structural resilience, which refers to the capacity of shared systems and institutions to support individual resilience.
Implementing the Agentic Paradigm in Practice
- Focus on Structural Resilience: Practitioners should prioritize interventions that enhance the structural resilience of communities. This involves creating environments that support individual agency and promote health across populations.
- Promote Congruence: Policies and interventions should aim for congruence, ensuring that systems and institutions are aligned and supportive of individual resilience.
- Encourage Affiliation: Building affiliative relationships within communities can enhance collective resilience and improve health outcomes.
Encouraging Further Research
The agentic paradigm offers a promising framework for understanding and improving population health. However, further research is needed to explore its empirical and pragmatic applications. Practitioners are encouraged to engage in research that examines the impact of structural resilience and congruence on health outcomes.
Conclusion: A Path Forward
The agentic paradigm represents a significant shift in population health science, moving beyond the limitations of the biomedical model. By focusing on structural resilience and interconnectedness, practitioners can better address the complex determinants of health and create environments that support individual agency. This paradigm shift holds the potential to improve health outcomes and reduce disparities across populations.
To read the original research paper, please follow this link: Beyond the biomedical, towards the agentic: A paradigm shift for population health science.
