An epidemiological model for health policy analysis


Health programs needing health and other related data have failed in their solutions because they have lacked a rational framework for analysis. A cursory analysis of present disease patterns reveals chronic conditions for which the present system of organized health care has no immediate cures. On the other hand, infectious diseases of decades past have been all but eliminated by vaccines and antibiotics. Before we are able either to prevent or to arrest current disease processes, we must dissect the health field into more manageable elements that reflect a creative area for epidemiological models.

An epidemiological model that supports health policy analysis and decisiveness must be broad, comprehensive, and must include all matters affecting health. Consequently, four primary divisions have been identified: (1) System of Health Care Organization; (2) Life Style (self-created risks); (3) Environment; and (4) Human Biology.

An application of the epidemiological model involves four steps: (1) the selection of diseases that are of high risk and that contribute substantially to the overall morbidity and mortality; (2) to proportionately allocate the contributing factors of the disease to the four elements of the epidemiological model; (3) to proportionately allocate total health expenditures to the four elements of the epidemiological model; and (4) to determine the difference in proportions between (2) and (3) above.

Five tables illustrate how the epidemiological model is applied, showing the diseases selected for analysis; the contributing factors of each disease to the four components of the epidemiological model; the distribution of Federal outlays for medical and health-related activities by category; the distribution of Federal outlays of health expenditures by category; and a comparison of Federal health expenditures to the allocation of mortality in accordance with the epidemiological model.

The conclusion to be drawn from this study is that, based on current procedures for reducing mortality and morbidity, little or no change in our present disease patterns will be accomplished unless we dramatically shift our health policy.

This is a preview of subscription content, access via your institution.


  1. 1.

    BlumH. L.: 1974, Planning for Health — Development and Application of Social Change Theory, Human Sciences Press, New York, N.Y.

    Google Scholar 

  2. 2.

    BurtM. R.: 1974, Policy Analysis — Introduction and Application to Health Programs, Information Resources Press, Washington, D.C.

    Google Scholar 

  3. 3.

    CullingworthJ. B. (ed.): 1973, Problems of an Urban Society, Vol. 3, Planning for Change, University of Toronto Press, Toronto, Ontario, Canada.

    Google Scholar 

  4. 4.

    Dever, G. E. A.: 1974, Dimensions of Environmental Health, paper presented at the Georgia Public Health Association.

  5. 5.

    Dever, G. E. A.: 1974, The Future of Health Services in Georgia, paper presented at a Workshop on Change, Armstrong State College, Savannah, Georgia.

  6. 6.

    ErhardtC. L. and BerlinJoyce E. (eds.): 1974, Mortality and Morbidity in the U.S., Vital and Health Statistics Monographs, American Public Health Association, Harvard University Press, Cambridge, Mass.

    Google Scholar 

  7. 7.

    Hunter, J. M. (ed.): 1974, The Geography of Health and Disease, Papers of the First Carolina Geographical Symposium, Dept. of Geography, University of North Carolina, Chapel Hill, N.C.

  8. 8.

    KotlerP. and ZaltmanG.: 1971, ‘Social Marketing: An Approach to Planned Social Change’, J. Marketing 35, 3–12.

    Google Scholar 

  9. 9.

    LaFramboiseH. L.: 1973, ‘Health Policy: Breaking the Problem Down into more Manageable Segments’, J. Can. Med. Assoc. 108, 388–393.

    Google Scholar 

  10. 10.

    LalondeM.: 1974, A New Perspective on the Health of Canadians, Office of the Canadian Minister of National Health and Welfare, Ottawa.

    Google Scholar 

  11. 11.

    LillefeldA. M. and GiffordA. J. (eds.): 1966, Chronic Diseases and Public Health, The Johns Hopkins Press, Baltimore.

    Google Scholar 

  12. 12.

    Minister of Industry, Trade, and Commerce, Office of the Senior Advisor on Interpretation, Statistics Canada: 1974, Perspective Canada: A Compendium of Social Statistics, Information Canada, Ottawa.

    Google Scholar 

  13. 13.

    NewellK. W.: 1975, ‘Public Health Research: Possibilities and Opportunities’, W.H.O. Chronicle 29, 3–5.

    Google Scholar 

  14. 14.

    Special Analyses, Budget of the United States Government, 1976, Federal Health Programs, Special Analysis K. Office of Management and Budget, February 1975, p. 169–196.

  15. 15.

    TofflerA.: 1970, Future Shock, Random House, Inc., A Bantam Book, New York, N.Y.

    Google Scholar 

  16. 16.

    U.S. Dept. of H.E.W.: 1970, Man's Health and the Environment — Some Research Needs, Report of the Task Force on Research Planning in Environmental Health Sciences. U.S. Government Printing Office, Washington, D.C.

    Google Scholar 

  17. 17.

    ZaltmanG. and VertinskyI.: 1971, ‘Health Service Marketing: A Suggested Model’, J. Marketing 35, 19–27.

    Google Scholar 

  18. 18.

    Fiscal data as illustrated in Table III is not available for Georgia; therefore, the U.S. fiscal data is utilized.

Download references

Author information



Additional information

The completion of this paper was dependent upon direct staff support in the Health Services Research and Statistics Section. I wish to thank Judy Morris and Geneva Hopkins for their stenographic skills as well as Anne Caldwell and Michael Lavoie for their statistical expertise.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Dever, G.E.A. An epidemiological model for health policy analysis. Soc Indic Res 2, 453–466 (1976).

Download citation


  • Life Style
  • Health Expenditure
  • Care Organization
  • Health Care Organization
  • Rational Framework