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Thinking Upstream: A 25-Year Retrospective and Conceptual Model Aimed at Reducing Health Inequities
1Washington State University College of Nursing, Spokane.
ANS. Advances in Nursing Science
|December 9, 2016
Summary
Thinking upstream, a nursing concept from 1990, addresses health inequities by focusing on economic, political, and environmental factors. This article explores its evolution and introduces the Butterfield Upstream Model for Population Health (BUMP Health).
Area of Science:
- Nursing
- Public Health
- Health Policy
Background:
- "Thinking upstream" introduced in 1990 to broaden health perspectives.
- Nursing scholars adapted upstream precepts to reduce health inequities.
- Emphasis on economic, political, and environmental health determinants.
Observation:
- Upstream concepts gained traction in US health care reform policy.
- Broader adoption of upstream language in policy documents.
- Semantic exploration of the upstream thinking concept.
Findings:
- Upstream approaches redirect actions to address root causes of health issues.
- Focus on broader determinants of health beyond individual behaviors.
- Introduction of the Butterfield Upstream Model for Population Health (BUMP Health).
Implications:
- Potential for significant reduction in health inequities.
- Enhanced understanding of population health determinants.
- Provides a new model (BUMP Health) for guiding upstream interventions.
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