Division on Health Policy

Louise Russell, Ph.D. directs the Division on Health Policy. The division’s work focuses on how to improve the allocation of health resources in the United States to promote better health for all Americans, an issue that will remain central in the years ahead regardless of how the organization of the health sector evolves. Within that focus the division directs its work primarily toward disease prevention and health promotion. The potential for disease prevention and health promotion has grown enormously over the last 50 years as new evidence on the health impact of smoking, elevated blood pressure, elevated cholesterol, diabetes, and other conditions has stimulated new methods for intervening against these risk factors. Health policy makers, clinicians, and individuals face a bewildering array of choices from which they must select interventions most likely to help.

Within the division two major lines of research have been directed at informing choices: (1) simulation modeling to project the long-term health outcomes of risk factors for disease, such as smoking and elevated blood pressure; and (2) cost-effectiveness analysis to evaluate the costs and health outcomes of health interventions.

Under Dr. Russell's direction a team of social scientists and physicians has developed a computerized simulation model, the Risk and Risk Factor Model, that projects the health consequences of changes in baseline risk factors such as smoking, elevated blood pressure, and diabetes. Supported with funding from the Agency for Healthcare Research and Quality, the model is based on data from the National Health and Nutrition Examination Survey I Epidemiologic Followup Study (NHEFS). Extensive baseline information, longitudinal followup, and a large sample size all contribute to making the NHEFS uniquely valuable for analyzing relationships among risk factors and subsequent health outcomes. The model is unusual in basing its methodology on a single, internally consistent dataset. The current model allows users to project the effects of modifying risk factors on deaths from all causes, hospital admissions, and nursing home admissions in NHANES III adults aged 25-74.

The Division's work on cost-effectiveness analysis includes research and training on a range of subjects from methodological issues, such as the modeling of age in cost-effectiveness analyses, to applications of the method to specific clinical interventions and to policy issues such as the impact of drug prices on the health of the elderly. Dr. Russell co-chaired the U.S. Public Health Service Panel on Cost-Effectiveness in Health and Medicine (1993-1996). Since 2011 she has been one of a group of five leaders in the field who organized and facilitated the work of the Second Panel on Cost-Effectiveness in Health and Medicine. An updated, second edition of the the book, Cost-Effectiveness in Health and Medicine, will reflect the many advances in cost-effectiveness analysis.