| Course | HCD 420 Population Health Management |
|---|---|
| Module | Module 6 |
| Paper type | Cumulative population health paper |
| Length | About 883 words, 6 pages |
| Format | APA 7 student paper |
| School | Arizona State University |
| Program | BS in Health Care Administration and Policy |
| Updated | October 2026 |
Free sample paper for HCD 420 Module 6
A System That Lets Measles Back In: Population Health Management for a Preventable Disease
Student Name
BS in Health Care Administration and Policy, Arizona State University
HCD 420: Population Health Management
Instructor Name
Month Day, Year
A System That Lets Measles Back In: Population Health Management for a Preventable Disease
Introduction
Measles is one of the most preventable serious infections, yet after its elimination from the United States in 2000 it has returned repeatedly, with 1,249 cases in 2019 alone (Patel et al., 2019). This paper argues that the return of measles is best understood as the product of a system, in which laws, communities, health care and public health interact, and that population health management can only succeed if it treats measles that way. The paper draws on my earlier writing workshops and closes with a systems view of what should be done.
The Burden and Its Distribution
Recent cases fall mostly on young unvaccinated children: from 2020 to March 2024, half of patients were 3 or younger and nine in ten were unvaccinated or of unknown status (Mathis et al., 2024). Cases cluster in place. In 2019, outbreaks in close-knit, undervaccinated New York communities produced 934 of the year's U.S. cases (Patel et al., 2019), and the New York City outbreak was concentrated in one Brooklyn neighborhood (Zucker et al., 2020). Over time, counts surged in 2019, fell during the pandemic and rose again in early 2024.
Social Determinants and Policy
Vaccination coverage reflects access to care, social networks and information environments as well as individual choice. State exemption laws shape how many children enter school unvaccinated; national kindergarten exemptions reached 3.3% in the 2023-24 school year (Seither et al., 2024). California's elimination of personal belief exemptions lowered the proportion of incoming kindergartners lacking required doses, though other exemptions partly took their place (Delamater et al., 2019).
Law and Outbreak Investigation
Health departments have strong legal tools, including mandatory reporting, access to records for disease control and the police power upheld in Jacobson v. Massachusetts (1905). Their practical limits are the size of the susceptible population and the staff and trust needed to use their authority. New York City's response required 559 staff members (Zucker et al., 2020).
Economics and Collaboration
Outbreaks are costly for public budgets, from $2.7 million to $5.3 million for sixteen outbreaks in 2011 (Ortega-Sanchez et al., 2014) to $8.4 million for one city's response in 2018-2019 (Zucker et al., 2020). Because practices bear the cost of prevention while health departments and communities bear the cost of outbreaks, collaboration requires policy that aligns incentives.
Three Approaches to the Same Problem
Population health describes outcomes and their distribution across a group (Kindig & Stoddart, 2003). Population health management applies data and outreach to an organization's defined population (Steenkamer et al., 2017). Public health protects whole communities through surveillance, law and programs. Each covers part of the measles problem, and none covers all of it.
A Systems View of Measles
Systems thinking treats a health problem as the result of interacting parts and feedback loops rather than a single cause, and public health practitioners have identified both its value and the practical difficulty of using it (Trochim et al., 2006). Applied to measles, three loops stand out.
Complacency loop. High coverage prevents outbreaks; without outbreaks, families and legislators see little risk; perceived low risk supports more exemptions; coverage declines. Success erodes its own support.
Clustering loop. Exemptions concentrate in particular communities; outbreaks occur there; heavy-handed responses can deepen mistrust; mistrust reduces vaccination further.
Funding loop. Outbreaks bring emergency funds; funds fade after the outbreak ends; partnerships lapse; the next outbreak finds the system unprepared.
| Loop | Point of influence | Action |
|---|---|---|
| Complacency | Visible risk information and school-entry rules | Publish school and county coverage; limit nonmedical exemptions |
| Clustering | Trust and access | Partner with community leaders; hold community clinics |
| Funding | Sustained financing | Fund registry reminders and joint drills between outbreaks |
A Coordinated Plan
The earlier workshops proposed separate policies. Seen as a system, they become one plan. A state should limit nonmedical exemptions while reviewing medical exemptions centrally, so that the complacency loop meets a structural brake. It should fund registry-linked reminders and community clinics continuously, so that the funding loop does not reset after each outbreak. And it should invest in partnerships with community and faith leaders before outbreaks occur, so that the response to the clustering loop builds trust rather than spending it. Health systems would contribute their patient data and clinical staff; health departments would contribute surveillance, legal authority and community reach.
What Systems Thinking Adds
Systems thinking changes the measure of success. A single-cause view would judge a policy by the coverage gain in its first year. A systems view asks whether the gain lasts, whether it holds in the communities where risk concentrates and whether it strengthens or weakens the trust the next response will need. It also explains why measures that work in one place disappoint in another, as California's experience suggests.
Limitations
This paper relies on published national and city reports, which may not capture smaller local outbreaks, and the loops described are hypotheses that would need data to test. The plan's effects on coverage would need evaluation.
Conclusion
Measles returns where a system allows it: where laws permit exemptions, communities cluster, funding fades and sectors fail to coordinate. Population health management can help by reaching patients through health systems, but only as part of a system that also includes public health's authority and the trust of the communities most at risk.
References
Delamater, P. L., Pingali, S. C., Buttenheim, A. M., Salmon, D. A., Klein, N. P., & Omer, S. B. (2019). Elimination of nonmedical immunization exemptions in California and school-entry vaccine status. Pediatrics, 143(6), e20183301. https://doi.org/10.1542/peds.2018-3301
Jacobson v. Massachusetts, 197 U.S. 11 (1905).
Kindig, D., & Stoddart, G. (2003). What is population health? American Journal of Public Health, 93(3), 380-383. https://doi.org/10.2105/AJPH.93.3.380
Mathis, A. D., Raines, K., Masters, N. B., Filardo, T. D., Kim, G., Crooke, S. N., Bankamp, B., Rota, P. A., & Sugerman, D. E. (2024). Measles: United States, January 1, 2020-March 28, 2024. Morbidity and Mortality Weekly Report, 73(14), 295-300. https://doi.org/10.15585/mmwr.mm7314a1
Ortega-Sanchez, I. R., Vijayaraghavan, M., Barskey, A. E., & Wallace, G. S. (2014). The economic burden of sixteen measles outbreaks on United States public health departments in 2011. Vaccine, 32(11), 1311-1317. https://doi.org/10.1016/j.vaccine.2013.10.012
Patel, M., Lee, A. D., Clemmons, N. S., Redd, S. B., Poser, S., Blog, D., Zucker, J. R., Leung, J., Link-Gelles, R., Pham, H., Arciuolo, R. J., Rausch-Phung, E., Bankamp, B., Rota, P. A., Weinbaum, C. M., & Gastañaduy, P. A. (2019). National update on measles cases and outbreaks: United States, January 1-October 1, 2019. Morbidity and Mortality Weekly Report, 68(40), 893-896. https://doi.org/10.15585/mmwr.mm6840e2
Seither, R., Yusuf, O. B., Dramann, D., Calhoun, K., Mugerwa-Kasujja, A., Knighton, C. L., Kriss, J. L., Miller, R., & Peacock, G. (2024). Coverage with selected vaccines and exemption rates among children in kindergarten: United States, 2023-24 school year. Morbidity and Mortality Weekly Report, 73(41), 925-932. https://doi.org/10.15585/mmwr.mm7341a3
Steenkamer, B. M., Drewes, H. W., Heijink, R., Baan, C. A., & Struijs, J. N. (2017). Defining population health management: A scoping review of the literature. Population Health Management, 20(1), 74-85. https://doi.org/10.1089/pop.2015.0149
Trochim, W. M., Cabrera, D. A., Milstein, B., Gallagher, R. S., & Leischow, S. J. (2006). Practical challenges of systems thinking and modeling in public health. American Journal of Public Health, 96(3), 538-546. https://doi.org/10.2105/AJPH.2005.066001
Zucker, J. R., Rosen, J. B., Iwamoto, M., Arciuolo, R. J., Langdon-Embry, M., Vora, N. M., Rakeman, J. L., Isaac, B. M., Jean, A., Asfaw, M., Hawkins, S. C., Merrill, T. G., Kennelly, M. O., Maldin Morgenthau, B., Daskalakis, D. C., & Barbot, O. (2020). Consequences of undervaccination: Measles outbreak, New York City, 2018-2019. New England Journal of Medicine, 382(11), 1009-1017. https://doi.org/10.1056/NEJMoa1912514
Reading the HCD 420 Module 6 assignment instructions
The Cumulative Paper comes due in Module 14 of HCD 420 and is worth 30 of the course's 132 points, the largest single item in the grade. It brings together the sections drafted in the writing workshops on one disease or condition, and it falls in the module on systems thinking, whose objective asks students to interpret the role of systems thinking in addressing health challenges. Revise rather than paste: instructors usually expect feedback from the workshops to show in the final version, and the sections must read as one argument. The full prompt and rubric are in Canvas. Expect the final exam, covering Modules 9 to 15, to follow soon after, so plan the paper's revision early in the module.
How this HCD 420 Module 6 example is built
The sample states a thesis in the introduction and then condenses each workshop into a short section: burden and distribution, social determinants and policy, law and investigation, economics and collaboration and the three population health concepts. The core of the paper is a systems view that describes three feedback loops in cause-and-effect chains, a table of points where action can change each loop and a coordinated plan that combines the earlier proposals. It closes by explaining what systems thinking adds, stating limitations and returning to the thesis. Ten sources, all used in the workshops, support the paper. Each loop ends with an action, which ties the analysis back to the course's solutions focus.
HCD 420 Module 6 rubric: what earns full marks
The final paper carries 30 points, marked on a Canvas rubric where 80% is the posted goal. Cumulative papers are typically credited for a clear thesis, integration of the workshop sections into one argument, evidence of revision, accurate and current data, a genuine application of systems thinking with feedback loops or interactions, a coordinated and realistic plan and APA formatting. Papers lose credit when sections are pasted in without transitions, when systems thinking is mentioned but not applied, when earlier errors are left uncorrected and when the conclusion introduces new material. Many instructors also read the final paper against the workshop feedback, so a corrected figure or a sharpened proposal is visible evidence of growth.
HCD 420 Module 6 help from the desk
Start by writing your thesis in one sentence, then cut each workshop section to what supports it. Draw your system on paper before writing: list the parts, connect them with arrows and look for loops that reinforce or balance each other. Turn separate proposals into one plan by showing how they work together. Leave time to reread the whole paper for consistent terms and data. If you would like a reader for the integrated draft, the desk can review it. Cut repetition between sections as you integrate them; facts that appeared in two workshops should appear once in the final paper, in the section where they do the most work.
Write yours, or have the desk draft it
This paper is an original model document written by our desk, not a submitted student paper and not an official Arizona State University document. Read it for the moves, then write your own to the instructions in your classroom. If you want one built to your exact prompt and rubric, the first custom sample is free and arrives in 24 to 48 hours.
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HCD 420 Module 6 questions, answered
Where can I find a free HCD 420 Module 6 sample paper?
This page carries a full HCD 420 Module 6 sample: the cumulative final paper on measles in the United States, with a systems thinking analysis.
How much is the HCD 420 final paper worth?
The posted grading table lists the final paper at 30 points and 30% of the grade, the largest single item.
What is systems thinking in public health?
An approach that treats health problems as the product of interacting parts and feedback loops rather than single causes.
What is a feedback loop?
It is a circle of influence: a change sets off consequences that loop back and either amplify it, as with complacency, or dampen it.
When is the HCD 420 cumulative paper due?
In Module 14, the systems thinking module, after five writing workshops.