Health Impact Pyramid

The Health Impact Pyramid is a five-tier framework, published by Thomas Frieden in a 2010 American Journal of Public Health article, ranking public health interventions by their likely population impact against the individual effort each requires. From the base upward the tiers run: interventions addressing socioeconomic determinants of health, interventions that change the context so a healthy choice becomes the easy default, long-lasting protective interventions requiring limited individual contact, ongoing direct clinical care, and health education and counseling at the narrow top. The pyramid's core claim is that impact and individual effort run in opposite directions: interventions lower on the pyramid reach broader segments of a population and require less of any one person, so they carry the greatest potential to improve population health, while interventions at the top are the most readily available to build but reach and move the needle on the fewest people.