integration, health disparities, health information technology, health care finance, health care policy, public health law, workforce education and training, organizational management, and child health. The committee was charged to:

•   Identify the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts. These examples were to illustrate shared accountability; workforce integration; collaborative governance, financing, and care coordination; and the effective use of information technology to promote integration and achieve high-quality primary care and public health.

•   Examine ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act (ACA) to promote the integration of primary care and public health.

•   Discuss how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at cardiovascular disease prevention, as well as other issues relevant to health disparities or specific populations, such as maternal and child health and colorectal cancer screening, and describe actions HRSA and CDC should take to promote these changes.

Funding for this study was provided by HRSA, CDC, and the United Health Foundation.

In conducting the study, the committee held five formal meetings, as well as three subgroup meetings, and used a variety of sources: the published literature, discussions with HRSA and CDC, presentations from practitioners, and commissioned papers. In drawing on these sources, the committee developed a list of key principles for the integration of primary care and public health, which are outlined below and discussed in detail in Chapter 2. These principles were used as a guiding framework in presenting examples of successful integration, identifying opportunities for interagency collaboration, and formulating the recommendations presented in this report.


Primary Care

The committee adopted an earlier IOM definition of primary care: “the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care

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