National Academies Press: OpenBook
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

PRIMARY CARE AND PUBLIC HEALTH

Exploring Integration to Improve Population Health

Committee on Integrating Primary Care and Public Health

Board on Population Health and Public Health Practice

INSTITUTE OF MEDICINE
OF THE NATIONAL ACADEMIES

THE NATIONAL ACADEMIES PRESS

Washington, D.C.

www.nap.edu

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

THE NATIONAL ACADEMIES PRESS   500 Fifth Street, NW   Washington, DC 20001

NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This study was supported by Contract Nos. 200-2005-13434 and HHSH250200976014I between the National Academy of Sciences, Centers for Disease Control and Prevention and the Health Resources and Services Administration and funding from the United Health Foundation. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for this project.

International Standard Book Number-13: 978-0-309-25520-2

International Standard Book Number-10: 0-309-25520-1

Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu.

For more information about the Institute of Medicine, visit the IOM home page at: www.iom.edu.

Copyright 2012 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The serpent adopted as a logotype by the Institute of Medicine is a relief carving from ancient Greece, now held by the Staatliche Museen in Berlin.

Cover design by LeAnn Locher.

Suggested citation: IOM (Institute of Medicine). 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press.

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

Knowing is not enough; we must apply.
Willing is not enough; we must do.

—Goethe

image

INSTITITE OF MEDICINE
OF THE NATIONAL ACADEMIES

Advising the Nation. Improving Health.

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

THE NATIONAL ACADEMIES

Advisers to the Nation on Science, Engineering, and Medicine

The National Academy of Sciences is a private, nonprofit, self-perpetuating society of distinguished scholars engaged in scientific and engineering research, dedicated to the furtherance of science and technology and to their use for the general welfare. Upon the authority of the charter granted to it by the Congress in 1863, the Academy has a mandate that requires it to advise the federal government on scientific and technical matters. Dr. Ralph J. Cicerone is president of the National Academy of Sciences.

The National Academy of Engineering was established in 1964, under the charter of the National Academy of Sciences, as a parallel organization of outstanding engineers. It is autonomous in its administration and in the selection of its members, sharing with the National Academy of Sciences the responsibility for advising the federal government. The National Academy of Engineering also sponsors engineering programs aimed at meeting national needs, encourages education and research, and recognizes the superior achievements of engineers. Dr. Charles M. Vest is president of the National Academy of Engineering.

The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine.

The National Research Council was organized by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy’s purposes of furthering knowledge and advising the federal government. Functioning in accordance with general policies determined by the Academy, the Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in providing services to the government, the public, and the scientific and engineering communities. The Council is administered jointly by both Academies and the Institute of Medicine. Dr. Ralph J. Cicerone and Dr. Charles M. Vest are chair and vice chair, respectively, of the National Research Council.

www.nationalacademies.org

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

COMMITTEE ON INTEGRATING PRIMARY
CARE AND PUBLIC HEALTH

PAUL J.WALLACE (Chair), Senior Vice President and Director, Center for Comparative Effectiveness Research, The Lewin Group, Falls Church, VA

ANNE M. BARRY, Deputy Commissioner, Minnesota Department of Human Services, St. Paul

JO IVEY BOUFFORD, President, New York Academy of Medicine, New York

SHAUN GRANNIS, Director and Principal Investigator for DRI-ICE and Assistant Professor, Department of Family Medicine, Indiana Center of Excellence in Public Health Informatics, Regenstrief Institute, Inc., Indianapolis

LARRY A. GREEN, Epperson-Zorn Chair for Innovation in Family Medicine, University of Colorado at Denver

KEVIN GRUMBACH, Professor and Chair, Department of Family and Community Medicine, University of California, San Francisco, and Chief, Family and Community Medicine, San Francisco General Hospital

FERNANDO A. GUERRA, Public Health Consultant and Director of Health, City of San Antonio and the San Antonio Metropolitan Health District, Texas

JAMES HOTZ, Clinical Services Director/Medical Director, Albany Area Primary Health Care, Georgia

ALVIN D. JACKSON, Director (former), Ohio Department of Health, Fremont

BRUCE E. LANDON, Professor of Health Care Policy, Department of Health Care Policy, Professor of Medicine, Harvard Medical School, Boston, MA

DANIELLE LARAQUE, Chair, Department of Pediatrics, Maimonides Medical Center, Brooklyn, NY

CATHERINE G. MCLAUGHLIN, Senior Research Fellow, Mathematica Policy Research, Ann Arbor, MI

J. LLOYD MICHENER, Professor and Chairman, Department of Community and Family Medicine, and Director, Duke Center for Community Research, Duke University Medical Center, Durham, NC

ROBERT L. PHILLIPS, JR., Director, Robert Graham Center, American Academy of Family Physicians, Washington, DC

DAVID N. SUNDWALL, Clinical Professor of Public Health, School of Medicine in the Division of Public Health, University of Utah, Salt Lake City

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

MARY WELLIK, Community Health Services Administrator (Retired), Olmsted County Public Health Services, Rochester, MN

WINSTON F. WONG, Medical Director, Community Benefit Disparities Improvement and Quality Initiatives, National Program Office, Kaiser Permanente, Oakland, CA

Consultants

SARA ROSENBAUM, George Washington University School of Public Health and Health Services, Washington, DC

PHILIP SLOANE, University of North Carolina at Chapel Hill

KATRINA DONAHUE, University of North Carolina at Chapel Hill

FEDERAL FUNDS INFORMATION FOR STATES, Washington, DC

RONA BRIERE, Briere Associates, Inc., Felton, PA

Staff

MONICA N. FEIT, Study Director

JOSHUA JOSEPH, Associate Program Officer

TREVONNE WALFORD, Research Associate

ANDRES GAVIRIA, Senior Program Assistant (from August 2011)

KATHLEEN MCGRAW-SHEPHERD, Senior Program Assistant (until August 2011)

RACHEL MIRIANI, Intern, Summer 2011

ROSE MARIE MARTINEZ, Director, Board on Population Health and Public Health Practice

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

Reviewers

This report has been reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with procedures approved by the National Research Council’s Report Review Committee. The purpose of this independent review is to provide candid and critical comments that will assist the institution in making its published report as sound as possible and to ensure that the report meets institutional standards for objectivity, evidence, and responsiveness to the study charge. The review comments and draft manuscript remain confidential to protect the integrity of the deliberative process. We wish to thank the following individuals for their review of this report:

Bobbie Berkowitz, Columbia University School of Nursing and Columbia University Medical Center

Kurtis Elward, Family Medicine of Albemarle

Barbara Ferrer, Boston Public Health Commission

Michael Katz, March of Dimes Foundation

Mitch Katz, Los Angeles County Department of Health Services

Paula Lantz, The George Washington University

David O. Meltzer, University of Chicago

James W. Mold, University of Oklahoma Health Sciences Center

Joshua M. Sharfstein, Maryland Department of Health and Mental Hygiene

William Welton, University of Washington

Steven H. Woolf, Virginia Commonwealth University Center on Human Needs

Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

Although the reviewers listed above have provided many constructive comments and suggestions, they were not asked to endorse the report’s conclusions or recommendations, nor did they see the final draft of the report before its release. The review of this report was overseen by Susan J. Curry, The University of Iowa, and Mark R. Cullen, Stanford University. Appointed by the National Research Council and Institute of Medicine, they were responsible for making certain that an independent examination of this report was carried out in accordance with institutional procedures and that all review comments were carefully considered. Responsibility for the final content of this report rests entirely with the authoring committee and the institution.

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

Acknowledgments

The Institute of Medicine (IOM) Committee on the Integration of Primary Care and Public Health would like to express its sincere gratitude to everyone who assisted with this report.

This work would not have been possible without the support of our sponsors. The committee would like to thank the Health Resources and Services Administration (HRSA), the Centers for Disease Control and Prevention (CDC), and the United Health Foundation for their generous sponsorship. We appreciate the time taken by Mary Wakefield, Ph.D., R.N., administrator of HRSA; Sarah Linde-Feucht, M.D., chief public health officer, HRSA; Judith Monroe, M.D., director, Office for State, Tribal, Local and Territorial Support, CDC; Chesley Richards, M.D., M.P.H., FACP, director, Office of Prevention through Healthcare, Office of the Associate Director for Policy, CDC; and Reed Tuckson, M.D., FACP, executive vice president and chief of medical affairs, UnitedHealth Group for meeting with the committee to clarify its charge. In addition, we would like to acknowledge the following staff for their assistance throughout the study:

HRSA

Natasha Coulouris, M.P.H.

Matthew Burke, M.D.

Chris DeGraw, M.D., M.P.H.

Seiji Hayashi, M.D., M.P.H.

Suzanne Heurtin-Roberts, Ph.D., M.S.W.

Michele Lawler, M.S., R.D.

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

Beverly Wright, C.N.M., M.S.N., M.P.H.

Audrey Yowell, Ph.D., M.S.S.S.

CDC

Paula Staley, M.P.A., R.N.

Wanda Barfield, M.D., M.P.H., FAAP Peter Briss, M.D., M.P.H.

Lydia Ogden, Ph.D., M.P.P., M.A.

Marcus Plescia, M.D., M.P.H.

Michael Schooley, M.P.H.

United Health Foundation

Shelly Espinosa, M.P.H.

The committee would like to acknowledge and thank the many individuals who presented to the committee and provided insight on various topics throughout the study. These individuals include many of the staff listed above as well as those listed below.

Charlie Alfero, M.A. (Hidalgo Medical Service)

Alina Alonso, M.D. (Palm Beach County Health Department, Florida Department of Health)

Katherine Brieger, M.A., R.D., CDE (Hudson River Health Care)

Helen Darling, M.A. (National Business Group on Health)

Ralph Fuccillo, M.A. (DentaQuest Foundation)

M. Chris Gibbons, M.D., M.P.H. (Johns Hopkins Urban Health Institute)

Ben Gramling (Sixteenth Street Community Health Center)

Jean Johnson, Ph.D., FAAN (The George Washington University School of Nursing)

David B. Nash, M.D., M.B.A., FACP (Jefferson School of Population Health)

Robert Resendes, M.B.A. (Yavapai County Community Health Services)

Barbara Safriet, J.D., L.L.M. (Lewis & Clark Law School)

Ellen-Marie Whelan, Ph.D., N.P., R.N. (Center for Medicare & Medicaid Services Innovation Center)

Steven Woolf, M.D., M.P.H. (Virginia Commonwealth University Center on Human Needs)

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

Finally, the committee would like to recognize the consultants who aided in the creation of the report, Sara Rosenbaum, Philip Sloane, Katrina Donahue, and the Federal Funds Information for States organization. Their efforts proved invaluable to the committee. The committee is also grateful to Rona Briere and Alisa Decatur of Briere and Associates, Inc., for their assistance in editing the report and to LeAnn Locher for her work in creating the cover and the design elements throughout the report.

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

This page intentionally left blank.

Page xiii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

Preface

In 2010, the Institute of Medicine (IOM) was asked by the Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) to convene a committee to study and prepare a report providing recommendations on how they, as national agencies, could work collectively to improve health through the integration of primary care and public health. The CDC and HRSA sponsorship was reinforced by support from the United Health Foundation. To conduct this study, the IOM formed the Committee on Integrating Primary Care and Public Health.

This effort is not the first, nor will it likely be the last, to explore how these two sectors can complement each other and align their resources to improve population health. At the same time, the committee had a strong appreciation for the unique contributions, accountabilities, and perspectives of both sectors and respected those attributes in proposing opportunities for expanded collaboration.

Several factors contribute to the timeliness of this report with respect to both the demand for and an environment conducive to meaningful progress. Key among these factors is the sponsorship of this effort by organizations with national perspective and influence that are motivated to find ways to leverage their resources in a more collaborative manner. All of the study’s sponsors are increasingly focused on various aspects of population health, including maternal and child health; cancer prevention; and management of noncommunicable chronic diseases, such as obesity, diabetes, and heart disease. The science of management of these conditions is continually being refined, and innovations in population-focused care

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

services are rapidly evolving. The accelerating use of health information technologies has the potential to extend access to high-quality, evidence-based care to all members of the population. Finally, investments under the American Recovery and Reinvestment Act, together with the passage and ongoing implementation of the Patient Protection and Affordable Care Act, support widespread and increasingly consequential change in how health care is delivered to and accessed by Americans.

In addressing its charge and producing this report, the committee sought to find the right balance between a grand vision of enhanced population health and the need to offer actionable recommendations for the sponsoring organizations. The committee appreciated the sponsors’ leadership and commitment to pursuing this endeavor, as well as the thoughtful and enthusiastic participation of many agency staff members in testimony on and discussion of existing services and considerations for future change. The committee acknowledges the complexity and challenges of effecting large-scale change in organizations with rich histories, traditions of advocacy and leadership at the agency level, and ongoing responsibilities for traditional activities.

The committee also had the opportunity to examine and learn from many initiatives designed to better align and integrate the targeted services at the local and community levels. This experience highlighted a key challenge: across the nation, most efforts to integrate care delivery and improvement in primary care and public health are locally led and defined, and there are very few examples of successful integration on a larger scale. Consequently, the committee sought to draw key principles from these local and community successes and to propose how those principles might guide actions at the national level.

Overall, the committee sought to provide strategic and practical guidance that could be implemented with anticipated resources and leadership commitment while fully leveraging emerging opportunities in the knowledge, policy, funding, and information technology environments. This guidance is built on the committee’s conclusions with respect to how population health can be improved by implementing and expanding integration now, with the belief and intent that the momentum achievable through these changes can catalyze future progress toward a truly transformed, robust, and equitable population health system.

Paul J. Wallace, Chair
Committee on Integrating Primary Care and Public Health

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

Acronyms and Abbreviations

ABCS

aspirin use, blood pressure control, cholesterol management, and smoking cessation

ACA

Patient Protection and Affordable Care Act

ACF

Administration for Children and Families

ACO

accountable care organization

AHRQ

Agency for Healthcare Research and Quality

ARRA

American Recovery and Reinvestment Act

CBO

Congressional Budget Office

CCNC

Community Care of North Carolina

CDC

Centers for Disease Control and Prevention

CHIP

Children’s Health Insurance Program

CMMI

CMS Innovation Center

CMS

Centers for Medicare & Medicaid Services

COPC

community-oriented primary care

DHI

Durham Health Innovations

EIS

Epidemic Intelligence Service

FOBT

fecal occult blood test

FQHC

federally qualified health center

HERO

Health Extension Rural Office

HHS

Department of Health and Human Services

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×

HIT

health information technology

HITECH

Health Information Technology for Economic and Clinical Health (Act)

HPRN

High Plains Research Network

HRSA

Health Resources and Services Administration

INPC

Indiana Network for Patient Care

IOM

Institute of Medicine

IRS

Internal Revenue Service

MCH

maternal and child health

NACCHO

National Association of County and City Health Officials

NAS

National Academy of Sciences

NHSC

National Health Service Corps

NIH

National Institutes of Health

NYC DOHMH

New York City Department of Health and Mental Hygiene

PCEP

Primary Care Extension Program

PRAMS

Pregnancy Risk Assessment Monitoring System

PPS

Prospective Payment System

REACH

Regional Electronic Adoption Center for Health

SPARC

Sickness Prevention Achieved through Regional Collaboration

SSBG

Social Services Block Grant

UDS

Uniform Data System

WHO

World Health Organization

Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R1
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R2
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R3
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R4
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R5
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R6
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R7
Page viii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R8
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R9
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R10
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R11
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R12
Page xiii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R13
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R14
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R15
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R16
Page xvii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R17
Page xviii Cite
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R18
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R19
Suggested Citation:"Front Matter." Institute of Medicine. 2012. Primary Care and Public Health: Exploring Integration to Improve Population Health. Washington, DC: The National Academies Press. doi: 10.17226/13381.
×
Page R20
Next: Summary »
Primary Care and Public Health: Exploring Integration to Improve Population Health Get This Book
×
Buy Paperback | $45.00 Buy Ebook | $35.99
MyNAP members save 10% online.
Login or Register to save!
Download Free PDF

Ensuring that members of society are healthy and reaching their full potential requires the prevention of disease and injury; the promotion of health and well-being; the assurance of conditions in which people can be healthy; and the provision of timely, effective, and coordinated health care. Achieving substantial and lasting improvements in population health will require a concerted effort from all these entities, aligned with a common goal. The Health Resources and Services Administration (HRSA) and the Centers for Disease Control and Prevention (CDC) requested that the Institute of Medicine (IOM) examine the integration of primary care and public health.

Primary Care and Public Health identifies the best examples of effective public health and primary care integration and the factors that promote and sustain these efforts, examines ways by which HRSA and CDC can use provisions of the Patient Protection and Affordable Care Act to promote the integration of primary care and public health, and discusses how HRSA-supported primary care systems and state and local public health departments can effectively integrate and coordinate to improve efforts directed at disease prevention.

This report is essential for all health care centers and providers, state and local policy makers, educators, government agencies, and the public for learning how to integrate and improve population health.

  1. ×

    Welcome to OpenBook!

    You're looking at OpenBook, NAP.edu's online reading room since 1999. Based on feedback from you, our users, we've made some improvements that make it easier than ever to read thousands of publications on our website.

    Do you want to take a quick tour of the OpenBook's features?

    No Thanks Take a Tour »
  2. ×

    Show this book's table of contents, where you can jump to any chapter by name.

    « Back Next »
  3. ×

    ...or use these buttons to go back to the previous chapter or skip to the next one.

    « Back Next »
  4. ×

    Jump up to the previous page or down to the next one. Also, you can type in a page number and press Enter to go directly to that page in the book.

    « Back Next »
  5. ×

    Switch between the Original Pages, where you can read the report as it appeared in print, and Text Pages for the web version, where you can highlight and search the text.

    « Back Next »
  6. ×

    To search the entire text of this book, type in your search term here and press Enter.

    « Back Next »
  7. ×

    Share a link to this book page on your preferred social network or via email.

    « Back Next »
  8. ×

    View our suggested citation for this chapter.

    « Back Next »
  9. ×

    Ready to take your reading offline? Click here to buy this book in print or download it as a free PDF, if available.

    « Back Next »
Stay Connected!