An exploration of integrating primary care and public health: Challenges and opportunities

In recognition of the potential for improved population health outcomes through increased linkages between public health and primary care, the Institute of Medicine (IOM) issued a report in early 2012 detailing principles for integrating public health and primary care. This report was followed just months later with a special supplemental issue of the American Journal of Public Health (AJPH) entirely dedicated to the proposition of integration.

The IOM report and the supplemental issue of AJPH make a compelling case for the potential of integrated health systems for addressing population health needs. However, several important questions need to be answered, including: (1) how to establish an explicit shared goal of population health in a community; (2) how to engage the community, including leaders of health systems, in defining and addressing population health needs; (3) how to align leadership across sectors and established organizations to invest more fully in integration; (4) how to develop sustainability around integration efforts; and (5) how to develop collaboration and sharing around health data and analysis.

Drawing on the results of a rigorous mixed-method study, this paper begins to unpack the answers to these questions. Important lessons learned related to challenges to and facilitators of integration will be shared. Implications for innovations in health services delivery, as well as the importance of more collaborative and integrated health systems will be discussed.