Public Health Services Research: Building the Evidence

Feb 15, 2012, 7:29 PM, Posted by NewPublicHealth

AcademyHealth’s Public Health Systems Research Interest Group held a breakfast briefing yesterday, sponsored by the Robert Wood Johnson Foundation, during their National Health Policy Conference this week.

The session, “Evidence Matters: Research Findings to Inform Public Health Policy and Practice,” featured Glen Mays, PhD, the F. Douglas Scutchfield Endowed Professor at the University of Kentucky College of Public Health, and Randall R. Bovbjerg, a Senior Fellow at the Urban Institute’s Health Policy Center. The session was moderated by Paul Wallace, MD, Senior Vice President and Director of the Center for Comparative Effectiveness Research at the Lewin Group.

Paul Wallace pointed to two critical questions:

  • What are the strategic opportunities for public health in the health care landscape?
  • How do we preserve what we’ve got and anticipate the roadblocks?

Wallace reviewed events and decisions that created the current public health environment:

  • Public health and health care delivery have not always been separate domains
  • Health care took the biomedical route and left behind the social determinants of health, and “became quite enthralled” with technology
  • In 1960 the Rockefeller Foundation made the strategic decision to create schools of public health, creating a philosophical and organizational schism between public health and health care
  • The 1966 Fulsome Report looked at what it would take to find the common ground between public health and health care. Since then, every few years the issue of creating better alignment between public health and health care resurfaces, but none of those efforts have stuck.

What’s needed is not to merge or eliminate public health, said Wallace, but to find common ground between the fields. “How do we use public health as a convening area instead of a wrestling ground?”

Next steps discussed during the session include creating shared leadership and recognition that neither health care delivery nor public health is up to the task alone. New solutions are coming out of local experimentation. A good example is Chicago, which is working with public health, health care and other community partners to improve population health. “To be successful in population health, you need to have that third party. It doesn’t matter who it is; it could be schools or social services [for example],” said Wallace.

Glen Mays reiterated the need to make the business case—learning the value of investments in public health to inform policy decisions going forward, and reminded the group that only 3 percent of national spending goes toward public health and preventive services, while 97 percent goes toward medical care, treatment, rehab and long-term care.

Mays also says that public health needs to align themselves with emerging Accountable Care Organizations “because that is where the funding is.”

>>Read more on the value and return on investment in public health and prevention.

Weigh In: How is public health working with health care organizations in your community?

This commentary originally appeared on the RWJF New Public Health blog.