The Robert Wood Johnson Foundation and its partners are building the field of Public Health Systems and Services Research (PHSSR) to answer some of the most important and challenging questions about how best to structure, fund and support our public health system so it can improve the lives of the people it serves.

As the avian flu, hurricanes and other natural disasters, bioterrorism, and disease outbreaks dominate the news, the capability of America's public health system to effectively face these and other challenges is being called into question. What demands are placed on public health agencies? What services are they expected to provide? Does the public health system have the capacity, funding, organizational structure, and information it needs to help people lead healthier lives? Public Health Systems and Services Research, a burgeoning field, seeks to answer these questions and ultimately improve health outcomes for all Americans.

From state to state and community to community, there are significant variations in public health infrastructure, resources and services, and almost no evidence base has been developed to determine which public health practices and organizations are the most effective. RWJF believes that we need reliable benchmarks and baselines in public health quality to effectively measure public health performance, demand accountability, and transform public health for the better. A key strategy of RWJF is to develop Public Health Systems and Services Research to address this critical need for an evidence base and reliable benchmarks, so that public health practitioners and policy-makers can get the essential decision making tools they need to improve performance.

In 2003, the Center for Disease Control and Prevention launched the first PHSSR research agenda. Since then RWJF has used that platform as a springboard for current efforts and to increase awareness among both potential researchers and funders for this important area of work. Interest in Public Health Systems Research is gaining momentum, as evidenced by the 100 percent increase in grant applications for PHSSR research from 2006 to 2008.

RWJF stands at the forefront of funding for this effort. To date, RWJF has provided approximately $7 million to support Public Health Systems and Services Research. In 2008, the Foundation funded the third round of grants to advance Public Health Systems and Services Research. These researchers will be examining a range of issues, including: an examination of current strategies to rapidly expand public health services in the event of large-scale disasters or emergencies; an analysis of the relationship between public health outcomes in rural communities and how public health agencies in those communities do their work; an analysis of federal, state and local public health responsibilities to protect our nation's food supply; and studies to determine how various financing strategies might improve the performance of public health agencies. The Foundation also supported the first annual Keeneland Conference on Public Health System and Services Conferences in April 2008.

While progress has been made in Public Health Systems and Services Research, the field still has a lot of ground to cover to catch up to Health Services Research, which has a 15- to 20-year head start. For instance Health Services Research has been credited with unearthing the critical link between health insurance coverage and children receiving the recommended level of care. RWJF believes the field of Public Health Systems and Services Research can reach similar levels of accomplishment in terms of significant findings that alter practice. However, the Foundation cannot advance the field alone; it will take a concerted effort by public and private players-at the local, state and national levels.

The U.S. Department of Health and Human Services (HHS), the Centers for Disease Control and Prevention (CDC), and other private sector partners are also helping to advance this important area of research. The Foundation expects that this momentum and enthusiasm will result in a robust field of Public Health Systems and Services Research, one that ultimately improves our public health system and programs and the lives of the people it serves.