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Between 1996 and 1998, the New York Academy of Medicine, New York, oversaw the development of two books on the changing roles and responsibilities of public health and medicine in the 21st century.
The project involved a partnership between the American Medical Association (AMA) and the American Public Health Association (APHA), and promoted a dialogue between public health and medicine.
The firm Research/Strategy/Management, Lanham, Md., conducted 10 focus groups of health professionals and students as background for the research.
The Robert Wood Johnson Foundation (RWJF) supported the project with five grants totaling $1,041,262 between February 1996 and December 1998.
In the current health care environment, the medical and public health sectors are becoming increasingly dependent on one another to achieve their missions, address health problems, and respond to economic and performance measures. The growth of managed care and the move to downsize government provide the public health and medical community an opportunity to work together to strengthen population-based health.
However, historically unresolved differences between public health and medicine raise challenges for successful collaborations. The medical sector focuses on individual patients, and emphasizes biological determinants of disease and technologically sophisticated diagnoses and treatments. The public health sector looks at health problems from a population perspective and emphasizes prevention by promoting healthy conditions in the community.
In 1994, leaders from the AMA and the APHA established the Medicine/Public Health Initiative to provide a forum in which representatives from both sectors could explore their mutual interest in improving health and define collaborative mechanisms to achieve this goal.
The initial grant for this project (ID# 028618) supported the convening of leading thinkers and stakeholders to participate in a dialogue between public health and medicine that would result in the development and dissemination of a monograph on the changing roles and responsibilities of public health and medicine in the 21st century. The APHA and the AMA were to serve as advisors to the process and play primary roles in the dissemination of the monograph.
The project was managed by The New York Academy of Medicine (NYAM), a nonprofit organization that examines health problems and formulates and shapes health care policy. A 13-member multidisciplinary Committee on Medicine and Public Health (see the Appendix) oversaw the project.
At that same time, RWJF made two additional grants (ID#s 029937 and 031144) to Research/Strategy/Management Associates (RSM), a private research organization, to conduct 10 focus groups with medical and public health practitioners and students on their attitudes, perceptions, and beliefs about the two sectors. The second grant was made so RSM could conduct focus groups in rural areas, which had proven more difficult to organize than more highly populated areas.
Under the direction of staff at NYAM, the project solicited, collected, and analyzed 414 case studies of collaboration between medicine and public health, and the project director wrote a monograph based on the case studies. A fourth grant (ID# 031988 to NYAM) paid for the publication and dissemination of a pocket guide to the collaboration case studies, with the W.K. Kellogg Foundation providing an additional $35,000. A fifth grant (ID# 034689 to NYAM) covered the cost of disseminating 40,000 copies of the monograph, one to every incoming medical, public health and community health nursing student in the country.
Medicine and Public Health: The Power of Collaboration was mailed to 145,000 health and public health professionals and organizations, and to 40,000 incoming medical, public health, and community health nursing students. In addition, 1,400 copies were downloaded from a NYAM Web site. The book has been reissued by Health Administration Press. It is used as a text in some 100 courses in schools of medicine, osteopathic medicine, public health, nursing, and other programs. The Pocket Guide to Cases of Medicine and Public Health Collaboration was sent to 10,500 health professionals. It is also available in an electronic, searchable version online.
The project director and associates made 44 presentations to national, state, and local health organizations and academic groups. Project principals wrote five published journal articles, including one in The Journal of the American Medical Association. Nine press releases were sent to the health and medical press. Nineteen articles appeared in the trade press. (See the Bibliography for details.)
In 1998, N.Y.AM established a new Center for the Advancement of Collaborative Strategies in Health, which is adding new cases of collaboration to the database. The center develops tools and avenues for further research and provides technical assistance for groups that want to collaborate, including the RWJF national program, Turning Point: Collaborating for a New Century in Public Health, an initiative to transform and strengthen the public health infrastructure in the United States.
Public Health and Medicine: Partnering to Improve Community Health Monograph and Pocket Guide
The New York Academy of Medicine (New York, NY)
Roz Lasker, M.D., M.P.H.
Research/Strategy/Management Inc. (Lanham, MD)
Vincent Breglio, Ph.D.
Committee on Medicine and Public Health
Roz D. Lasker, M.D., M.P.H.
Chair and Project Director
Division of Public Health
The New York Academy of Medicine
New York, N.Y.
Christopher G. Atchison, M.P.A.
Iowa Department of Public Health
Des Moines, Iowa
Lester Breslow, M.D., M.P.H.
Professor and Dean Emeritus
School of Public Health
University of California at Los Angeles
Los Angeles, Calif.
Gert H. Brieger, M.D., M.P.H., Ph.D.
William J. Welch Professor
Department of the History of Science, Medicine, and Technology
The Johns Hopkins University School of Medicine
Sherry Glied, Ph.D.
Assistant Professor, Division of Health Policy and Management
Columbia School of Public Health and Department of Economics
New York, N.Y.
Charles C. Hughes, Ph.D. (deceased)
Professor, Department of Anthropology and Director Graduate Programs in Public Health
University of Utah School of Medicine
Salt Lake City, Utah
Bonnie J. Kostelecky, M.S., M.P.A., R.N.
Director, Division of Assessment and Epidemiology
Southwest Washington Health District
Russell Miller, M.D.
Immediate Past President
State University of New York Health Science Center at Brooklyn
Thomas R. Reardon, M.D.
Family Physician and Chair, Board of Trustees
American Medical Association
Stanley J. Reiser, M.D., M.P.A., Ph.D.
The Griff T. Ross Professor of Humanities and Technology in Health Care
University of Texas-Houston Health Science Center
Alfred Sommer, M.D., M.H.S.
Dean, The Johns Hopkins School of Hygiene and Public Health
Gail L. Warden
President and Chief Executive Officer
Henry Ford Health System
(Current as of date of this report; as provided by grantee organization; not verified by RWJF; items not available from RWJF.)
Lasker RD and the Committee on Medicine and Public Health. Medicine and Public Health: the Power of Collaboration.New York: The New York Academy of Medicine, 1997. Reissued by Health Administration Press, 1999. 185,000 copies produced and distributed. Also available online, from which 1,400 copies of the book have been downloaded.
Lasker RD, Abramson DM, and Freedman GR. Pocket Guide to Cases of Medicine and Public Health Collaboration. New York: The New York Academy of Medicine, 1998. 10,500 copies produced and distributed. Also available online, where users can search database through multiple index terms.
Breglio VJ. Public Health Collaboration: The Views of Health Professionals.Lanham, Md.: Research/Strategy/Management, 1996.
Breglio VJ. Public Health Collaboration: The Views of Rural Health Professionals.Rockville, Md.: Research/Strategy/Management, 1997.
Instrument to solicit cases of medicine and public health collaboration. New York: The New York Academy of Medicine, 1996.
Moderator's guides for focus groups with practitioners and students in medicine and public health. Rockville, Md.: Research/Strategy/Management, 1996.
Instrument to validate and update case information in the Pocket Guide. New York: The New York Academy of Medicine, 1996.
Voelker R. "Medicine and Public Health Join Forces." Journal of the American Medical Association,277(20): 1579, 1997.
Reiser SJ. "Topics for Our Times: The Medicine/Public Health Initiative." American Journal of Public Health, 87(7): 10981099, 1997.
Lasker RD. "Overview of Urban Collaborative Initiatives." Journal of Urban Health: Bulletin of the New York Academy of Medicine, 75(2): 391400, 1998.
"In Sickness and In Health: A National Symposium on the Evolving Relationship Between Medicine and Public Health," April 9, 1997, Roz D. Lasker. The New York Academy of Medicine, New York, N.Y. Attended by 350 individuals from hundreds of public and private sector organizations involved in medicine and public health. Some 20 presentations given:
Roz D. Lasker, "Science and Public Policy," keynote address at the Dedication of the University at Albany's New Campus and the Tenth Anniversary of the School of Public Health, November 1, 1996, Albany, N.Y.
Roz D. Lasker, "Roundtable on Public Health and Medicine," 124th Annual Meeting of the American Public Health Association, November 19, 1996, New York, N.Y. Attended by approximately 160 individuals from APHA.
Roz D. Lasker, Interim Meeting, American Medical Association, House of Delegates, December 7, 1996, Atlanta, Ga. Attended by approximately 60 individuals from the AMA House of Delegates.
Roz D. Lasker, "Medicine and Public Health: Collaborations to Improve Quality of Care," at the meeting of the New York Association for Health Care Quality, April 25, 1997, New York, N.Y.
Roz D. Lasker, "Common Goals and Common Vision: Medicine and Public Health in Hypertension and Diabetes Control," at the Conference on Medicine, Managed Care and Public Health, May 13, 1997, Philadelphia, Pa.
Roz D. Lasker, "Medicine and Public Health The Imperative for Cross-Sectoral Collaboration in Addressing Urban Health Issues," at the Harlem Hospital Center/Urban Health Institute Conference on Urban Health Issues, May 17, 1997, New York, N.Y.
Roz D. Lasker, "Medicine and Public Health: the Power of Collaborations" for the Public Health Leadership Institute Teleconference on Medicine and Public Health, June 2, 1997, New York, New York.
Roz D. Lasker, "Moving from Interdisciplinary Practice to Interdisciplinary Education: Lessons from the Medicine and Public Health Project," at the Fourth Congress of Health Professions Educators of the Association of Academic Health Centers, June 3, 1997, Washington, D.C.
Christopher G. Atchison, ("Conference Overview") and Gail L. Warden ("Public Health and Health Plans: Can There Be A Viable Partnership") at A Barn Raising for Public Health: A Governor's Conference on Iowa's Emerging Health Issues. Drake University, June 56, 1997, Des Moines, Iowa.
Roz D. Lasker, "The Impact of Market Forces on Community Health: Implications for Medicine and Public Health," at the Public Health Institute First Annual Leadership Conference, July 10, 1997, San Francisco, Calif.
Roz D. Lasker, "Medicine and Public Health: the Power of Collaboration," keynote address at the Florida Medicine and Public Health Summit, August 26, 1997, Tampa Fla.
Roz D. Lasker, "Medicine and Public Health: The Power of Collaboration," keynote address at the First Interstate Regional Conference on Medicine and Public Health: Discovering Our Health Destiny in the Carolinas, October 6, 1997, Charlotte, N.C.
David M. Abramson, "The Evolving Relationship between Managed Care and Public Health," plenary session at the Northeast Epidemiology Conference, October 16, 1997, Rensselaerville, N.Y.
Roz D. Lasker, "The NEOUCOM Curriculum in a Broader Collaborative Context," at the Northeastern Ohio Universities College of Medicine, October 17, 1997, Akron, Ohio.
Roz D. Lasker, "Transformation of Public Health in New York City: The Benefits of Collaborative Strategies," keynote address at the Annual Meeting of the Public Health Association of New York City, October 30, 1997, New York, N.Y.
Roz D. Lasker, "Overview of Urban Collaborative Initiatives," at The New York Academy of Medicine Sesquicentennial Symposium: Toward an Urban Health Agenda, November 18, 1997, New York, N.Y.
Roz D. Lasker, "Medicine and Public Health: The Power of Collaboration," joint Internal Medicine/Public Health Grand Rounds at the Ohio State University College of Medicine and Public Health, January 8, 1998, Columbus, Ohio.
Roz D. Lasker, "Using Collaborative Strategies to Improve the Public's Health in New York City," seminar for the New York City Department of Health/Columbia University School of Public Health Preventive Medicine Residents, January 30, 1998, New York, N.Y.
Roz D. Lasker, "Medicine and Public Health: The Power of Collaboration to Improve Cardiovascular Health," closing plenary at Cardiovascular Health: Coming Together for the 21st Century, February 21, 1998, San Francisco, Calif.
Roz D. Lasker, Bonnie J. Kostelecky, Nancy M. Bennett, and Dexter Cook, "A Quiet Transformation: Medicine and Public Health Partnering for the Public's Health," at the Grantmakers in Health Annual Meeting on Health and Human Services Philanthropy, February 26, 1998, Los Angeles, Calif.
Roz D. Lasker, "Effective Collaborative Strategies," at the Public Health Association of New York City Conference on Medicine and Public Health Collaboration in New York: Planning for Action, March 5, 1998, New York, N.Y.
Roz D. Lasker, "The Power of Medicine and Public Health Collaboration in Addressing HIV/AIDS," at the NYS Department of Health AIDS Institute, March 9, 1998, New York, N.Y.
Roz D. Lasker, "Medicine and Public Health: A Big-Picture View of Health and Health Policy," at the David Rogers Health Policy Colloquium, Cornell University Medical College, March 11, 1998, New York, N.Y.
Roz D. Lasker, "Challenges in Accessing Useful Information in Health Policy and Public Health" at the National Forum at The New York Academy of Medicine, March 23, 1998, New York, N.Y.
Roz D. Lasker, "What to Teach Medical Students about Public Health for Synergistic Practice," at the Macy Foundation Conference on Education for More Synergistic Practice of Medicine and Public Health, June 28, 1998, Palm Beach, Fla.
Roz D. Lasker, "Improving Public Health Outcomes Through Partnerships and Collaboration," at the Northeast Regional Public Health Leadership Institute, July 31, 1998, Rensselearville, N.Y.
Roz D. Lasker, "Partnerships with Public Health: The Role of State Health Departments," at the Joint Meeting of the Association of State and Territorial Health Officials and the National Association of County and City Health Officials, September 23, 1998, St. Louis, Mo.
Roz D. Lasker, "Collaborative Community Health Assessment: Strategies for Addressing Data, Process, and Capacity Issues," at the New York State Community Health Assessment and Information Workgroup, October 1, 1998, Albany, N.Y.
Roz D. Lasker, "Transforming Public Health: Strategies for Successful Partnerships," at the New Hampshire Turning Point Conference, October 5, 1998, Manchester, N.H.
Roz D. Lasker, "Healthy Carolinians: Building Partnerships to Improve Health and Health Systems," at the Seventh Annual Healthy Carolinians Conference, October 12, 1998, Greensboro, N.C.
Roz D. Lasker, "Public Health Transformation at the Community Level," at the Turning Point Forum: Partners Teaching Partners, October 28, 1998, Phoenix, Ariz.
Roz D. Lasker, "Collaborative Strategies to Improve the Practice of Medicine," at the Olmsted Medical Center Rounds, November 5, 1998, Rochester, Minn.
Roz D. Lasker, "Population Health Care: Partnerships for Quality," at the Mayo Clinic Quality Conference, November 5, 1998, Rochester, Minn.
Roz D. Lasker, "Medicine and Public Health: The Power of Collaboration," at the Zumbro Valley Medical Society Annual Meeting, November 5, 1998, Rochester, Minn.
Roz D. Lasker, "Partnerships and Support Public Health System Transformation: New Developments," at the annual Meeting of the American Public Health Association, November 17, 1998, Washington, D.C.
Roz D. Lasker, "Developing Community Infrastructures to Support Collaboration: Issues for State Legislators," at the Meeting of the Public Health Advisory Panel of the National Conference of State Legislatures, February 5, 1999, Denver, Colo.
Roz D. Lasker, A Key to Sustainability: Integrating Reach Out into the Infrastructure of Community Health Systems," at the Reach Out Program Annual Meeting, March 12, 1999, Charleston S.C.
Roz D. Lasker, "Challenges to Public Health Leadership," at the Public Health Leadership Institute On-Site Retreat, March 15, 1999, Santa Cruz, Calif.
Roz D. Lasker, "Medicine and Public Health Collaboration Involving Medical Schools" at Prevention 99: Scientific, Political and Social Priorities for the 21st Century, March 19, 1999, Arlington, Va.
Roz D. Lasker, "Community Building and Public Health: The Power of Collaborative Public Health Strategies," at Community Voices Networking Meeting, April 7, 1999, Tempe, Ariz.
Roz D. Lasker, "How Collaboration Can Help the Academic Medical Center Achieve its Service, Education, and Research Missions," at the Governor's Commission Conference on Public Health and Academic Medicine in Kansas: Opportunities Amidst Change, April 24, 1999, Kansas City, Mo.
Roz D. Lasker, "Optimizing Public/Private Synergies," at the Future of Community Care Networks Conference, May 21, 1999, Washington, D.C.
Roz D. Lasker, "Building on Reach Out to Link Health and Health Care: Programmatic and Policy Implications for the Robert Wood Johnson Foundation," at The Robert Wood Johnson Foundation, May 24, 1999, Princeton, N.J.
Roz D. Lasker, "Building a Framework to Assess and Strengthen Community Public Health Care Systems," at the Turning Point National Forum, June 4, 1999, Atlanta, Ga.
The Emerging Role of Public Health in Today's Health Care Environment, AMA/APHA Media Briefing, December 2, 1997, New York, N.Y. Attended by more than 50 people, including reporters form NBC Network News, CBS Evening News, ABC World News Tonight, CNN, New York Post, American Health, WCBS Radio, and Reuters Health.
News release on the project by The Robert Wood Johnson Foundation, the American Medical Association, the American Public Health Association, and The New York Academy of Medicine, February 26, 1996.
News release with full project description by The New York Academy of Medicine, March 1, 1996.
News release on the project Medicine and Public Health Collaboration by The New York Academy of Medicine to the Newsletter of the Medical Society of the State of New York, July 23, 1996.
News release on the project by The New York Academy of Medicine to The Nation's Health, July 23, 1996.
News release on the project by The New York Academy of Medicine to the American Medical Association News, July 23, 1996.
Press release on the project distributed before and during APHA Roundtable, November 1996.
Press release on the symposium "In Sickness and in Health: The Evolving Relationship Between Medicine and Public Health" by The New York Academy of Medicine distributed March 26, 1997.
Press release by The New York Academy of Medicine, "W.K. Kellogg Foundation Awards $1.3 Million to Public Health Division's Center for the Advancement of Collaborative Strategies in Health," November 1998.
Press release by Health Administration Press, on commercial publication of Medicine and Public Health: The Power of Collaboration, January 6, 1999.
"Time for Medicine, Public Health to Join Forces," in American Medical News, March 1996.
"Seeking Common Ground: Leaders of Public Health, Medicine Begin Process of Collaboration," in The Nation's Health, April 1996.
"Fostering Collaboration between Medicine and Public Health," in Physician's News Digest, June 1997.
"Medicine and Public Health Symposium Planned for April 9," in The Nation's Health, February 1997.
"Collaborations That Work," in Reuters Medical News, April 11, 1997.
"Healthcare Leaders Call for Medicine and Public Health to Unite," in Reuters Medical News, April 10, 1997.
"Joint Initiative Focuses on State, Local Activities," in American Medical News, April 28, 1997.
"Linking Medicine, Public Health," in American Medical News, April 28 1997.
"Report From the Field: Medicine and Public Health Leap Barriers to Improve Outcomes," in Outcomes & Guidelines Alert, April 24 1997.
"Medicine, Public Health Collaboration Focus of New York Public Health Week Event," in The Nation's Health, May/June 1997.
"Epidemiology Said to Have Special Role in Linking Medicine and Public Health," in Epidemiology Monitor, June 1997.
"A Partnership for Public Health: Medicine and Public Health Team Up to Combat Modern Illness," in Minnesota Medicine, August 1997.
"Market Changes Boost Interaction between Public Health, Medicine," in American Medical News, December 15, 1997.
"Monograph: Model for Collaboration," in The Nation's Health, January 1998.
"Community Health Partnerships Needed," in the Medical Tribune, January 8, 1998.
"Collaborations Needed to Improve U.S. Health," in American Medical News, May 1998.
"Pocket Guide Makes it Easy to Learn About Exemplary Projects," in The Nation's Health, November 1998.
"Medicine, Public Health: Working for Healthier Communities," in American Medical News, December 1998.
"One On One With Roz Lasker, MD," in Public Outlook, Fall 1998.
"Medicine and Public Health: Closing the Cultural Divide," in State Health Notes, January 4, 1999.
"Pocket Guide to Cases of Medicine and Public Health Collaboration," in Health Affairs, 1999.
"Prescription Prevention," in the Faulkner & Gray Sourcebook, 1999.
Yonke A. "A Pre-Baccalaureate Course on Becoming a Health Professional," in Academic Medicine, May 1999.
"Public-Private Partnership," in American Medical News, July 5, 1999.
"Medicine & Public Health: The Power of Collaboration," Fall 1999 supplement to Academic Medicine.
Healthstyles, WBAI-FM, New York, N.Y., March 27, 1998. One-hour interview about the monograph with Roz Lasker.
Report prepared by: Lilly Cohen
Reviewed by: Susan G. Parker
Reviewed by: Robert Narus
Program Officer: Marilyn Aguirre Molina
Program Officer: Susan Hassmiller (ID#s 028618, 031988, 029937, and 031144)
Program Officer: Paul Tarini (ID# 034689)
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