Within the context of health reform, the Obama administration's ambitious goal of integrating prevention, public health and health care delivery systems anticipates greatly expanding prevention and wellness activities as the primary means to reduce the burden of disease, injury and disability in the United States. This prescription for change represents a significant challenge.

If public health is to succeed in delivering on the promise of prevention, as well as exert our leadership role, then it needs to counter with bold initiatives that promote accountability, performance and improvements in public health. The reason is clear—without a high-performing public health system, we will not be able to attain the goals of the new administration and, most important, the health aspirations of communities across the nation.