Report Suggests Better Alignment of Primary Care, Public Health

Researchers from the Johns Hopkins Center for Health Security have produced a report with recommendations on aligning public health and primary care “to ensure that the disastrous response to the COVID-19 pandemic is not repeated.”

The recent report from Johns Hopkins noted that public health and primary care operate largely in silos and are chronically underfunded.

To explore the degree of collaboration that has occurred among primary care and public health providers during the pandemic to date, the researchers conducted a literature review and interviewed primary care providers at family medicine and general internal medicine practices in integrated health systems and federally qualified health centers, personnel at the National Association of Community Health Centers, and state and local public health officials across several states.

The researchers argue that their study demonstrates that the failure to bring primary care providers into a frontline role as responders, alongside public health, resulted in many missed opportunities to provide better quality care, faster testing, more effective contact tracing, greater acceptance of vaccination, and better communication with patients.

“Participants in this study further indicated that better integration of primary care, public health, and community-based organizations could have provided greater support for the public health response, thereby easing the burden on overstretched public health personnel; and could have accessed primary care’s reach to amplify public health messaging,” notes the executive summary. “If these coordinated activities had been effectively implemented, they could have saved lives and reduced the health, economic, and societal impact of the pandemic in the United States.”

The research team made the following recommendations:

• Co-locate primary care and public health services to benefit population-level health and facilitate active collaboration.
• Primary care societies must align their efforts with public health in a unified voice to drive congressional action in order to ensure that the disastrous response to the COVID-19 pandemic is not repeated.
• Craft efforts to support, protect, and sustain the primary care and public health workforces to drive integration across disciplines.
• Public health “moves at the speed of trust” and people trust their primary care providers and community-based organizations; therefore, primary care and public health collaborative partnerships with strong ties to their community organizations should enhance health systems surge capacity, extend public health disease containment interventions, and position the United States for improved response to future pandemic.