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Commentary
July 1, 2009

Building Bridges Between Medical Care and Public Health

Author Affiliations

Author Affiliations: RAND Corporation, Arlington, Virginia (Dr Lurie); and RAND Corporation, Santa Monica, California (Dr Fremont).

JAMA. 2009;302(1):84-86. doi:10.1001/jama.2009.959

Medicine and public health have been likened to trains on parallel tracks, with windows facing opposite directions, looking out on the same landscape. As described by Shalala,1 those individuals on the medical train see the individual trees—the subtle differences in size, color, age, and health; and those individuals aboard the public health train see the forest—populations of similar trees, growing together and weathering the same storms. Although the 2 have potentially complementary perspectives, efforts to improve care as well as personal and population health are hampered by lack of communication and coordination between medical and public health professionals and fragmented data systems. Differing perspectives and disconnected data have also hindered effectiveness of shared efforts between health professionals and other stakeholders, including community-based organizations and health plans. Although the call for greater synergy between medical care and public health is hardly new, emerging technologies and the urgent need for health reform create the opportunity and imperative for them to come together.

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