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Research ArticleFAMILY MEDICINE AND THE HEALTH CARE SYSTEM

Uniting Public Health and Primary Care for Healthy Communities in the COVID-19 Era and Beyond

John M. Westfall, Winston Liaw, Kim Griswold, Kurt Stange, Larry A. Green, Robert Phillips, Andrew Bazemore, Carlos Roberto Jaén, Lauren S. Hughes, Jen DeVoe, Heidi Gullett, James C. Puffer and Robin S. Gotler
The Journal of the American Board of Family Medicine February 2021, 34 (Supplement) S203-S209; DOI: https://doi.org/10.3122/jabfm.2021.S1.200458
John M. Westfall
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Winston Liaw
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Kim Griswold
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Kurt Stange
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Larry A. Green
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Robert Phillips
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Andrew Bazemore
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Carlos Roberto Jaén
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Lauren S. Hughes
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Jen DeVoe
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Heidi Gullett
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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James C. Puffer
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Robin S. Gotler
From the Robert Graham Center for Policy Studies in Primary Care, American Academy of Family Physicians, Washington, DC (JMW); Health Systems and Population Health Sciences, University of Houston, College of Medicine, TX (WL); Department of Family Medicine, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo (KG); Departments of Family Medicine and Community Health, Population and Quantitative Health Sciences, General Medical Sciences and Sociology, and Case Comprehensive Cancer Center Case, Western Reserve University Cleveland, OH (KS); Farley Health Policy Center, University of Colorado School of Medicine Aurora, CO (LAG, LSH); Center for Professionalism and Value in Health Care, American Board of Family Medicine, Washington, DC (RP, AB); Departments of Family & Community Medicine and Population Health Sciences Lozano Long School of Medicine, University of Texas Health, San Antonio (CRJ); Larry A. Green Center for the Advancement of Primary Health Care for the Public Good, Virginia Commonwealth University, Richmond (KS, RSG); Cuyahoga County Board of Health, Parma, OH (HG); Department of Family Medicine, Oregon Health and Science University, Portland (JD); American Board of Family Medicine (JCP); Center for Community Health Integration, Case Western Reserve University, Cleveland, OH (KS, RSG).
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Abstract

The Coronavirus disease 2019 (COVID-19) pandemic has laid bare the dis-integrated health care system in the United States. Decades of inattention and dwindling support for public health, coupled with declining access to primary care medical services have left many vulnerable communities without adequate COVID-19 response and recovery capacity. “Health is a Community Affair” is a 1966 effort to build and deploy local communities of solution that align public health, primary care, and community organizations to identify health care problem sheds, and activate local asset sheds. After decades of independent effort, the COVID-19 pandemic offers an opportunity to reunite and align the shared goals of public health and primary care. Imagine how different things might look if we had widely implemented the recommendations from the 1966 report? The ideas and concepts laid out in “Health is a Community Affair” still offer a COVID-19 response and recovery approach. By bringing public health and primary care together in community now, a future that includes a shared vision and combined effort may emerge.

  • Community Medicine
  • COVID-19
  • Integrated Health Care Systems
  • Pandemics
  • Primary Health Care
  • Public Health
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The Journal of the American Board of Family  Medicine: 34 (Supplement)
The Journal of the American Board of Family Medicine
Vol. 34, Issue Supplement
February 2021
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Uniting Public Health and Primary Care for Healthy Communities in the COVID-19 Era and Beyond
John M. Westfall, Winston Liaw, Kim Griswold, Kurt Stange, Larry A. Green, Robert Phillips, Andrew Bazemore, Carlos Roberto Jaén, Lauren S. Hughes, Jen DeVoe, Heidi Gullett, James C. Puffer, Robin S. Gotler
The Journal of the American Board of Family Medicine Feb 2021, 34 (Supplement) S203-S209; DOI: 10.3122/jabfm.2021.S1.200458

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Uniting Public Health and Primary Care for Healthy Communities in the COVID-19 Era and Beyond
John M. Westfall, Winston Liaw, Kim Griswold, Kurt Stange, Larry A. Green, Robert Phillips, Andrew Bazemore, Carlos Roberto Jaén, Lauren S. Hughes, Jen DeVoe, Heidi Gullett, James C. Puffer, Robin S. Gotler
The Journal of the American Board of Family Medicine Feb 2021, 34 (Supplement) S203-S209; DOI: 10.3122/jabfm.2021.S1.200458
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