Andrew Goodman, Adam M. Karpati, Ebony Boulware, Molly J. Coye, A. Eugene Washington
In a recent Viewpoint, Dr Washington and colleagues1 proposed a convening and leadership role for academic health systems in community efforts to improve population health. Although well intentioned, we believe this vision is misguided.
The authors overlooked the central role of the government public health system in advancing population health. In contrast to health care institutions, government public health agencies are mandated to protect and promote—and be accountable for—the health of their populations. Moreover, they are uniquely placed to facilitate the multistakeholder partnerships necessary to influence health at the population level, comprising academic and not-for-profit public health partners and governmental and nongovernmental agencies beyond the health sector. Government public health agencies are also positioned to enforce and catalyze the regulatory and policy changes essential for sustainable change at scale.
We fully acknowledge the critically important role of government-led public health systems as vital to ensuring and advancing population health, as described by Drs Goodman and Karpati. At the same time, we believe academic health systems can meaningfully augment (not replace) the effectiveness of government-led public health systems to improve population health. Academic health systems are institutions with substantial expertise and resources, and they are influential agents in commerce, employment, and health care delivery. During this time of transition,1 academic health systems are well positioned to contribute more significantly than they have in the past to population-wide health improvement efforts. Our Viewpoint was intended to encourage academic health systems to collaborate with other sectors and stakeholders to achieve just this aim—improve overall health and well-being in the communities they serve.
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