Primary care and public health activities in select U.S. health centers: Documenting successes, barriers, and lessons learned

Purpose: The goal of the current study was to examine primary care and public health activities among federally funded health centers, to better understand their successes, barriers encountered, and lessons learned. Methods: Qualitative and quantitative methods were used to collect data from nine health centers, stratified by administrative division, urban-rural location, and race/ethnicity of patients served. Descriptive data on patient and institutional characteristics came from the Uniform Data System, which collects data from all health centers annually. Questionnaires were administered and phone interviews were conducted with key informants. Results: Health centers performed well on primary care coordination and community orientation scales and reported conducting many essential public health activities. Specific needs were identified for integrating primary care and public health: (1) more funding for collaborations and for addressing the social determinants of health, (2) strong leadership to champion collaborations, (3) trust-building among partners, with shared missions and clear expectations of responsibilities, and (4) alignment and standardization of data collection, analysis, and exchange. Conclusions: Lessons learned from health centers should inform strategies to better integrate public health with primary care.