The integration of primary care and public health to improve population health: tackling the complex issue of multimorbidity

Excerpt

Forty years after the Declaration of Alma-Ata, primary care and public health have shared a common goal of promoting the health and well-being of all people, but these two disciplines historically have operated independently of one another (Institute of Medicine 2012). While the separation of primary care and public health has long been recognized, new challenges and opportunities are emerging to bring these two sectors together in ways that will yield substantial and lasting improvements in the health of individuals, communities and populations (Institute of Medicine 2012). Primary care focuses on providing medical services to individual patients, while public health focuses on offering a broader range of services to communities that collectively aim to help individuals remain healthy (Institute of Medicine 2012). Primary care deals with conditions that are largely preventable and closely linked to social or environmental causes (i.e. upstream determinants) (Daniel et al. 2018), as well as bridging the gap between clinical medicine and population health (Galea and Kruk 2019). As noted by the Institute of Medicine (2012), the challenges in integrating primary care and public health are significant, so are the opportunities and rewards. The integration of primary care and public health can occur on a continuum, while ultimately aiming to protect and promote the health of populations (Galea and Kruk 2019; Institute of Medicine 2012). This integration is needed to fully engage with foundational behavioural, social, economical and contextual determinants. Indeed, this integration is needed for one of the most complex health issues: multimorbidity. …