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The Intersection of Public Health and Medical Care: How a Public Health Consultant Can Support Bridging the Gap

Jul 13, 2018 05:19PM ● By Sandra Melstad

By Sandra Melstad, MPH-CEO, SLM Consulting, LLC

Over the past twenty years the global burden of mortality and morbidity has shifted from communicable diseases to noncommunicable or chronic disease and its associated risk factors. In addition, rural America, which covers much of the Midwest service area, is disproportionately affected by health outcomes due to social, economic, and environmental factors. healthcare costs continue to rise, attributable to employee productivity and treatment expenditures.  

While healthcare was once considered the sole method to improve health, this method is no longer key to improving the health of populations and communities. Social, economic, and environmental factors determine health outcomes more than health behaviors and genetics combined.  In short, a person’s zip code determines their health outcomes. To effectively shift the needle on health outcomes of patients and communities, efforts must focus on addressing these social determinants of health. After all, if a patient is affected by factors beyond healthcare and behaviors, how can they be expected to improve their health if those factors are not addressed?

Public health, in additional to healthcare, is a necessary ingredient to addressing and improving the health of populations.  Increasing healthcare costs, health inequities and risk factors for chronic disease, e.g. physical inactivity, poor nutrition, or tobacco use, reminds us of the value and need for public health efforts. According to the Centers for Disease Control and Prevention, “public health is credited with adding 25 years to the life expectancy of the people in the United States in this century.”  

While public health cannot alone fix local, state, national or even global health, it can reduce the burden of disease and risk for disease in populations. Public health research continues to expand and identify evidence-based practices that are proven to contribute to improving population health.  

Specifically, strategies that are proving effective and critical to moving the needle are upstream, collaborative efforts between public health and healthcare effectively breaking silos and bridging gaps to transform the health system. Research conducted by the Robert Wood Johnson Foundation, AcademyHealth, and the Network for Regional Healthcare Improvement on five communities’ efforts to advance a culture of health found that regional collaboratives of diverse stakeholders are helping health providers and social service groups develop common metrics and mechanisms for sharing data and evidence, focused on solving community-wide problems (2017).  These communities also found that they must consider the following moving forward; cross-sector collaboration; metrics, data, and evidence; care delivery requirements and incentives focused on transforming care delivery; and value-base payment and population models.

So how can healthcare and public health move upstream together? A Public Health Consultant (PHC) can serve as convener of diverse partners and stakeholders to help guide upstream efforts. The PHC has the skills and expertise to help bridge the gap between healthcare and public health, guided by evidence-based public health practices and strategies to address social determinants of health. Where healthcare may at times be lacking, a PHC can support research and evaluation of public health programs, develop and implement public health programs, develop and advocate for policies that impact the future of public health, provide training on pertinent public health issues that affect healthcare, or provide consultation to hospitals on community health needs assessment and improvement planning efforts. A PHC also has the expertise to support policy, systems, and environment change; essential to supporting upstream efforts. Essentially, a PHC provides a public health lens to key components of transforming healthcare, including strategic planning, project management, evaluation, partner collaboration, and training.

Regardless of how healthcare and public health intersect, this intersection is essential to improving the long-term health where people live, work, learn, and play.

SLM Consulting, LLC is a public health consulting company, established 2012, focused on providing data driven public health solutions to create healthy communities and improve population health guided by prevention, research, and evidence-based public health. Sandra Melstad, MPH, serves as the CEO and a Public Health Consultant, guided by 13 years of experience in public health, working across diverse sectors to address priority health issues, build community capacity through training and education to foster change.

SLM Consulting is committed to understanding and addressing factors that affect population health, translating evidence-based practice into public health approaches that achieve health equity. In addition, SLM Consulting has experience training and educating health professionals on evidence-based public health practices, building their capacity to adopt preventative approaches to healthcare.

If you want to learn more about how SLM Consulting, LLC can support upstream efforts between healthcare and public health, visit us at or contact us at [email protected]. We are committed to improving population health.


Robert Wood Johnson Foundation, Network for Regional Healthcare Improvement, and AcademyHealth. (2017). Fostering Collaboration to Support a Culture of Health: Update from Five Communities. Retrieved from