Redefining the Team in Team-Based Care: Role of Public Health.

In North Carolina, our public health infrastructure consists of a state health department and 85 local health departments representing all 100 counties. The state health department, local health departments, health systems, and clinical providers work literally and figuratively as a team to improve the health of our citizens. In this article, we provide examples of the critical role of public health practitioners as part of the broader team addressing health, specifically in the areas of chronic disease, communicable disease, oral health, environmental health, and maternal and child health.

A qualitative assessment of Charlotte REACH: an ecological perspective for decreasing CVD and diabetes among African Americans.

An ecological perspective of health promotion was used as the framework for a Charlotte community-based intervention to eliminate rates of health disparities in cardiovascular disease and diabetes. Interventions are targeted on 5 levels of influences, with interaction between levels creating a supportive system for sustained change. The purpose of this qualitative assessment was to explore changes that have occurred among and between the following levels of influences: intrapersonal, interpersonal, organizational, community, and policy.

A regional health care system partnership with local communities to impact chronic disease.

Regional health care systems have significant opportunities to adopt community-oriented approaches that impact the incidence and burden of chronic disease. In 1998, a vertically integrated, regional health care system established a community health institute to identify, understand, and respond to health needs from a community perspective. The project was implemented in four communities (two rural counties, a rural/urban transitional county, and an inner-city community) using five steps: 1) support or form a local community coalition; 2) hire and support a local coordinator; 3) prepare a formal community assessment; 4) fund locally designed interventions; and 5) evaluate each project.