Public health departments have a statutory responsibility to assure care for patients who may pose a risk to the public health and to make efforts to control the spread of infectious diseases. These departments have typically operated within the public health sphere, outside of the sphere of the "other" (personal) health care delivery system. Yet, treatment for patients with communicable diseases such as tuberculosis (TB), HIV/AIDS, other sexually transmitted diseases, and viral hepatitis, as well as efforts to immunize others from becoming infected, is part of a public health strategy that relies in part on individual health care providers.

Public health departments and personal health providers have a lot to offer each other. Shared information, such as electronic immunization registries and data on patient histories, is among the many potential strategies to improve care to patients and to protect the public's health. While preserving anonymity, funding agencies should encourage, if not mandate, shared databases for information that is meaningful both to individuals seeking personal treatment and to the public health generally. For instance, this kind of collaboration has traditionally worked between TB control officers and private physicians. TB control officers are able to maintain longitudinal records on patients who may see multiple providers over time. These medical records are then uniquely helpful in making treatment decisions that may prevent the development of drug-resistance, a benefit to both the individual patient and the public health. Another example is the maintenance of registries that serve both individuals and the public health. Recently, states have developed centralized immunization registries so that personal physicians can inquire on a patient's behalf about his or her immunization history. Approximately 43 percent of children under age six are now on these registries. ^[1]  

Policy makers should encourage public health departments and organized health care delivery programs to collaborate on health promotion, disease prevention, and early detection programs through public policy and financial incentives. Areas for collaboration should be selected based on high prevalence of a particular disease or a high-risk of infection among a particular population. Where there is scientific data to prove that interventions reduce morbidity, reduce mortality, reduce cost, or reduce public health risks, public health officials should work with service delivery providers. Such collaboration should focus on potentially high yield activities, including:

• Health education in areas where behavior affects health outcomes, including nutrition, exercise, and smoking;
• Detection of cancers and communicable diseases where early identification is cost-effective, such as cancer of the breast and cervix, tuberculosis, HIV/AIDS, and other sexually transmitted diseases;
• Detection of chronic disease where early identification is cost-effective, such as asthma, coronary heart disease, diabetes, hypertension, and elevated lipids.

Expanding vaccine availability for adults is another specific strategy for improving the efficacy of a public health program. The nation has had substantial success with the Vaccine for Children Program, a federally funded program providing no-cost immunizations against various communicable diseases to poor children. ^[2]   Poor adults are also at high risk for certain illnesses which can be prevented through vaccines, including viral hepatitis. Further, patients with chronic diseases such as asthma, diabetes, and HIV/AIDS are especially vulnerable to influenza and pneumococcal pneumonia; vaccines to protect adults from infection from both of these illnesses are available. Accordingly, substantial public health benefits may be achieved by expanding the Vaccine for Children program – or creating some other means for providing affordable immunizations to low-income, high-risk adults. ^[3]