The Robert Wood Johnson Foundation's work in the field of public health services and systems research (PHSSR) has supported more than 140 individual studies over the past 5 years on these topics, applying the methods and frameworks of health services research to the public health system. Many of these studies are designed and implemented through a national cohort of Public Health Practice-Based Research Networks (PBRNs), which collectively engage more than 2,000 state and local public health organizations and more than 50 university research centers across 32 states in collaborative, practice-based research studies.
Collectively, this body of research documents wide variation in the availability and quality of core public health services and cross-cutting public health infrastructure across the U.S. Communities that are underserved by public health services include people who reside in low-income, rural, and selected inner-city public health jurisdictions, and communities with larger proportions of residents from racial and ethnic minority groups. Governance structures and interorganizational relationships within public health delivery systems play powerful roles in shaping the availability and quality of public health services. A growing body of evidence indicates that when communities make larger investments in public health services, they experience tangible health and economic gains from these investments over time, including lower rates of preventable deaths and slower growth in per-capita medical care spending.