Systems for Action (S4A) is a national program of the Robert Wood Johnson Foundation (RWJF) that aims to discover and apply new evidence about ways of aligning the delivery and financing systems that support a Culture of Health. Since 1998, the National Longitudinal Survey of Public Health Systems or NALYSYS has followed a nationally representative cohort of U.S. communities to measure the implementation and impact of multi-sector population health improvement activities. The following studies were conducted by the S4A intramural team using NALSYS data.