Association for Public Policy Analysis & Management

Over the last decade, there has been a growing recognition that health is impacted by the intersection of health care, public health, and social services, and leaders in each sector have begun to explore how they might align goals and resources to improve health. At the same time, there has been a growing awareness of the importance of health equity in health outcomes

Aligned systems are those which: systems and leaders share a set of priorities for outcomes (that are valued by the people they serve); create a shared data, metrics, and measurement system; establish stable financing with incentives and share accountability; and have strong governance with leadership and structured relationships. The Robert Wood Johnson Foundation (RWJF) is testing the hypothesis that when health care, public health, and social service systems are aligned, they will achieve greater, more sustained progress toward improving health and health equity. Additionally, RWJF is exploring how aligned systems incorporate and advance community co-design, embed equity-enhancing features into individual tactics, and monitor impact of systems alignment on health equity.

RWJF’s Alignment and Coordinating Office at Georgia State University has two near term goals: building a stronger evidence base on the conditions that support alignment and increasing activity among stakeholders to align health systems. This paper will review the Office’s earliest work synthesizing recent research, describe a research and action agenda to move the field of alignment forward, and suggest how an equity lens can be employed as the field advances.