LAUSR

Although the United States is one of the wealthiest countries in the world and a leader in biomedical innovation, its health care system is consistently ranked among the worst in terms of cost and health outcomes. Americans have short life expectancies, high infant mortality and obesity rates, and soaring chronic disease rates compared with other wealthy nations. In 2021, the National Academy of Medicine (NAM) was charged with examining what it would take to improve US primary care. The NAM report described the practice of siloing public health from primary care or treating these areas as separate fields of scientific inquiry, practice, and billable service.1 NAM identified this separation as a key driver of poor health outcomes and health inequities in the United States. The Institute of Medicine (IOM) examined similar phenomena in a 2012 report, noting how the two fields tend to operate independently, despite complementary functions and common goals.2Where these silos persist, we see communication and process breakdowns at the point of care. For instance, when large swaths of Americans turned to trusted primary care providers for COVID-19 vaccine insights, their primary care providers did not always have the most up-todate information, in part because of a lack of interprofessional cohesion (including fragmented public health messaging and data systems). If we are to remedy such issues, a substantive paradigm shift must take place: We must move toward what DeSalvo et al.3 termed "Public Health 3.0." In this model, multiple sectors, specialties, and stakeholders form coalitions to mobilize data, people power, and resources in a strategic manner to advance health for all. To be truly strategic, we must think carefully about how to leverage nurses-who care for patients across the lifespan and in nearly all public health nursing (PHN) and primary care settings-within these coalitions.The 2021 NAM report urges health care teams to undertake the mission of integrating systems. However, NAM stops short of describing exactly how teams ought to accomplish this aim and the proposed makeup ofsaid teams. Like any group project, success will depend on the ability of teams to identify leaders and clearly delineate responsibilities. The purpose of this editorial is to explore the potential of PHN and primary care nurses and to describe the roles they might assume in the collaborative integration of their respective silos.