Hospitals can be significant contributors to investment in upstream community health programs. This article provides a scale that can be used not only by hospitals but by other health care and public health organizations to better align their community health strategies, investments, and partnerships with programming and policies that address the foundational causes of population health and equity within the communities they serve.

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In August of 2003, 23 institutions submitted proposals to build closer ties between state and local public health departments and schools of public health in response to a solicitation from the Association of Schools of Public Health supported by the Centers for Disease Control and Prevention. This article describes the strategies proposed to build collaboration between public health academia and practice. Qualitative analysis discerned five principal approaches: the development of comprehensive planning processes; reform of the way practica are planned and implemented; the identification and nurturing of boundary-spanning individuals in academia and health agencies; the fostering of new approaches to joint research; and workforce development programs. Major themes that emerged included the importance of achieving a balance of power between academic and health department partners; the need to address cultural differences between institutions; a conviction that efforts at institutional change require both strong leadership and the cultivation of boundary spanners farther down the chain of command; and the idea that prospects for success may be improved if faculty and practitioners have tangible incentives to collaborate.