Communities of Solution: The Folsom Report Revisited

Abstract

Efforts to address the current fragmented US health care structure, including controversial federal reform, cannot succeed without a reinvigoration of community-centered health systems. A blueprint for systematic implementation of community services exists in the 1967 Folsom Report-calling for "communities of solution." We propose an updated vision of the Folsom Report for integrated and effective services, incorporating the principles of community-oriented primary care. The 21st century primary care physician must be a true public health professional, forming partnerships and assisting data sharing with community organizations to facilitate healthy changes. Current policy reform efforts should build upon Folsom Report's goal of transforming personal and population health.

Reducing Cardiovascular Disparities Through Community-Engaged Implementation Research

“…85 Recently, there has been a resurgence in the desire to link medical care with public health through the creation of local and regional communities of solution (COS) that identify the critical links among community, public health, and primary care and call for ongoing demonstrations of COSs grounded in patient-centered care. 86,87 The COS begins by identifying the local problem shed, in this case, issues related to CVD disparities, and then identifies the asset shed, that is, those people, organizations, and health systems that can contribute to a local solution. 86,87 The COS combine the key elements of implementation research by aligning strategic partners in developing local solutions to local health problems.…”

“…86,87 The COS begins by identifying the local problem shed, in this case, issues related to CVD disparities, and then identifies the asset shed, that is, those people, organizations, and health systems that can contribute to a local solution. 86,87 The COS combine the key elements of implementation research by aligning strategic partners in developing local solutions to local health problems. In addition to the use of local and regional COS in implementation research, several opportunities and challenges in efforts recommended for NHLBI to consider for eliminating CVD disparities are identified in Table 5.…”

Child Health Disparities: What Can a Clinician Do?

“…9,10 Today, these ideas continue to resonate. Because communities are constantly changing, CLAS standards emphasize the importance of conducting “regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of populations in the service area.” 11 Free and easy-to-navigate websites provide city, district, county, state and national data and maps on child and family demographics, health status and wellbeing by race/ethnicity and poverty status with comparisons to others and targets for improvement (Table 1).…”

Praxis-based Research Networks: An Emerging Paradigm for Research That is Rigorous, Relevant, and Inclusive

“…Although there are significant benefits to a population-based approach to primary care, the predominant fee-for-service payment model in the U.S. has not supported the development of an integrated primary care-public health system(13–16) To address this issue, provisions in the Patient Protection and Affordable Care Act of 2010 are enabling the U.S. Department of Health and Human Services to fund initiatives that bridge this longstanding separation. (10, 17–19) Further, a pproaches to the integration of primary care, public health, and communities put forth in the 1967 Folsom Report(20) are being revisited(21) for their potential to address this division by embracing the community-oriented primary care model pioneered by Kark in the 1940s. (15, 20–22)…”

“…PBRN-initiated partnerships to create ‘communities of solution’(21) using community-based participatory research methods have been described,(37, 38) and a growing number of PBRNs are partnering across boundaries to address complex health issues. (6, 39)…”