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"Medicare had created a national database showing how long it took hospitals across the country to get heart patients' arteries opened. It was a bell curve year after year, and the times were not getting any better. But there were a few hospitals at the tail end of the curve that year after year were treating people in an hour or so. Dr. Krumholz and his colleagues visited the 11 best performing hospitals. They were not famous institutions or major medical centers, said Elizabeth Bradley, a professor of public health at Yale and a leader in the project. Some were community hospitals; others were far from major population centers. The investigators recorded every detail of how the hospitals got things done and ended up with a short list of what the stellar performers had in common - procedures Lourdes later adopted."

"stimulating a movement in which communities are convening stakeholders across sectors to pursue shared goals and collect data to track progress.23 Clinicians and health care systems find it unrealistic and overwhelming to tackle complex social problems, but they are not alone. Teachers, police officers, parents, employers, and many others also feel powerless to solve social problems without partners. Meaningful change requires broader thinking than what Chetty et al recommend: "changing health behaviors among low-income individuals." As the history of tobacco control teaches, multilevel interventions across the socioecological framework-from legislation to marketing-are essential to advance population health. A culture of collaboration across sectors provides a venue for medicine and public health to join forces with business leaders, school systems, the park authority, investors, retailers, the media, and community groups. Each sector can bring their respective skills to the task, together accomplishing more by leveraging resources and talent than any sector could achieve alone. A medical journal article reporting that income is significantly associated with life expectancy is a call to arms, but the answer cannot come from medicine or public health alone but from the health professions working with partners who share an interest in prosperity and good health. Finding common causes, bridging silos, and leveraging talents hold the promise of much deeper influence and benefit than yesterday's fragmented efforts could achieve."