Collaborations between healthcare and public health in rural settings.

Introduction: Local health departments and healthcare organizations in rural areas face challenges, including workforce shortages and complex population health-related needs. While they share related roles in their communities, incentives to collaborate may be sparse. Methods: Using a 2-tiered qualitative approach, we describe the purpose, motivations, benefits, and barriers to collaborations between local health departments and healthcare delivery organizations serving rural communities, with a focus on workforce factors. Twenty-four semi-structured interviews were conducted, including 18 interviews with individuals from local organizations and 6 interviews with representatives of membership groups that support these organizations. Interviews were analyzed using a deductive rapid coding process. Results: We find that collaborations are necessary, common, and often driven by workforce or other capacity limitations. However, potential competition for staff, differing structures, and a lack of familiarity with the role of public health were identified as barriers to robust and sustained collaborations. Conclusions: There are potential benefits of collaborations between local health departments and healthcare organizations in rural areas, including for both the organizations and community. Developing and sustaining collaborations requires time, resources, and relationships. Inherent to collaborative work is a need for communication across professions, including the articulation of each organization's role, expertise, and value.