"If we can get [the Los Angeles County Medical Association] working with us on a single side of some issues, we could make a big impact," says Jonathan Fielding, MD, director of the Los Angeles County Department of Public Health. He met with members of LACMA District 1 at the association's headquarters on June 21 to call for more joint activities.

Dr. Fielding says public health issues are often intertwined with economic, transportation and education concerns. "[Those factors] are major determinants of the health of our population," he says. "That's what we care about as physicians."

He sees LACMA and DPH working together on projects under increasing levels of "intensity"--communication, cooperation, coordination and collaboration. At the most involved level--collaboration--Dr. Fielding hopes the organizations will develop emergency preparedness and response plans. "I think it's really important that we work on a regional response, and we have to figure out with [LACMA] what we do in times of emergencies," he says.

Department officials would like to know whether and how LACMA doctors are willing to work with the agency during emergencies, Dr. Fielding says. "We'd like you to sign up for the Health Alert Network, which is how you get information on critical issues," he says.

In coordination--the second-most intense level--physicians report diseases to DPH, and DPH promotes specific disease treatment models. "We also want to work together to promote immunization," including Tdap, HPV and Herpes zoster vaccines, Dr. Fielding adds.

Further, he is trying to build interest for department-association promotion of legislation on a spectrum of public health issues, such as parks and green spaces. "I think there are opportunities, for example, in increasing the minimum wage. We don't think about that as a way to improve health, [but] it does," he says. Job training, social support, cigarette taxes and expanding health insurance coverage are all areas where the two organizations can improve public health, he says.

In the meantime, the department wants to know what information it can provide LACMA physicians and how it can make those data useful, including information on reporting requirements for HIV and other pathogens, Dr. Fielding says.

To contact the public health department, call 800/427-8700 or go to www.lapublichealth.org.