The researchers examined public health system organization and public health performance in eight rural communities through a comparative case study. Their focus was particularly on rural communities, since the scarcity of resources there increases the importance of integrating public and private resources optimally. In particular, they: 1) described the organization of key essential services networks within each rural community; 2) described the structures and processes that integrate activities across the essential services networks; and 3) compared public health system performance. The objective of this project was to illuminate the relationship between local public health systems and public health outcomes.