The delivery and financing systems for medical care, public health, and social and community services pursue many common goals and serve overlapping groups of families and communities.  Unfortunately, in most American communities these systems interact in complex and often poorly understood ways through fragmented funding vehicles, information flows, governance and decision-making structures, institutional relationships, implementation rules and strategies, and professional and interpersonal connections. New research approaches are required to untangle these interactions and expose novel pathways of influence that can support equitable improvements in service delivery, resource use, health impact, and wellbeing.  This presentation will summarize evidence from recent studies that highlight promising directions for aligning systems and services using various combinations of organizational, economic, and policy strategies within and across communities. The related evidence base concerning how to implement and sustain complex, multi-sector health interventions will also be explored.  Remaining uncertainties and future research needs and priorities will be examined, along with the roles that need to be played by academic, professional, commercial and community partners.