Summary box

• The past 20 years have witnessed an exponential growth in the global engagement of academic medical centres (AMCs) in the United States (US). In contrast to their global activity, US AMCs often do not adopt locally many of the evidence-based policies and practices adopted by the health systems of low-income and middle-income countries (LMICs).

• Some of the best AMCs in the US (and arguably, in the world) are surrounded by communities where life expectancy and healthcare access are considerably worse than the national average and comparable to (if not worse than) those of many LMICs. Much like what happens when they engage globally, there are steps that the centres could take to maximise their impact locally.

• These steps include: (1) include community health among the metrics by which the success of US AMCs is measured and alter financial incentives accordingly (2) establish/support public/community health departments/divisions; (3) establish multidisciplinary and multisectoral strategic partnerships; (4) prioritise capacity strengthening of local health stakeholders and sustainability; (5) increase diversity in composition of governance bodies and (6) establish hubs of innovation in health service delivery within surrounding communities.