Health Affairs February 3, 2023
Thomas E. Dobbs

The US public health system is not a singular entity but a decentralized, uneven patchwork of federal agencies and state, local, tribal, and territorial public health authorities. As a result, the collaborative endeavor of public health is only as strong as the weakest link.

As the health commissioner of Mississippi from 2018 to 2022, I had a front row seat to the weakest link: inadequate systems at the state and local level to support hiring people, spending available funds, and making contracts. There’s no value in a grant for an epidemiologist if the maximum salary allowed is too low for anyone to take the position. There’s no point to a plan to partner with community organizations if it takes so...

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