Health Affairs December 8, 2025
The public health ecosystem in the United States is a complex array of organizations and institutions both governmental and non-governmental. Federal agencies overseeing public health include the Department of Health and Human Services (HHS) and, in particular, the Centers for Disease Control and Prevention (CDC), which provides more than $14 billion to states in service of public health functions. Jurisdictional governmental coverage is more variable with more than 3,300 health departments at state, tribal, local, and territorial (STLT) levels. Non-governmental actors include community-based organizations, the health care delivery system, and academic public health institutions of higher education. These organizations are largely responsible for community outreach, training, education of the public health workforce, and depending on the jurisdiction, a large number...
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