ArticleRoles of Local Public Health Agencies Within the State Public Health SystemBeitsch, Leslie M. MD, JD; Grigg, Meade MA; Menachemi, Nir PhD, MPH; Brooks, Robert G. MDAuthor Information Leslie M. Beitsch, MD, JD, is Professor and Director, Center for Medicine and Public Health, Florida State University College of Medicine, Tallahassee. Meade Grigg, MA, is Director of the Office of Planning, Evaluation, and Data Analysis, Florida Department of Health, Tallahassee. Nir Menachemi, PhD, MPH, is Assistant Professor, Florida State University College of Medicine, Tallahassee. Robert G. Brooks, MD, is Associate Dean for Health Affairs and Professor, Florida State University College of Medicine, Tallahassee. Corresponding author: Leslie M. Beitsch, MD, JD, Division of Health Affairs, Florida State University College of Medicine, 1115 W Call St, Tallahassee, FL 32306 (e-mail: [email protected]). Journal of Public Health Management and Practice: May 2006 - Volume 12 - Issue 3 - p 232-241 Buy AbstractIn Brief Objectives In this study we assessed the structure and function of local and district health agencies throughout the United States. We compared these findings with those from a previous national assessment done a decade earlier Methods We surveyed the state health officers of all 50 states in the summer of 2001 in regard to the structures and functions of their state's local and district health agencies Results Forty-seven states completed the survey for a 94 percent response rate. Forty-three percent have a regional or district structure in place. According to more than 80 percent of the respondents, local health departments serve all areas of their state. Local boards of health provide guidance and oversight in two thirds of the states. Most local health departments continue to perform a variety of traditional public health functions, as well as a variety of newly emerging responsibilities. Many local functions varied by geographic regions, population size, and organizational type. Conclusions The study identified structural and functional changes in the local and district health agencies of state public health systems over the last decade. The stage is set for future work on the relationship between public health structure and function, and performance in the 21st century. This article assesses the structure and function of local and district health agencies throughout the United States and compares the findings with those from a previous survey conducted by the Centers for Disease Control and Prevention a decade earlier. © 2006 Lippincott Williams & Wilkins, Inc.