The late Speaker of the House Tip O'Neill is often remembered for his
observation that "all politics is local." That observation also applies to
progress in public health, where priorities, capacity, and results vary widely
from place to place. Recently, the anthrax outbreak dramatically underscored
shortfalls in the US public health system, the failure to support that system,
and the consequences that can follow being caught unprepared for a health
emergency. But, just as important, public health is also about the ability
of state and local agencies to monitor and attend to the everyday health problems
that all Americans face, regardless of where they live.
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