In order to more systematically and accurately classify state health departments in terms of their governance relationships with local health departments, ASTHO engaged NORC, with input from NACCHO, to develop a State and Local Health Department Governance Classification System.

State Public Health Agency Classification: Understanding the Relationship Between State and Local Health

Decision tree

JPHMP Governance Classification

The governmental public health system in the United States is comprised of federal agencies, state health agencies, tribal and territorial health departments, and more than 2,500 local health departments. Coordination across these different levels of government is essential in assuring the public’s health. This study, part of the National Public Health Improvement Initiative administered by the Centers for Disease Control and Prevention, focuses on nine states and describes how state and local health departments have developed structures and processes to facilitate collaboration.

Promising Practices in the Coordination of State and Local Public Health

Case Studies in State and Local Public Health Collaboration

Case Study 1: Arizona

Case Study 2: California

Case Study 3: Florida

Case Study 4: Massachusetts

Case Study 5: Ohio

Case Study 6: Oklahoma

Case Study 7: Oregon

Case Study 8: Washington

Case Study 9: Wisconsin