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Reply to this discussion.In the United States, federal agencies, the state and territorial public health agencies. The agencies are critical to effectively financial and personnel, and to protect and promote the health of populations. Public health nurses employed in all these agencies work together to identify, develop, and implement interventions that will improve and maintain the nation’s health.Federal public health agencies develop regulations that implement policies formulated by Congress, provide a significant amount of funding to state and territorial health agencies for public health activities, survey the nation’s health status and health needs, set practices and standards, provide expertise that facilitates evidence-based practice, coordinate public health activities that cross state lines, and support health services research.In the United States, states hold primary responsibility for protecting the public’s health. Each of the states and territories has a single identified official state public health agency that is managed by a state health commissioner. State public health agencies are responsible for monitoring health status and enforcing laws and regulations that protect and improve the public’s health. The agencies distribute federal and state funds to the local public health agencies to implement programs at the community level, and they provide oversight and consultation for local public health agencies. State health agencies also delegate some public health powers, such as the power to quarantine, to local health officers.Local public health agencies have responsibilities that vary, but the goal of the local public health department is to safeguard the public’s health and to improve the community’s health status. The health department’s authority is delegated by the state for specific functions. The duties of local health departments vary depending on the state and local public health codes and ordinances and the responsibilities assigned by the state and local governments. Usually, the local public health department provides for the administration, regulatory oversight, public health, and environmental services for a geographical area. The National Association of County and City Health Officials operational definition of a local health department provides a descriiption of the basic public health protections people in any community, regardless of size, can expect from their local health department.

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