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There are nearly 3,000 local health departments (LHDs) across the country working to create healthier communities and deliver the 10 Essential Public Health Services.

LHDs work with community partners as part of a network of organizations with various roles and functions who contribute to the public’s health. The local health department is the center of that system, acting as a strategist and convener to engage partners around programs, policies, and services that address population health needs.

The Local Public Health Network

The Local Public Health Network

Though the focus of the work of local health departments is within their community system, their relationship with state health departments can affect how they deliver the 10 Essential Services.

Service Map
  • In centralized states, the local health departments are local or regional units of the state health department and staff at the LHDs are state employees.
  • In de-centralized states, the local health departments are locally governed and staff are LHD employees.
  • In mixed states, there is a combination of both centralized and de-centralized LHDs, where some LHDs are part of the large state health department and others are not.
  • In shared states, LHDs may be staffed and governed by a mix of state or local employees. The governance structure that a LHD operates within can impact how resources are allocated or passed down, how policies or processes are developed and implemented, and whether decision making authority sits at the state or local level.

What is the function of local health departments?

Local health departments are on the front lines, ensuring the health of the public. The public may not always see the work they do, but communities are safer and healthier because of it. LHDs protect and improve community wellbeing not only by preventing disease, illness, and injury, but also by addressing the social, economic, and environmental factors that impact health.

LHD functions can include:

  • Tracking and investigating health problems and hazards in the community.
  • Preparing for and responding to public health emergencies such as:
    • Infectious disease outbreaks.
    • Climate adaptation and natural disasters.
    • Emerging crises like opioid use and other safety threats.
  • Linking people to health services.
  • Mobilizing communities around important health issues.
  • Developing policies and regulations that improve and ensure health safety.

Local Public Health in Action

Local health departments impact our lives every day

Local health departments work on a wide variety of projects from communication and education campaigns, to environmental health, to preparedness. Across all projects, public health promotes health equity through community partnerships, expanding access to health services, and tailoring programs to the needs of the populations they serve.
See the stories below to learn more about recent local public health projects:

Interested in reading more stories about the work of local health departments?

Check out the National Association of County and City Health Officials (NACCHO)’s Stories from the Field Blog (opens in new tab)

Local Health Department Directory

Looking for a specific health department?
Use NACCHO's Health Department Directory to navigate the directory of local health departments by state.

Connect with Local, State, and Territorial Health Departments

To find local governmental public health jurisdictions, see - www.naccho.org

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