The United States has twenty-eight hundred local public health departments, but these authorities are not organized into any coherent system. Half report to a centralized board of health; half do not. Some have carve-outs and carve-ins, where animal health is excluded but environmental health is included, and vice versa. No two are the same. Add to that antiquated information technology systems and it is no wonder that these departments cannot collect complete, reliable data on public health threats.
