In effect, she was telling them what she had figured out when she was herself a local public-health officer. There was no system of public health in the United States, just a patchwork of state and local health officers, beholden to a greater or lesser degree to local elected officials. Three thousand five hundred separate entities that had been starved of resources for the past forty years. Yes, these local nobodies might allow themselves to be led by a health officer they respected—say, somebody from the Centers for Disease Control, or a state health officer who knew what she was doing.
A Patchwork Defense: The Fragmented Reality of American Public Health
