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This figure illustrates the complexity of the current systems of funding of public health. The left diagram represents a traditional, relatively parsimonious view of funding. In it, the federal government gives block and categorical grants (often originating in Congress) to state health departments and gives direct support to local health departments. The state government gives the state health departments discretionary funds, categorical or programmatic funds, and dedicated revenue. Some of the funding is passed on to local health departments, which also receive funding from city and county government. Both the state and local health departments receive some funding from private groups and receive fees, fines, and, in some cases, Medicaid and Medicare dollars. The left diagram does not communicate the expansive, complicated, and intertwining nature of the delivery of public health, as the right diagram begins to illustrate.



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