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The public health infrastructure is a set of agencies and organizations whose mission is to create the environment in which we can be healthy. This broadest of definitions includes state and local health departments, selected federal agencies, and a wide range of other governmental, nonprofit, and for-profit agencies and organizations. This report will limit itself to state and local health departments and the federal Centers for Disease Control and Prevention (CDC), the nation's foremost public health agency. With numerous exceptions, this public health infrastructure is in a state of crisis, incapable of meeting our collective needs for public health protections and services, and likely to get worse in the near-term future.