Preface
In recent years， there has been a growing sense that public health， as a
~rofession， as a governmental activity， and as a commitment of society is
leither clearly defined， adequately supported， nor fully understood. Con-
erns for chronic diseases， geriatric disorders， substance abuse， teen preg-
ancy， and toxic substances in the environment seem to some critics of public
ealth， both within and outside government， to be inadequately addressed
y a public health apparatus originally conceived and constructed to meet a
ifferent set of concerns. To many observers， problems of delivery， financ-
tg， coverage， and quality of personal health services seem inadequately
ddressed by health departments and other official agencies.
Yet， many of these critics express the belief that the health problems now
cing the public are complex， cha lenging， and diverse; that they cover a
road Spectrum of infectious and chronic diseases; that they demand supe-
or personal and environmental health services; and that they involve
\"eventive， therapeutic， and rehabilitative intervention. This very complex-
~， when added to the perceived potential vulnerability to new epidemics
~d environmental hazards of virtually the entire population， lead many
~Servers to Conclude that a governmental presence perhaps
~ an expanded
esence， in health has never been more necessary.
But what is the most appropriate nature of that governmental presence?
3w should government s role relate to
ould governme，，.， \". that of the private sector? How
._， . -，，u ，esponstmnty tor public health be apportioned among
~ state， and federal levels? Should government be the health care
avider of last resort or does it have a greater responsibility? Should public
alth consist only of a necessary residuum of activities not met by private
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