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There is a public health saying that the federal government has the money, the state has the authority and the local government has the problem. Because public health is under the authority of the states, there are 50 different ways that the public health is carried out in the United States. The Future of Public Health written by the Institute of Medicine (U.S.) Committee for the Study of the Future of Public Health, (The Future of Public Health, National Academy of Sciences 1988.) reviewed the status of public health in America and found it in disarray. Although it has been over 10 years since the Future of Public Health was published, it remains the most comprehensive, in depth look at public health and began a process of systematic change and improvement in the public health infrastructure. This work by a committee of distinguished public health leaders provides a vision for Public Health.