The County Role in Public Health
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Counties play a critical role in promoting and protecting the health of people and the communities in which they live, learn, work and play. As administrators and operators of the local health safety net, county agencies employ a wide range of public health services that protect resident health and well-being through the prevention of illness, injury and other adverse health outcomes.
A robust public health system centers equity and actively promotes policies, systems and overall community conditions that drive optimal health.1
Public health is an intersectional field that works to address the underlying causes of health outcomes. This work requires both intergovernmental collaboration between federal, state and local governments, as well as multisectoral partnership across local government agencies.
This brief provides an overview of how counties provide integral public health services for all Americans, describes their public health authority, their role in preparedness and response efforts, and local public health efforts to address social determinants of health (SDOH) in our communities. The brief will also outline key federal policy recommendations for our federal partners to safeguard funding and authority for local public health services and programs.
U.S. Department of Health and Human Services moves to reduce public comment in rulemaking
On February 28, the U.S. Department of Health and Human Services (HHS) announced a policy change limiting public comment opportunities to only those required by law. Published in the Federal Register on March 3, the decision rescinds the “Richardson Waiver,” a 1971 directive from then-HHS Secretary Elliot Richardson that encouraged broader public input on regulations related to public benefits, grants and healthcare policies.
U.S. Department of Health and Human Services renews Public Health Emergency Declaration to address national opioid crisis
On March 18, the U.S. Department of Health and Human Services (HHS), under the direction of Secretary Robert F. Kennedy, Jr. renewed the public health emergency (PHE) declaration to address the ongoing opioid crisis, extending critical federal support for coordination, treatment expansion and research efforts. While overdose deaths have declined by 25.5 percent over the past year, synthetic opioids like fentanyl continue to drive fatalities, with approximately 150 Americans dying daily from overdoses.
Join NACo in celebrating County Health Day on April 18, 2025
County Health Day, which falls during National County Government Month, honors the vital role counties play in supporting health and well-being across every stage of life — from infancy to older adulthood.
CMS announces extended funding application period to improve the continuity of care for justice-involved individuals
On September 27, the Centers for Medicare & Medicaid Services announced $106.5 million in state planning grants aimed at improving healthcare continuity for individuals transitioning from incarceration.
National Association of Counties expands programming to address opioid crisis
New cohort, resources will strengthen intergovernmental collaboration and equip local leaders to invest opioid settlement dollars.
Measles outbreak underscores rural healthcare challenges
Texas and New Mexico counties are working to boost vaccination rates in response to the recent measles outbreak, which has included deaths in both states.
Supported Mothers, Thriving Children: Connecting Maternal Health and Child Wellbeing
Counties can significantly improve children's health and wellbeing by supporting maternal mental health through a variety of key strategies. In this webinar, speakers will explore examples of local policies and programs that bolster county efforts to holistically address child wellbeing through focusing on maternal mental health and substance use. Participants will gain insights into local options for addressing maternal mental health needs and substance misuse, learn about the challenges and triumphs experienced by county programs, and discover new opportunities to strengthen their local children’s health services.
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