A centralized public health department is operated by which entity, and how many states use this method?

• A. Operated by the state health agency/state board; five states use this method
• B. Operated by local government; twenty-seven states use this method
• C. Operated by federal agencies; ten states use this method
• D. Operated by private foundations; twelve states use this method

Answer: (A)

Centralization means authority is concentrated at the state level, with the state health agency or state board of health directing public health functions, setting statewide policy, and providing funding that local health departments implement.

This arrangement is operated by the state health agency or state board of health, and only five states use this method. In this model, local health departments carry out programs, but under uniform statewide guidance rather than independent local control. This is in contrast to systems where local government or another entity has primary control, which is more common in other governance structures.