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Brian Vastag

JAMA. 2002;288:2807-2808.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Philadelphia—While last fall's anthrax mail attacks laid bare significant deficiencies in the US public health system, those in the know have long realized that problems were brewing. A 1988 report from the Institute of Medicine (IOM) concluded that "the governmental public health infrastructure is in disarray." Fourteen years later, a broader report—which tackles public health players both inside the government and out—reaches much the same conclusion.

"Public health . . . is taken for granted and the system continues to be in disarray," said Jo Ivey Boufford, MD, dean of the Graduate School of Public Service at New York University and cochair of the committee that issued the new IOM study. "Especially disturbing is the continued failure to have a consistent investment plan."

Anyone who has worked for a local public health department would understand Boufford's comment. "Something like 30% of all local departments don't even have . . . [Full Text of this Article]