Improving awareness of how public health systems are organized, financed and utilized will require vast research and a broad assessment of the current system. At present, U.S. public health systems deliver services through a collection of divergent structural arrangements. 

Public health systems are networks of state and local agencies that deliver health care services to communities across the United States. This article summarizes what medical professionals know about the attributes of U.S. public health systems. The authors discuss organizational characteristics across four categories: 1) system boundaries and size; 2) organizational and inter organizational structures; 3) financing and economics; and 4) workforce characteristics.

Key attributes of U.S. public health systems:

• State and local jurisdictions that define the boundaries of public health systems make it difficult to identify common tendencies. 
• The use of local tax bases to support public health creates disparities in public health spending. 
•  What is known about efficiency and cost-effectiveness within public health systems relates to specific interventions rather than delivery systems as a whole.

The ultimate goal of research into the nature of public health systems is improved effectiveness in the delivery of services. Future research might examine nongovernmental organizations and alternative funding mechanisms.