Each state is composed of an agency that is having responsibility for public health issues. however, the structures vary across different organizations. For example, in some states, the agency that is dealing with public health issues is part of a human services department and health (Ingram et al., 2012). The relationship between the local health departments and state agencies vary considerably. Some state has an organizational structure that is centralized, whereby the state agencies have direct control over all services related to public health. On the other hand, other states have a decentralized structure, whereby they provide the local health department a remarkable discretion during decision-making and delivery of services. Moreover, some states have a mixed structure, in that they have both centralized and decentralized organizational structure. The local health department has a significant variation in terms of jurisdictional responsibility and size. Some of the local health departments possess jurisdiction over a single county or city. other local health departments may be regionalized having jurisdiction of several county blocks. The public health services are also diverse in that the services can be population-based or individualized. Those services that are population-based include the screening of diseases, health promotion, environmental health services, surveillance of diseases and responses to an emergency. Personalized services include child health care, maternal care and care for patients who are not insured. In summary, the organization of the U.S public health structure is in three tires that consist of federal, local and state. The federal government possesses all the powers to regulate any trade, set laws that help the government to tax citizens and raise money that assists the national public health program, as well as allocating monetary resources to local government.