This well-written, thorough text describes the varied spectrum of work performed at the local level by public health practitioners, and how it is they who take the lead in social justice today. The wide array of approaches each public health department takes, such as budgeting, staffing, services, involvement in personal health services, and their relationships with states is discussed. Lessons taken from these approaches are disclosed, such as the leadership of the health worker of the present and future is clearly the person who can organize and lead a coalition. Lack of resources and other challenges are confronted, and how clearly defined and shared goals of other groups in the community can create a successful local health department. All local public health professionals, instructors and state and local health planners with policy-making responsibilities will find this book a valuable reference.