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The essential role local health departments have played in the control
of infectious diseases has not been matched with an equivalent
contribution in prevention of chronic diseases. Local health
departments have attempted to define and build that capacity, but they
have been confronted with budget cuts and competing public health
priorities, most notably bioterrorism
preparedness. This article is based on interviews with local health
officials and describes some of the common ways local health
departments in California have forged ahead to develop the capacity to
engage in comprehensive approaches to chronic disease prevention in
spite of the challenges. Additionally, the article highlights future
considerations that need to be addressed if these promising trends
in chronic disease prevention are to become more widespread.
Chronic Disease Prevention Toolkit