Strategic media work is an integral part of modern public health practice. This article describes how Contra Costa Health Services (CCHS) and others have worked with the media, and encourages Local Health Departments (LHDs) to view media work as core to their essential functions. LHDs and other public health agencies can be deliberate in applying a range of media strategies including Media Advocacy, Social Marketing, Counter Advertising, Crisis and Emergency Risk Communication, and the basic staple of LHD media work: Credible Source Communication. CCHS has learned through experience that these media strategies, when used appropriately, complement and support the traditional spectrum of public health approaches ranging from individual education to effecting policy change. The credibility of LHDs in the community makes LHDs particularly effective media advocates and can help LHDs frame issues to provide a broader understanding of the social and environmental factors that shape community health. Like any core public health program or strategy, media work requires planning, training, leadership and funding. This strategic use of media can help transform interactions with the media into welcomed opportunities to advance a public health agenda and improve community health.