Government Health Care Activities
Social legislation increasingly expanded health department activities into such areas as maternal and child health, environmental health, and medical care for the indigent and aged. Much of the federal government's regulatory power, on the other hand, in health derives from its constitutional power to regulate interstate commerce, but with increased urbanization, travel, industrialization, and interstate problems, the federal government has assumed responsibility for certain population groups, health insurance, and a wide variety of programs. State health departments used to delegate most direct services to local health departments and provided only general liaison, consultation, and special services as needed. But they retained certain statewide regulatory and planning functions, such as licensure, budgeting, auditing, and personnel management. Much of the federal government's efforts to affect the delivery of health care take place at the state and local level. These efforts involve federal, state, and locally administered programs for health services, manpower training, and research.