ABSTRACT
Historically, Public Health Service relations with the states were a good example of the traditional "layer-cake" federalism. It is generally accepted that federal institutions affect health, education, and welfare policies, although the effects are difficult to trace. The PHS collected vital statistics, enforced interstate sanitation and quarantine, and provided technical assistance to state departments of public health. As a matter strictly of legislative history, the modern era in federal-state relations for public health began in 1935 with Title VI of the Social Security Act, which authorized $8 million annually for training and technical assistance to state and local health work. Establishment of the local health units and categorical support for weak program areas would strengthen the "continuum of care" by aid to nonprofitable medicine and help create an equitable "partnership" with private medicine. The scheme for public health units seems, with the perspective of twenty years, curiously anachronistic and parochial.
