This should be a very nice story to tell: most people -from the average citizen to the elected official -believe in the importance of protecting and improving the public's health, and they also believe that where, how and when you do so really matters. Yet it's not true -not for many, and maybe most, Pennsylvanians. The message that Drexel University researchers often heard throughout three years of working with wonderfully committed organizations and individuals in four Pennsylvania counties

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... that -for very many people -attending to public health locally is at best unimportant and wasteful, and, at worst, threatening. One of the national goals for improving the health and quality of life of all Americans is to ensure that all public health agencies -including local ones -have the infrastructure to provide essential services effectively (U.S. Department of Health and Human Services, Healthy People 2010). Why? First, there are environmental threats: natural disasters (floods included) and man-made ones (bioterrorism especially) that would require direct, local, "hands-on" intervention; and many causes and sources of air, water, and ground contamination. Second, there are existing, and potentially catastrophic, threats of disease epidemics. Third, there are many behavioral risk factors, such as smoking, poor diet, physical inactivity, and excessive drinking, that are linked to the leading causes of death in the United States. Confronting these behavioral risk factors through health education and promotion, and