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Before 1918, before World War I to be more specific, the role of the state in
public health was very limited on a national basis, on a federal basis. The United
States Public Health Service was relatively immobilized by the lack of -- it had very
few personnel, it had not a very large budget, there were state public health
departments which were more effective, and there was a great concern and a great interest
in hygiene and in the promotion of health. But as far as having the kind of equipment
and the kind of personnel and the kind of authority to move in and intervene effectively
in areas where health was threatened, it was very, very unclear how much the public
was willing to give the state, either as the federal government or as the state government,
or as the city government.
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