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Covid-19 pummeled public health agencies and organizations. Future crises, whether from infectious disease, extreme weather, or other sources, are likely to do the same unless they change their approach to public health reporting, data management, and information exchange.

Managing public health is not easy, especially in the United States. Not only is this country home to diverse populations that have varying genetic predispositions and cultural patterns of medical significance, it is also geographically huge. How epidemics or climate change affect California may be quite different from their impacts in Maine. The needs of Pittsburghers can vary widely from the needs of those living 50 miles away in rural Pennsylvania.

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These factors necessitate that locally focused — community and statewide — public health policies and technology infrastructures be maintained for most efforts, and this is the right response in many cases. A top-down approach implemented at the federal level would miss important nuances and decrease the ability to meet people where they are. But a highly contagious virus, or climate change, do not recognize municipal, county, or state lines.

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