A local department of public health and the geospatial data infrastructure.

Local health departments (LHD) are the most widely distributed aspect of the United States public health infrastructure. The role of LHDs has changed since the terrorist attacks of September 11, 2001, and an increased concern about bioterrorism. This concern resulted in more emphasis on disease surveillance and the need for new institutional linkages of LHDs with other entities for effective response. These changes coincide with technological changes in spatial data integration and the growth of medical informatics in public health. The integration of GIS into the daily work of an LHD holds promise of improving not only bioterrorism response capabilities, but also the management of emerging infectious diseases, such as West Nile Virus or food borne illness, as well as longstanding programs focused on nutrition and safety. Still, the impediments to using GIS at an LHD remain strong as funding decisions and a complex technology continue to challenge implementation efforts.