The purpose of this study is to contribute to a more thorough understanding of how public health governance affects how states structure and organize the delivery of public health services, and how this, in turn, influences the strategies adopted for meeting community public health needs in rural areas. Using a case study approach, the study examined three themes: 1) lines of reporting and accountability among public health entities, 2) provision of public health services, and 3) public health funding for localities. This work suggests that it would be of value to develop a comprehensive profile of state' public health systems, which would include specific aspects of each state's public health infrastructure, as well as community population and health statistics. Report available on request by contacting the Center.