Local Public Health in Colorado

Local public health agencies are the frontline of Colorado's public health system.

Local Public Health Agencies (LPHAs)

​Colorado has a decentralized public health system wherein each of its 64 counties are required to either operate a local public health agency or participate in a district public health agency. Currently, 56 local public health agencies, some representing multiple counties, provide a set of Core Public Health Services, and additional services customized to their community needs and resources. LPHAs are lead by a public health director, who is appointed by a local board of health. ​Local boards of health (LBOHs) provide administrative, policy, and financial oversight to their local public health agencies. 

• Learn more about LBOHs.
• Find your LPHA here. 

Funding & Infrastructure

​Current public health funding streams are typically siloed, disease-specific, and unpredictable. These categorical programs do not support infrastructure such as data systems, facilities, and long-term workforce – all of which are critical drivers of success. CALPHO advocates for increased funding and improved funding structures so that each dollar can do more. Learn more about how public health is funded in these CALPHO Issue Briefs:

• Funding Sources and Types
• Challenges in Measuring Funding
• Role of Emergency Funding  

Workforce

​Retaining today’s public health professionals is our highest workforce priority. The pandemic thinned the ranks of local public health workers, but it also demonstrated their resilience, determination, and professionalism. Other priorities include increasing community representativeness in the workforce, improving the education-to-profession pipeline, and expanding mental health supports. Along with our partners at Trailhead Institute, the Colorado Health Institute (CHI), and CDPHE's Office of Public Health Practice, Planning, and Local Partnerships (OPHP), CALPHO conducted a workforce gap and needs assessment in early 2023.  Download the final report. 

History of Local Public Health in Colorado

To understand how Colorado’s governmental public health system is changing, it is important to know our history and how our system has developed over time. This brief history, adapted from the 1969 publication “Health in Colorado: The First One Hundred Years” and most recently revised in 2021, provides key insight into our current and evolving system of public health​. Read it here. Some historic system turning points: 

• 1877 - Colorado State Board of Health established. Learn more about the CO State Board of Health.
• 1947 - Dr. Florence Sabin lobbies CO legislature to form a state public health system, establishing the state health department (now CO Department of Public Health & Environment)
• 2006 - 2007 - CALPHO founded and forms the Public Health Alliance to build a better public health system.
• 2008 - CALPHO and allies lobby successfully for the Public Health Act, establishing combined local public & environmental health agencies and requiring regular Community Health Assessments and Public Health Improvement Plans.
• 2020 - 2023: COVID-19 pandemic disrupts the public health systems and its workforce, yet also highlights their dedication, creativity, and patriotism. Staggering U.S. mortality revives advocacy to address chronic under-funding of public health. 
• 2018 - present: CALPHO and allies building public health systems change and transformation movement concerned with improving governance, funding, workforce, and data capacities. 

Dr. Florence Sabin sculpture in U.S. Capitol