The Future of Public Health, issued in 1988, set forth a vision of public health and a specific role for the governmental public health agency within that vision, including the mission and content of public health, and an organizational framework. In the eight years since the report was released, there has been a significant strengthening of practice in governmental public health agencies and other settings. Substantial social, demographic, and technological changes in recent years, however, have made it necessary to reexamine governmental public health agencies' efforts to improve the public's health. Drawing on the activities and discussions initiated by the Institute of Medicine (IOM) Committee on Public Health, the current report addresses two critical public health issues that can greatly influence the opportunity for our public to be healthy as the United States enters a new century-(1) the relationship between public health agencies and managed care organizations, and (2) the role of the public health agency in the community-and their implications for the broader issues raised in The Future of Public Health.