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    Government

    Who the Health Cares? with Prof Michael Sparer – Center for Public Health Systems

    America has 3,300 local health departments. They are the backbone of our public health system, yet they are agencies most of us never think about. Until there’s a crisis. 

    They respond to disease outbreaks, inspect restaurants, ensure safe drinking water, and coordinate emergency responses. Yet their work remains invisible, their budgets are perpetually squeezed, and their authority is increasingly questioned.

    Host Michael Sparer traces how we built this fragmented public health infrastructure, from Constitutional debates to 1866 garbage collection to today’s vaccine controversies. He examines why healthcare spending dwarfs public health investment, why public health agencies vary so dramatically from community to community, and why understanding this system matters for everyone.

    This isn’t partisan politics. It’s about the public health infrastructure that protects us every day. 

    Who the health cares? We all should.

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    Copyright: © Center for Public Health Systems, Columbia University

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    Welcome to Who the Health Cares? Nov 24, 2025
    Show notes

    America has 3,300 local health departments. They are the backbone of our public health system, yet they are agencies most of us never think about. Until there's a crisis.

    Join Michael Sparer from Columbia's Mailman School of Public Health as he explores how the US built this fragmented public health system, why it's struggling, and what we need to do to fix it. From Constitutional debates to garbage collection in 1866 New York to today's vaccine controversies, this podcast reveals the invisible infrastructure your health depends on.

    Who the health cares? We all should.

    Listen to the trailer now, then subscribe so you don't miss the first episode dropping mid-November. Find us on Apple Podcasts, Spotify, or wherever you listen.



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