Summary and Comment

The introduction of the New Federalism by the President in Jan­ uary, 1973, opened a new era in federal public policy that is having a major impact on many fronts. For schools of public health the impact has been stunning. The crucial issue was that the President’s budget message ended federal support through institutional grants to the schools, thereby threatening the quality of many programs and the actual existence of some schools. As the schools reeled under the shock of that message, they responded in three ways: attempts to regain fiscal stability by turning to both local and national sources; intensification of the self-assessment that the schools had already been pursuing; and further development of education, research, and technical assist­ ance programs that are close to national health needs. Now, in February, 1974, a year after the President’s bud­ getary message and three months after the symposium of which the preceding papers were a part, it seems likely that the schools will ride out the immediate fiscal threats to their survival. Beyond that, there is the possibility that they will establish themselves as an essential resource in the nation’s efforts to improve its health services. It may be a paradox that the New Federalism will turn out to have played a dual role: severely threatening the viability of the schools, thereby stimulating them to more rigorous and more relevant action, and promoting new approaches to organiz­ ing, financing, and managing health services that will in part be dependent on the participation of schools of public health. The impact of the New Federalism on schools of public health cannot be separated from the larger story of the New Federalism itself, a story that is still unfolding. The leading principle of the New Federalism was to increase self-reliance at the state, local, and individual levels through de­ centralizing decisions on the use of federal funds. Major decen­ tralizing actions have included revenue sharing with state and local