In the United States certain state governments spend relatively more money than other states per capita on public health services. Why is it that some are willing to spend more to protect their respective populations? This study seeks to discover what factors impact this discrepancy, but it is most concerned with the impact of citizen ideology on funding. Is there a strong connection between the political beliefs of the citizens in a given state and their public health policy? If not, why not, and where is the disconnect? Since there is significant variation from state to state in the funding of childhood immunizations, data from a 50 state survey of immunization program officials is used to observe this variance. To provide context, the history and structure of public health services, the role of state governments, and the public health/health care dichotomy are briefly presented. For a more in-depth case study the text focuses on a single state, Texas. Policy makers and concerned members of the electorate who seek to understand factors that influence public health policy at the state level should find this book both informative and provocative.