Figure.

Marginal effects estimates versus NALSYS-weighted averages of cumulative COVID-19 death rates per 100 000 residents across comprehensive, intermediate, and limited public health systems from April 7, 2020, through February 28, 2021. Three levels of capability of public health systems were defined: (1) limited capability, defined as systems implementing fewer than half of the 20 public health activities on average with the smallest networks of contributing organizations; (2) intermediate capability, defined as systems implementing more than half of the activities on average with moderate-sized networks of contributing organizations; and (3) comprehensive capability, defined as implementing two-thirds or more of the activities on average with the largest networks of contributing organizations. Abbreviation: NALSYS, National Longitudinal Survey of Public Health Systems. Data sources: NALSYS, ²³ US Census Bureau, ³⁴ Health Resources & Services Administration, ²⁷ The New York Times, ³¹ The Atlantic’s COVID Tracking Project, ³³ Centers for Disease Control and Prevention, ²⁸ Johns Hopkins’ Center for Systems Science and Engineering, ²⁴ and Ballotpedia. ³²