Local health departments (LHDs) play a critical role in promoting community health but continue to face challenges related to funding, technology, workforce capacity, and infrastructure. Since 2020, restructuring among LHDs—including regionalization, consolidation, dissolution, and transfers of authority—has received increased attention, yet little is known about what drives these changes or how they affect the local public health workforce.

This article identifies instances of LHD restructuring since 2020 and examines their motivations and perceived impacts to help inform future research and strategies for strengthening local public health infrastructure.