The difference between state and local governments is: states determine how much authority local governments can exercise and what type of local government is created. Local laws apply only to those within the local government’s jurisdiction.
Some examples of state/local agencies working together are: aging services, agriculture, economic development, historic preservation, libraries, public schools, tax and licensing, and transportation. Communities can work through local and state advocacy organizations, community activists and organizers, local and independent media and podcasts. The same energy that concerned citizens have put into issues of water, land use, voting practices, and affordable housing can be applied to better health outcomes at all levels of government.