For health departments to create equitable conditions for health in their communities and across their state, they must have sufficient funding and capacity to respond to community priorities and needs. Using data, expertise, and evidence, health departments must demonstrate their value and make the case for public health to policymakers and partners. In this new publication, these critical themes and more are highlighted from three 21st Century states – Ohio, Oregon, and Washington – as they work to modernize their public health systems.