Organization of the Centers for Disease Control and Prevention: Difference between revisions

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Since 1980, the U.S. Centers for Disease Control and Prevention has been organized around constituent centers, institutes, and offices (CIOs). Five centers were created in 1980, from which the current centers are descended from, with the exception of the National Institute for Occupational Safety and Health and National Center for Health Statistics, which were absorbed from outside CDC.

During 1980–2005, the CIOs were in a flat structure reporting directly to the CDC Director. In 2005, they were collected into four Coordinating Centers in a matrix organization framework as part of the CDC Futures Initiative, but in 2009 the Coordinating Centers were replaced with leaner Deputy Director offices. The 2023 CDC Moving Forward returned to a flat structure.

History

Early history

From its establishment in 1946 until 1980, CDC's organization was mainly oriented around a functional framework of epidemiology, laboratory, and training divisions. During this time, the number of top-level divisions ranged between four and twelve.^[1]

Creation of individual centers

CDC's modern organization of having multiple constituent centers, institutes, and offices (CIOs) was established in 1980, at the same time its name changed from the singular "Center for Disease Control" to plural "Centers for Disease Control". The 1980 reorganization replaced the functional framework with an outcome-oriented one, and allowed expansion into areas other than communicable disease. The new organization was was spearheaded by CDC Director William Foege and inspired by Health Canada's organization, which was divided into biological, environmental, lifestyle, and medical care divisions.^[1]

Five centers were established in 1980, with three more spun off from these five prior to 2003:^[1]

The Center for Infectious Diseases was largely created from merging the pre-existing Laboratory Bureau and Epidemiology Bureau.^[1]
The Center for Environmental Health was an outgrowth of CDC's heavy involvement in recent environmental health incidents such as chemical contamination in Triana, Alabama and Love Canal, the Three Mile Island nuclear accident, and the eruption of Mount St. Helens; it a;so inherited existing programs in rat control, lead, dental disease, cancer clusters, and birth defects.^[1]
- In 1992, the National Center for Injury Prevention and Control was spun off from the National Center for Environmental Health.^[2]
- In 2001, the National Center on Birth Defects and Developmental Disabilities was spun off from the National Center for Environmental Health due to Children's Health Act of 2000.^[3]^[4]
The Center for Health Promotion and Education incorporated programs in lifestyle studies, nutrition, family planning, and anti-smoking activities. By 1990, it was called the Center for Chronic Disease Prevention and Health Promotion.^[1]
The Center for Prevention Services was one of two that inherited CDC's traditional service functions.^[1] In 1996, it became the National Center for HIV, STD, and TB Prevention.^[5]
- In 1993, the National Immunization Program was spun off from the Center for Prevention Services.^[6] It would become the National Center for Immunization and Respiratory Diseases in 2006.^[7]
The Center for Professional Development and Training also inherited some of CDC's traditional service functions.^[1] Around 1986, it merged with the Laboratory Program Office to form the Training and Laboratory Program Office,^[8] which was renamed the Public Health Practice Program Office in 1989.^[9]

Additionally, there two centers during this period that were absorbed by CDC from outside:^[1]

The National Institute for Occupational Safety and Health (NIOSH), whose predecessor organization dated back to 1914,^[10] had been absorbed by CDC in 1973.^[11]
The National Center for Health Statistics, whose earliest predecessor dated back to 1899, was absorbed into CDC in 1987.^[12]

Futures Initiative era

CDC's Futures Initiative began in 2003 and was spearheaded by CDC Director Julie Gerberding.^[13]^[14] It was partially in response to criticism of the agency's response to the 1999 West Nile virus outbreak, the 2001 anthrax attacks, and the 2002–2004 SARS outbreak. It was also noted that these emergency response activities were putting pressures on the CDC Director's time, who also was responsible for to directly overseeing all 11 CIOs.^[15]^[16]

The strategic planning involved a broadly deliberative process seeking input from employees, partners, and other stakeholders for selecting strategic objectives.^[14] It emphasized preparedness as well as health promotion and disease prevention, and also streamlined the funding process for grants to state and local health departments.^[13]^[14] It reoriented CDC around a matrix organization structure that was less hierarchical, which was intended to prevent silos and enhance organizational flexibility and information sharing.^[14]^[15]

The reorganization became official in April 2005.^[14]^[17] The existing CDC centers were collected into four Coordinating Centers:^[14]

Coordinating Center for Infectious Diseases
Coordinating Center for Environmental Health and Injury Prevention
Coordinating Center for Health Promotion
Coordinating Center for Health Information and Service

During this time, there were three independent CIOs: the Coordinating Office for Global Health, the newly formed Coordinating Office for Terrorism Preparedness and Emergency Response, and NIOSH.^[14]

There were a few changes on the CIO level as well. An Office of Terrorism Preparedness and Emergency Response was created in August 2002.^[16] Two new centers for Public Health Informatics and Health Marketing were created in 2005.^[14] In 2007, the Center for Infectious Diseases was split into the National Center for Zoonotic, Vectorborne, and Enteric Diseases and National Center for Preparedness, Detection, and Control of Infectious Diseases, and the National Immunization Program became the National Center for Immunization and Respiratory Diseases.^[18]

There were negative effects in the immediate aftermath of the reorganization, including unpopularity with employees, low morale, and loss of long-term staff.^[14] Because many of CDC's leaders were scientists rather than managers, their aversion to the administrative burden of a reorganization led to its perceived failure.^[15] In December 2005, five former CDC directors sent Gerberding a letter expressing concern about the reorganization.^[19]

Post-Futures Initiative era

The Coordinating Centers were abolished in 2009 by new CDC Director Tom Frieden.^[20]^[21]^[22] Centers were instead placed under Deputy Director offices, which were much leaner than the former Coordinating Centers. For example, the Coordinating Center for Infectious Diseases had 600 employees, while the Office of Infectious Diseases had 12.^[21]

There were initially three Deputy Director offices, which was increased to four in 2018:^[22]^[23]

The Deputy Director for Infectious Diseases succeeded the Coordinating Center for Infectious Diseases.
The Deputy Director for Noncommunicable Diseases, Injury, and Environmental Health (later Deputy Director for Non-Infectious Diseases) succeeded the Coordinating Center for Environmental Health and Injury Prevention, and the Coordinating Center for Health Promotion.
The Deputy Director for Public Health Scientific Services (later Deputy Director for Public Health Science and Surveillance) succeeded the Coordinating Center for Health Information and Service.
The Deputy Director for Public Health Service and Implementation Science was created in 2018, absorbing three CIOs that had been been independent since the 2009 reorganization.^[24]

Several changes on the CIO level also occurred in 2009:

The former National Center for Zoonotic, Vectorborne, and Enteric Diseases and National Center for Preparedness, Detection, and Control of Infectious Diseases were realigned, with their programs moved into the new National Center for Emerging and Zoonotic Infectious Diseases, and Center for Global Health, as well as other parts of CDC.^[25]

Five program offices covering surveillance, epidemiology, informatics, laboratory science, and career development were formed,^[23]^[26] which merged into the Center for Surveillance, Epidemiology and Laboratory Services in 2013.^[27]^[28]
The Office of State and Local Support was formed,^[23] which in 2018 became the Center for State, Tribal, Local and Territorial Support.^[24]

CDC Moving Forward era

Another reorganization occurred in 2023 as a response to lessons learned from CDC's response to the COVID-19 pandemic.^[29]^[30] The Deputy Director level was removed, returning CDC to a flat structure. The infectious disease and non-infectious disease centers, Global Health Center, and NIOSH remained as CIOs, while the new Public Health Infrastructure Center was created by merging the Center for Surveillance, Epidemiology and Laboratory Services and the Center for State, Tribal, Local and Territorial Support. The other five CIOs (Office of Science, Office of Laboratory Science and Safety, National Center for Health Statistics, Office of Health Equity, and Office of Readiness and Response) were absorbed into the Office of the Director.^[31]

Current organization

Infectious disease centers

These centers were under the Coordinating Office for Infectious Diseases and later the Deputy Director for Infectious Diseases.^[23]

National Center for Emerging and Zoonotic Infectious Diseases - formed in 2009^[25] as an indirect successor to the Center for Infectious Diseases,^[18]^[25] one of the original centers established in 1980^[1]
National Center for HIV, Viral Hepatitis, STD and TB Prevention - successor to Center for Prevention Services,^[5] one of the original centers established in 1980^[1]
National Center for Immunization and Respiratory Diseases - spun off in 1993 from Center for Prevention Services^[6]^[7]

Non-infectious disease centers

These were under either the Coordinating Center for Environmental Health and Injury Prevention, or Coordinating Center for Health Promotion. They were later under the Deputy Director for Non-Infectious Diseases.^[23]

National Center for Chronic Disease Prevention and Health Promotion - one of the original centers established in 1980^[1]
National Center for Environmental Health (NCEH) - one of the original centers established in 1980^[1]
National Center for Injury Prevention and Control - spun off from NCEH in 1992^[2]
National Center on Birth Defects and Developmental Disabilities - spun off from NCEH in 2001 due to Children's Health Act of 2000^[3]^[4]

Other centers

National Institute for Occupational Safety and Health - its earliest predecessor was formed in 1914, became NIOSH in 1971,^[10] and was absorbed into CDC in 1973^[11]
Public Health Infrastructure Center - formed from merges of several programs in 2009^[23] and 2023,^[31] one of which descended from the Center for Professional Development and Training,^[8]^[9] one of the original centers established in 1980^[1]
Global Health Center - successor to the International Health Program Office^[32] established in 1980^[1]^[33]

Office of the Director components

Chief of Staff
Office of the Chief Operating Officer
Office of Policy, Performance, and Evaluation
Office of Equal Employment Opportunity and Workplace Equity
Office of Communications
CDC Washington Office
Office of Science
Office of Laboratory Science and Safety
Office of Public Health Data, Surveillance, and Technology
- National Center for Health Statistics
Office of Health Equity
Office of Readiness and Response

References

^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o Etheridge, Elizabeth W. (1992). Sentinel for Health: A History of the Centers for Disease Control. University of California Press. pp. xxviii, 310–315, 342–343. ISBN 978-0520910416.
^ ^a ^b Sleet, David; Bonzo, Sandra; Branche, Christine (1998-12). "An overview of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention". Injury Prevention. 4 (4): 308–312. doi:10.1136/ip.4.4.308. ISSN 1353-8047. PMC 1730415. PMID 9887426. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
^ ^a ^b Boyle, Coleen A.; Cordero, José F.; Trevathan, Edwin (2012 Dec). "The National Center on Birth Defects and Developmental Disabilities: Past, Present, and Future". American Journal of Preventive Medicine. 43 (6): 655–658. doi:10.1016/j.amepre.2012.08.015. PMC 4445684. PMID 23159262. {{cite journal}}: Check date values in: |date= (help)
^ ^a ^b Pub. L. 106–310 (text) (PDF), Title VI, Subtitle B
^ ^a ^b 61 FR 35219
^ ^a ^b 58 FR 59043
^ ^a ^b Schuchat, Anne; Anderson, Larry J.; Rodewald, Lance E.; Cox, Nancy J.; Hajjeh, Rana; Pallansch, Mark A.; Messonnier, Nancy E.; Jernigan, Daniel B.; Wharton, Melinda (2018 Jul). "Progress in Vaccine-Preventable and Respiratory Infectious Diseases—First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015". Emerging Infectious Diseases. 24 (7): 1178. doi:10.3201/eid2407.171699. PMC 6038744. PMID 29916350. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)
^ ^a ^b Cook, B. Kinnas (2012-12-06). Federal Yellow Book: The Directory of the USA Federal Government Departments and Independent Agencies. Springer Science & Business Media. ISBN 978-94-009-4213-4.
^ ^a ^b 54 FR 23537
^ ^a ^b The President's Report on Occupational Safety and Health. Commerce Clearing House. 1972. pp. 153–154.
^ ^a ^b Snyder, Lynne Page (1998). "The National Institute for Occupational Safety and Health, 1971–1996: A Brief History" (PDF). Retrieved 2021-05-05.
^ "Records of the Public Health Service [PHS], 1912-1968". National Archives. 2016-08-15. Retrieved 2021-08-04.
^ ^a ^b Mary, Quirk (July 2004). "CDC reorganisation begins". The Lancet Infectious Diseases. 4 (7): 390. doi:10.1016/S1473-3099(04)01076-X.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ Whitford, Andrew B. (2006). "Strategic Transformation in Public Health: In the Case of the Centers for Disease Control and Prevention". SSRN Electronic Journal. doi:10.2139/ssrn.872540. ISSN 1556-5068. S2CID 152608295.
^ ^a ^b ^c Herrington, Melody (Spring 2022). "Herding Scientists: A Story of Failed Reform at the CDC". UGA SPIA Online Magazine. Retrieved 2023-09-05.
^ ^a ^b "Centers for Disease Control and Prevention: Agency Leadership Taking Steps to Improve Management and Planning, but Challenges Remain". U. S. Government Accountability Office. 2004-01-30. pp. 3–5, 15–16, 19. Retrieved 2023-09-05.
^ Gerberding, Julie Louise (2005-04-21). "The Futures Initiative: Letter from Dr. Gerberding". U.S. Centers for Disease Control and Prevention. Archived from the original on June 29, 2016. Retrieved 2008-12-28.
^ ^a ^b "Infectious disease center increases public health impact". American Veterinary Medical Association. 2007-05-15. Retrieved 2024-11-03.
^ Kaiser, Jocelyn; Couzin, Jennifer (2006-10-13). "Gerberding Defends Her Transformation of CDC". Science. 314 (5797): 246–247. doi:10.1126/science.314.5797.246. ISSN 0036-8075. PMID 17038602. S2CID 153903954.
^ Koenig, Robert (2009-08-07). "New Chief Orders CDC to Cut Management Layers". Science. doi:10.1126/article.41382 (inactive 1 November 2024).{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)
^ ^a ^b Harris, Gardiner (2010-03-15). "Obama's C.D.C. Director, Wielding a Big Broom". The New York Times. ISSN 0362-4331. Retrieved 2023-09-05.
^ ^a ^b "Science, efficiency to drive CDC changes". Atlanta Journal-Constitution. 2010-01-04. Archived from the original on 2010-01-04. Retrieved 2024-11-03.
^ ^a ^b ^c ^d ^e ^f 74 FR 68630
^ ^a ^b 83 FR 48427
^ ^a ^b ^c "CDC reorganization creating emerging and zoonotic disease center". American Veterinary Medical Association. 18 January 2010. Retrieved 2023-09-05.
^ 75 FR 45134
^ "History of CSELS". U.S. Centers for Disease Control and Prevention. 17 December 2018. Retrieved 2024-11-03.
^ 78 FR 70049
^ Steenhuysen, Julie (2022-08-17). "U.S. CDC plans to focus on public health response after pandemic failings". Reuters. Retrieved 2022-08-17.
^ LaFraniere, Sharon; Weiland, Noah (2022-08-17). "Walensky, Citing Botched Pandemic Response, Calls for C.D.C. Reorganization". The New York Times. ISSN 0362-4331. Retrieved 2022-08-21.
^ ^a ^b Choi, Joseph (2023-01-24). "CDC informs staff of reorganization after pandemic criticisms". The Hill. Retrieved 2023-08-22.
^ 63 FR 38408
^ 45 FR 67772

[:102-1] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k ^l ^m ⁿ ^o Etheridge, Elizabeth W. (1992). Sentinel for Health: A History of the Centers for Disease Control. University of California Press. pp. xxviii, 310–315, 342–343. ISBN 978-0520910416.

[:3-2] Sleet, David; Bonzo, Sandra; Branche, Christine (1998-12). "An overview of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention". Injury Prevention. 4 (4): 308–312. doi:10.1136/ip.4.4.308. ISSN 1353-8047. PMC 1730415. PMID 9887426. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)

[:4-3] Boyle, Coleen A.; Cordero, José F.; Trevathan, Edwin (2012 Dec). "The National Center on Birth Defects and Developmental Disabilities: Past, Present, and Future". American Journal of Preventive Medicine. 43 (6): 655–658. doi:10.1016/j.amepre.2012.08.015. PMC 4445684. PMID 23159262. {{cite journal}}: Check date values in: |date= (help)

[:5-4] Pub. L. 106–310 (text) (PDF), Title VI, Subtitle B

[:7-5] 61 FR 35219

[:16-6] 58 FR 59043

[:18-7] Schuchat, Anne; Anderson, Larry J.; Rodewald, Lance E.; Cox, Nancy J.; Hajjeh, Rana; Pallansch, Mark A.; Messonnier, Nancy E.; Jernigan, Daniel B.; Wharton, Melinda (2018 Jul). "Progress in Vaccine-Preventable and Respiratory Infectious Diseases—First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015". Emerging Infectious Diseases. 24 (7): 1178. doi:10.3201/eid2407.171699. PMC 6038744. PMID 29916350. {{cite journal}}: Check date values in: |date= (help)CS1 maint: PMC format (link)

[:14-8] Cook, B. Kinnas (2012-12-06). Federal Yellow Book: The Directory of the USA Federal Government Departments and Independent Agencies. Springer Science & Business Media. ISBN 978-94-009-4213-4.

[:15-9] 54 FR 23537

[:92-10] The President's Report on Occupational Safety and Health. Commerce Clearing House. 1972. pp. 153–154.

[:17-11] Snyder, Lynne Page (1998). "The National Institute for Occupational Safety and Health, 1971–1996: A Brief History" (PDF). Retrieved 2021-05-05.

[:22-12] "Records of the Public Health Service [PHS], 1912-1968". National Archives. 2016-08-15. Retrieved 2021-08-04.

[:0-13] Mary, Quirk (July 2004). "CDC reorganisation begins". The Lancet Infectious Diseases. 4 (7): 390. doi:10.1016/S1473-3099(04)01076-X.

[:1-14] ^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ Whitford, Andrew B. (2006). "Strategic Transformation in Public Health: In the Case of the Centers for Disease Control and Prevention". SSRN Electronic Journal. doi:10.2139/ssrn.872540. ISSN 1556-5068. S2CID 152608295.

[:2-15] Herrington, Melody (Spring 2022). "Herding Scientists: A Story of Failed Reform at the CDC". UGA SPIA Online Magazine. Retrieved 2023-09-05.

[:6-16] "Centers for Disease Control and Prevention: Agency Leadership Taking Steps to Improve Management and Planning, but Challenges Remain". U. S. Government Accountability Office. 2004-01-30. pp. 3–5, 15–16, 19. Retrieved 2023-09-05.

[17] Gerberding, Julie Louise (2005-04-21). "The Futures Initiative: Letter from Dr. Gerberding". U.S. Centers for Disease Control and Prevention. Archived from the original on June 29, 2016. Retrieved 2008-12-28.

[:8-18] "Infectious disease center increases public health impact". American Veterinary Medical Association. 2007-05-15. Retrieved 2024-11-03.

[19] Kaiser, Jocelyn; Couzin, Jennifer (2006-10-13). "Gerberding Defends Her Transformation of CDC". Science. 314 (5797): 246–247. doi:10.1126/science.314.5797.246. ISSN 0036-8075. PMID 17038602. S2CID 153903954.

[20] Koenig, Robert (2009-08-07). "New Chief Orders CDC to Cut Management Layers". Science. doi:10.1126/article.41382 (inactive 1 November 2024).{{cite journal}}: CS1 maint: DOI inactive as of November 2024 (link)

[:9-21] Harris, Gardiner (2010-03-15). "Obama's C.D.C. Director, Wielding a Big Broom". The New York Times. ISSN 0362-4331. Retrieved 2023-09-05.

[:19-22] "Science, efficiency to drive CDC changes". Atlanta Journal-Constitution. 2010-01-04. Archived from the original on 2010-01-04. Retrieved 2024-11-03.

[:11-23] ^ ^a ^b ^c ^d ^e ^f 74 FR 68630

[:20-24] 83 FR 48427

[:10-25] "CDC reorganization creating emerging and zoonotic disease center". American Veterinary Medical Association. 18 January 2010. Retrieved 2023-09-05.

[26] 75 FR 45134

[:12-27] "History of CSELS". U.S. Centers for Disease Control and Prevention. 17 December 2018. Retrieved 2024-11-03.

[28] 78 FR 70049

[29] Steenhuysen, Julie (2022-08-17). "U.S. CDC plans to focus on public health response after pandemic failings". Reuters. Retrieved 2022-08-17.

[nytreorg-30] LaFraniere, Sharon; Weiland, Noah (2022-08-17). "Walensky, Citing Botched Pandemic Response, Calls for C.D.C. Reorganization". The New York Times. ISSN 0362-4331. Retrieved 2022-08-21.

[:13-31] Choi, Joseph (2023-01-24). "CDC informs staff of reorganization after pandemic criticisms". The Hill. Retrieved 2023-08-22.

[32] 63 FR 38408

[33] 45 FR 67772

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@@ Line 17: / Line 17: @@
 * The '''Center for Infectious Diseases''' was largely created from merging the pre-existing Laboratory Bureau and Epidemiology Bureau.<ref name=":102" />
 * The '''Center for Environmental Health''' was an outgrowth of CDC's heavy involvement in recent environmental health incidents such as chemical contamination [[Triana, Alabama#DDT pollution|in Triana, Alabama]] and [[Love Canal]], the [[Three Mile Island accident|Three Mile Island nuclear accident]], and the [[1980 eruption of Mount St. Helens|eruption of Mount St. Helens]]; it a;so inherited existing programs in rat control, lead, dental disease, cancer clusters, and birth defects.<ref name=":102" />
-** In 1992, the '''National Center for Injury Prevention and Control''' was spun off from the National Center for Environmental Health.<ref name=":3">{{Cite web |date=2023-04-28 |title=Injury Center Timeline 1992-2022 Error processing SSI file |url=https://www.cdc.gov/injury/about/timeline.html |access-date=2023-08-23 |website=www.cdc.gov |language=en-us}}</ref>
+** In 1992, the '''National Center for Injury Prevention and Control''' was spun off from the National Center for Environmental Health.<ref name=":3">{{Cite journal |last=Sleet |first=David |last2=Bonzo |first2=Sandra |last3=Branche |first3=Christine |date=1998-12 |title=An overview of the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention |url=https://injuryprevention.bmj.com/lookup/doi/10.1136/ip.4.4.308 |journal=Injury Prevention |language=en |volume=4 |issue=4 |pages=308–312 |doi=10.1136/ip.4.4.308 |issn=1353-8047 |pmc=PMC1730415 |pmid=9887426}}</ref>
 ** In 2001, the '''National Center on Birth Defects and Developmental Disabilities''' was spun off from the National Center for Environmental Health due to [[Children's Health Act of 2000]].<ref name=":4">{{Cite journal |last1=Boyle |first1=Coleen A. |last2=Cordero |first2=José F. |last3=Trevathan |first3=Edwin |date=2012 Dec |title=The National Center on Birth Defects and Developmental Disabilities: Past, Present, and Future |journal=American Journal of Preventive Medicine |language=en |volume=43 |issue=6 |pages=655–658 |doi=10.1016/j.amepre.2012.08.015 |pmc=4445684 |pmid=23159262}}</ref><ref name=":5">{{USPL|106|310}}, Title VI, Subtitle B</ref>
 * The '''Center for Health Promotion and Education''' incorporated programs in lifestyle studies, nutrition, family planning, and anti-smoking activities. By 1990, it was called the '''Center for Chronic Disease Prevention and Health Promotion'''.<ref name=":102" />
 * The '''Center for Prevention Services''' was one of two that inherited CDC's traditional service functions.<ref name=":102" />  In 1996, it became the '''National Center for HIV, STD, and TB Prevention'''.<ref name=":7">{{Federal Register|61|35219}}</ref>
-** In 1993, the '''National Immunization Program''' was spun off from the Center for Prevention Services. It would become the '''National Center for Immunization and Respiratory Diseases''' in 2006.<ref name="established" />
+** In 1993, the '''National Immunization Program''' was spun off from the Center for Prevention Services.<ref name=":16">{{Federal Register|58|59043}}</ref> It would become the '''National Center for Immunization and Respiratory Diseases''' in 2006.<ref name=":18">{{Cite journal |last=Schuchat |first=Anne |last2=Anderson |first2=Larry J. |last3=Rodewald |first3=Lance E. |last4=Cox |first4=Nancy J. |last5=Hajjeh |first5=Rana |last6=Pallansch |first6=Mark A. |last7=Messonnier |first7=Nancy E. |last8=Jernigan |first8=Daniel B. |last9=Wharton |first9=Melinda |date=2018 Jul |title=Progress in Vaccine-Preventable and Respiratory Infectious Diseases—First 10 Years of the CDC National Center for Immunization and Respiratory Diseases, 2006–2015 |url=https://pmc.ncbi.nlm.nih.gov/articles/PMC6038744/ |journal=Emerging Infectious Diseases |language=en |volume=24 |issue=7 |pages=1178 |doi=10.3201/eid2407.171699 |pmc=PMC6038744 |pmid=29916350}}</ref>
 * The '''Center for Professional Development and Training''' also inherited some of CDC's traditional service functions.<ref name=":102" />  Around 1986, it merged with the Laboratory Program Office to form the '''Training and Laboratory Program Office''',<ref name=":14">{{Cite book |last=Cook |first=B. Kinnas |url=https://books.google.com/books?id=_vnnCAAAQBAJ&dq=cdc+former+%22Center+for+Professional+Development+and+Training%22&pg=PT178 |title=Federal Yellow Book: The Directory of the USA Federal Government Departments and Independent Agencies |date=2012-12-06 |publisher=Springer Science & Business Media |isbn=978-94-009-4213-4 |language=en}}</ref> which was renamed the '''Public Health Practice Program Office''' in 1989.<ref name=":15">{{Federal Register|54|23537}}</ref>
 Additionally, there two centers during this period that were absorbed by CDC from outside:<ref name=":102" />
@@ Line 34: / Line 34: @@
 The strategic planning involved a broadly deliberative process seeking input from employees, partners, and other stakeholders for selecting strategic objectives.<ref name=":1" />  It emphasized preparedness as well as health promotion and disease prevention, and also streamlined the funding process for grants to state and local health departments.<ref name=":0" /><ref name=":1" />  It reoriented CDC around a [[Matrix management|matrix organization]] structure that was less hierarchical, which was intended to prevent [[Information silo|silos]] and enhance organizational flexibility and information sharing.<ref name=":1" /><ref name=":2" />
 [[File:CDC organization 2007.pdf|thumb|Organization of CDC in 2007, with the Coordinating Centers]]
-The reorganization became official in April 2005.<ref name=":1" /><ref>{{cite web |title=CDC Office of Director, The Futures Initiative |url=https://www.cdc.gov/futures/g_letter_04-21-05.htm |url-status=dead |archive-url=https://web.archive.org/web/20160629062149/http://www.cdc.gov/futures/g_letter_04-21-05.htm |archive-date=June 29, 2016 |access-date=2008-12-28 |publisher=CDC – National Center for Disease Control and Prevention}}</ref> The existing CDC centers were collected into four Coordinating Centers:<ref name=":1" />
+The reorganization became official in April 2005.<ref name=":1" /><ref>{{cite web |last=Gerberding |first=Julie Louise |date=2005-04-21 |title=The Futures Initiative: Letter from Dr. Gerberding |url=https://www.cdc.gov/futures/g_letter_04-21-05.htm |url-status=dead |archive-url=https://web.archive.org/web/20160629062149/http://www.cdc.gov/futures/g_letter_04-21-05.htm |archive-date=June 29, 2016 |access-date=2008-12-28 |publisher=U.S. Centers for Disease Control and Prevention}}</ref> The existing CDC centers were collected into four Coordinating Centers:<ref name=":1" />
 * '''Coordinating Center for Infectious Diseases'''
@@ Line 42: / Line 42: @@
 During this time, there were three independent CIOs: the Coordinating Office for Global Health, the newly formed Coordinating Office for Terrorism Preparedness and Emergency Response, and NIOSH.<ref name=":1" />
-There were a few changes on the CIO level as well.  An Office of Terrorism Preparedness and Emergency Response was created in August 2002.<ref name=":6" />  Two new centers for Public Health Informatics and Health Marketing were created in 2005, both within the Coordinating Center for Health Information and Service.<ref name=":1" />  In 2007, the Center for Infectious Diseases was split into the '''National Center for Zoonotic, Vectorborne, and Enteric Diseases''' and '''National Center for Preparedness, Detection, and Control of Infectious Diseases''', and the National Immunization Program became the '''National Center for Immunization and Respiratory Diseases'''.<ref name=":8">{{Cite web |date=2007-05-15 |title=Infectious disease center increases public health impact {{!}} American Veterinary Medical Association |url=https://www.avma.org/javma-news/2007-06-01/infectious-disease-center-increases-public-health-impact |access-date=2024-11-03 |website=www.avma.org |language=en}}</ref>
+There were a few changes on the CIO level as well.  An Office of Terrorism Preparedness and Emergency Response was created in August 2002.<ref name=":6" />  Two new centers for Public Health Informatics and Health Marketing were created in 2005.<ref name=":1" />  In 2007, the Center for Infectious Diseases was split into the '''National Center for Zoonotic, Vectorborne, and Enteric Diseases''' and '''National Center for Preparedness, Detection, and Control of Infectious Diseases''', and the National Immunization Program became the '''National Center for Immunization and Respiratory Diseases'''.<ref name=":8">{{Cite web |date=2007-05-15 |title=Infectious disease center increases public health impact |url=https://www.avma.org/javma-news/2007-06-01/infectious-disease-center-increases-public-health-impact |access-date=2024-11-03 |website=American Veterinary Medical Association |language=en}}</ref>
 There were negative effects in the immediate aftermath of the reorganization, including unpopularity with employees, low morale, and loss of long-term staff.<ref name=":1" /> Because many of CDC's leaders were scientists rather than managers, their aversion to the administrative burden of a reorganization led to its perceived failure.<ref name=":2" /> In December 2005, five former CDC directors sent Gerberding a letter expressing concern about the reorganization.<ref>{{Cite journal |last1=Kaiser |first1=Jocelyn |last2=Couzin |first2=Jennifer |date=2006-10-13 |title=Gerberding Defends Her Transformation of CDC |url=https://www.science.org/doi/10.1126/science.314.5797.246 |journal=Science |language=en |volume=314 |issue=5797 |pages=246–247 |doi=10.1126/science.314.5797.246 |pmid=17038602 |s2cid=153903954 |issn=0036-8075}}</ref>
@@ Line 49: / Line 49: @@
 [[File:CDC organization 2015.pdf|thumb|Organization of CDC in 2015, with three deputy directors]]
 [[File:CDC organization 2021.pdf|thumb|Organization of CDC in 2021, with four deputy directors]]
-The Coordinating Centers were abolished in 2009 by new CDC Director [[Tom Frieden]].<ref>{{Cite journal |last=Koenig |first=Robert |date=2009-08-07 |title=New Chief Orders CDC to Cut Management Layers |url=https://www.science.org/content/article/new-chief-orders-cdc-cut-management-layers |journal=Science |doi=10.1126/article.41382 |doi-broken-date=1 November 2024}}</ref><ref name=":9">{{Cite news |last=Harris |first=Gardiner |date=2010-03-15 |title=Obama's C.D.C. Director, Wielding a Big Broom |language=en-US |work=The New York Times |url=https://www.nytimes.com/2010/03/16/health/16prof.html |access-date=2023-09-05 |issn=0362-4331}}</ref><ref>{{Cite web |date=2010-01-04 |title=Science, efficiency to drive CDC changes {{!}} ajc.com |url=http://www.ajc.com/health/science-efficiency-to-drive-264238.html |access-date=2024-11-03 |archive-url=https://web.archive.org/web/20100104183708/http://www.ajc.com/health/science-efficiency-to-drive-264238.html |archive-date=2010-01-04 }}</ref> Centers were instead placed under Deputy Director offices, which were much leaner than the former Coordinating Centers.  For example, the Coordinating Center for Infectious Diseases had 600 employees, while the Office of Infectious Diseases had 12.<ref name=":9" />
+The Coordinating Centers were abolished in 2009 by new CDC Director [[Tom Frieden]].<ref>{{Cite journal |last=Koenig |first=Robert |date=2009-08-07 |title=New Chief Orders CDC to Cut Management Layers |url=https://www.science.org/content/article/new-chief-orders-cdc-cut-management-layers |journal=Science |doi=10.1126/article.41382 |doi-broken-date=1 November 2024}}</ref><ref name=":9">{{Cite news |last=Harris |first=Gardiner |date=2010-03-15 |title=Obama's C.D.C. Director, Wielding a Big Broom |language=en-US |work=The New York Times |url=https://www.nytimes.com/2010/03/16/health/16prof.html |access-date=2023-09-05 |issn=0362-4331}}</ref><ref name=":19">{{Cite web |date=2010-01-04 |title=Science, efficiency to drive CDC changes |url=http://www.ajc.com/health/science-efficiency-to-drive-264238.html |archive-url=https://web.archive.org/web/20100104183708/http://www.ajc.com/health/science-efficiency-to-drive-264238.html |archive-date=2010-01-04 |access-date=2024-11-03 |website=Atlanta Journal-Constitution}}</ref> Centers were instead placed under Deputy Director offices, which were much leaner than the former Coordinating Centers.  For example, the Coordinating Center for Infectious Diseases had 600 employees, while the Office of Infectious Diseases had 12.<ref name=":9" />
-There were initially three Deputy Director offices, which was increased to four in 2018:
+There were initially three Deputy Director offices, which was increased to four in 2018:<ref name=":19" /><ref name=":11" />
 * The '''Deputy Director for Infectious Diseases''' succeeded the Coordinating Center for Infectious Diseases.
 * The '''Deputy Director for Noncommunicable Diseases, Injury, and Environmental Health''' (later '''Deputy Director for Non-Infectious Diseases''') succeeded the Coordinating Center for Environmental Health and Injury Prevention, and the Coordinating Center for Health Promotion.
 * The '''Deputy Director for Public Health Scientific Services''' (later '''Deputy Director for Public Health Science and Surveillance''') succeeded the Coordinating Center for Health Information and Service.
-* The '''Deputy Director for Public Health Service and Implementation Science''' was created in 2018, absorbing three CIOs that had been been independent since the 2009 reorganization.
+* The '''Deputy Director for Public Health Service and Implementation Science''' was created in 2018, absorbing three CIOs that had been been independent since the 2009 reorganization.<ref name=":20">{{Federal Register|83|48427}}</ref>
 Several changes on the CIO level also occurred in 2009:
@@ Line 62: / Line 62: @@
 * The former National Center for Zoonotic, Vectorborne, and Enteric Diseases and National Center for Preparedness, Detection, and Control of Infectious Diseases were realigned, with their programs moved into the new '''National Center for Emerging and Zoonotic Infectious Diseases''', and Center for Global Health, as well as other parts of CDC.<ref name=":10">{{Cite web |title=CDC reorganization creating emerging and zoonotic disease center |url=https://www.avma.org/javma-news/2010-02-01/cdc-reorganization-creating-emerging-and-zoonotic-disease-center |access-date=2023-09-05 |website=American Veterinary Medical Association |date=18 January 2010 |language=en}}</ref>
-* The '''Offices of Surveillance, Epidemiology, Informatics, Laboratory Science, and Career Development''' were formed,<ref name=":11">{{Federal Register|74|68630}}</ref><ref>{{Federal Register|75|45134}}</ref> and merged into the '''Center for Surveillance, Epidemiology and Laboratory Services''' in 2013.<ref name=":12">{{Cite web |title=History of CSELS |url=https://stacks.cdc.gov/view/cdc/92347 |access-date=2024-11-03 |website=stacks.cdc.gov|date=17 December 2018 }}</ref><ref>{{Federal Register|78|70049}}</ref>
+* Five program offices covering surveillance, epidemiology, informatics, laboratory science, and career development were formed,<ref name=":11">{{Federal Register|74|68630}}</ref><ref>{{Federal Register|75|45134}}</ref> which merged into the '''Center for Surveillance, Epidemiology and Laboratory Services''' in 2013.<ref name=":12">{{Cite web |date=17 December 2018 |title=History of CSELS |url=https://stacks.cdc.gov/view/cdc/92347 |access-date=2024-11-03 |website=U.S. Centers for Disease Control and Prevention}}</ref><ref>{{Federal Register|78|70049}}</ref>
-* The '''Office of State and Local Support''' was formed.<ref name=":11" />  This later became the Center for State, Tribal, Local and Territorial Support.
+* The '''Office of State and Local Support''' was formed,<ref name=":11" /> which in 2018 became the '''Center for State, Tribal, Local and Territorial Support'''.<ref name=":20" />
 === CDC Moving Forward era ===
@@ Line 72: / Line 72: @@
 ;Infectious disease centers
-These centers were under the Coordinating Office for Infectious Diseases and later the Deputy Director for Infectious Diseases.
+These centers were under the Coordinating Office for Infectious Diseases and later the Deputy Director for Infectious Diseases.<ref name=":11" />
 * [[National Center for Emerging and Zoonotic Infectious Diseases]] - formed in 2009<ref name=":10" /> as an indirect successor to the Center for Infectious Diseases,<ref name=":8" /><ref name=":10" /> one of the original centers established in 1980<ref name=":102" />
 * [[National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention|National Center for HIV, Viral Hepatitis, STD and TB Prevention]] - successor to Center for Prevention Services,<ref name=":7" /> one of the original centers established in 1980<ref name=":102" />
-* [[National Center for Immunization and Respiratory Diseases]] - spun off in 1993 from Center for Prevention Services<ref name="established">Sternberg, Steve. "CDC plans big push for vaccination]". ''The Atlanta Journal-Constitution''. May 7, 1993. p. C3.</ref>
+* [[National Center for Immunization and Respiratory Diseases]] - spun off in 1993 from Center for Prevention Services<ref name=":16" /><ref name=":18" />
 ;Non-infectious disease centers
-These were under either the Coordinating Center for Environmental Health and Injury Prevention, or Coordinating Center for Health Promotion. They were later under the Deputy Director for Non-Infectious Diseases.
+These were under either the Coordinating Center for Environmental Health and Injury Prevention, or Coordinating Center for Health Promotion. They were later under the Deputy Director for Non-Infectious Diseases.<ref name=":11" />
 * [[National Center for Chronic Disease Prevention and Health Promotion]] - one of the original centers established in 1980<ref name=":102" />
 * [[National Center for Environmental Health]] (NCEH) - one of the original centers established in 1980<ref name=":102" />