As the setting for daily life and social interactions, the city is a natural level at which to organize health care. Stéphane Tessier, a public health physician, explains how health issues are organized and managed at the local level. While all major cities have a team of professionals typically organized within a municipal health and hygiene department, each municipality shapes its own policy; some of the most proactive ones have established municipal health centers or facilities offering preventive care and health promotion services. However, most decisions are not made at the municipal level, and the city lacks the resources to compensate for the shortcomings of other decision-making levels.