The AIDS crisis has aroused considerable interest in the criticai examina-tion of public health. Much of this work has come from the perspective of cultural analysis combining postmodernist theories with the politics of 'radical pluralism'. This work constitutes a rejection of Marxist state theory, and indeed has directed attention away from the state as an object of inquiry. This article is a response to 'cultural analysis', whiclruses an historical examination of public health in Canada to show the ways in which it has been oriented around the state, reflecting the character and limites of social policy.