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Better Defining Disability Will Make Data More Inclusive and Usable

Better Defining Disability Will Make Data More Inclusive and Usable ASTHO, association of state and territorial health officials, access to health care, centers for disease control, syndromic surveillance systems, health outcomes, person with a disability, disaster medical assistance team dmat, mental health conditions, people with disabilities, health disparities, mental health, health equity, public health emergencies, syndromic surveillance, disaster medical assistance teams, disability data, people living with disabilities, disability inclusion Margaret Nilz ASTHO | Syndromic surveillance data on disability prevalence will help people with disabilities in emergencies. Over the past two decades, the frequency and intensity of natural disasters have increased — and will continue to do so. While disasters impact whole communities, past incidents highlight specific effects on people with disabilities, as it is more challenging for them to prepare for and recover from an incident. Understanding the prevalence of disability in a jurisdiction helps fully address the population’s needs.​ There is not a universally accepted way to collect data on people with disabilities. However, the need for disaggregated data by disability status is critical to helping measure health disparities and underlying factors contributing to inequities. Such data will support the development and continuous evaluation and improvement of public health programs and policies. Key Considerations for Collecting Data on People with Disabilities Disability data is essential for inclusive public health practice. Several factors are important to keep in mind when gathering data on people with disabilities. Participation is critical as exclusion from research can further marginalize already vulnerable groups and limit access to advancements. Accounting for historical trauma/negative impacts helps people with disabilities who are at increased risk of coercion, inclusion without consent, and other exploitation. Unwarranted disability assessments, particularly those implemented with limited evidence of effectiveness, have been shown to have negative mental health impacts on participants with disabilities. Different models of disability provide a reference as programs, services, laws, and regulations are developed. Primary models of disability include the Medical Model, Functional Model, Social Model, and Medical/Rehabilitative Model. Current Measures and Definitions of Disability - Brief - Better Defining Disability Disability Inclusion in National Syndromic Surveillance Program (NSSP) NSSP includes electronic health record (EHR) data from 73% of the nation’s emergency departments (EDs). However, it contains no systemic way to identify people with disabilities. Including disability data within a system as valuable as NSSP can help close gaps in monitoring the impacts of emergencies on people with disabilities. Syndromic surveillance data can guide decision-making during emergencies and policy formation at the local, state, and national levels. There are limitations of using syndromic surveillance data. First, diagnostic codes may not map directly onto functional limitations. Second, codes do not provide information about residual functioning, loss of functioning, or disability severity. Additionally, reporting in EHRs may not be accurate due to input or data errors. Codes can be related to a visit or encounter, even if it does not end up being true for a patient. Furthermore, diagnostic codes reflecting disability may not be used in every encounter and people with disabilities may be missed through using ED data as it only represents a snapshot in time. Benefits of Expanding Disability Data Access and Use Expanding the collection, access, and use of disability data for public health program development and emergency preparedness promotes health equity for people with disabilities. More specifically, this data can inform fiscal, programmatic, service policy, and public health planning decisions. When Disaster Medical Assistance Teams (DMATs) deployed to shelters in North Carolina, CDC’s NSSP team asked health officials if they wanted to integrate these data. Within 24 hours, data from DMATs were available in NSSP, providing a snapshot of health in those shelters. Data were monitored along with ED visits to give a complete picture of the storm’s health impacts. In 2017, Hurricane Harvey made landfall in Texas, resulting in 88 deaths and $125 billion in infrastructure damage. Public health officials used syndromic surveillance to understand increases in ED visits by those who evacuated to the Dallas–Fort Worth (DFW) area. Area hospitals saw roughly 4,400 more ED visits than normal; at least 600 were evacuees. Syndromic surveillance data demonstrated extensive health care services use outside the affected areas by highlighting the importance of surge capacity planning one to four hours outside the disaster area. Ongoing Efforts Through a cooperative agreement with CDC, ASTHO is working with subject matter experts to create a definition of disability for syndromic surveillance. ASTHO conducted key informant interviews with disability professionals to inform the development of this new diagnostic code-based definition, along with four scientific panels to assess the drafting and review of national and state-level pilot testing. An expansion of this kind benefits jurisdictions through increased data capacity for fiscal, programmatic, and service policy decision-making and supporting longitudinal tracking of prevalence and risk. Conclusion Efforts to expand data about people with disabilities can help build public health capacity to monitor the health and well-being of people with disabilities before, during, and after public health emergencies. However, efforts in data collection on disabilities require interoperability and standardization across all systems to be successful. Efforts to contextualize public health emergency data and gather supporting data on impacted populations allow health officials to better turn data into action in pursuit of health equity across public health emergencies. NU38OT000290 website yes

Automated Syphilis Electronic Laboratory Processing: Effectively and Accurately Identifying Priority Syphilis Cases

STIs,

The Florida Department of Health created an effective algorithm to automate syphilis laboratory result processing that improves case assignment accuracy and prioritization. This tool outlines key steps and considerations for jurisdictions looking to adopt the algorithm.

Overdose Data to Action: Public Health-Public Safety Partnerships

ASTHO conducted focus groups to examine overdose-related issues and identify potential engagement opportunities for public health and public safety around overdose prevention. This brief outlines key takeaways and is designed to serve as a guide for public health building and strengthening relationships with public safety.

ASTHO Policy Committees (login required)

ASTHO Policy Committees (login required) Policy committees are instrumental in developing ASTHO policy through a process established by our membership in 2018. Committee members are subject matter experts in their field and are integral to the success of these committees. In collaboration with subcommittees, other work groups and task forces, and ASTHO staff, policy committees are charged with developing policy statements that align with ASTHO’s work in support of our mission, strategic goals, and objectives. Policy committees meet and submit reports to the Board of Directors quarterly. Each year, ASTHO conducts a policy committee appointment process to recruit members to serve for a one-year term. Committee appointments are made annually by the president. All individuals, other than current state/territorial health officials, interested in being considered for ASTHO policy committee service must apply by submitting a <!---->policy committee service application.<!--. The deadline to apply for the 2022/2023 term is Friday, June 3, 2022.--> ASTHO's Policy Committees and Subcommittees Community Health and Prevention The Community Health and Prevention Policy Committee provides policy direction for ASTHO on broad-based health promotion and prevention initiatives. This includes setting policy direction for the prevention of chronic diseases, tobacco, injuries, suicide, violence, firearm-related outcomes, substance use, overdoses, and adverse childhood experiences. The Committee also has responsibility for improving nutrition, physical activity, maternal and child health, mental health, and the social environments that promote health. Healthy Babies Subcommittee The Healthy Babies Subcommittee (HBS) guides ASTHO in supporting state efforts to eliminate health inequities and improve optimal health outcomes for all moms and babies. As a subcommittee of ASTHO’s Community Health and Prevention Policy Committee, the HBS’s primary objectives are to 1) Increase birth equity by addressing multi-level system changes and social determinants of health, 2) Improve systems of care impacting maternal and child health and the associated inequities, 3) Increase access to family and maternal health services including prenatal/perinatal care, high quality reproductive healthcare and the full range of contraception options to promote health and wellbeing across the lifespan. Subcommittee members are leaders representing various areas relevant to maternal and child health such as public health, clinical, hospital care, community support systems, communications, health equity, data, and payment mechanisms. New members are invited at the recommendation of the chair, current subcommittee members, and/or ASTHO leadership. Substance Misuse and Addiction Response Taskforce (SMART) Subcommittee The Substance Misuse and Addiction Response Taskforce Subcommittee functions under the auspices of the ASTHO Community Health Prevention Policy Committee and guides ASTHO’s efforts to promote substance use prevention, overdose prevention, harm reduction, treatment, and recovery initiatives in states and territories. The Subcommittee is a platform to influence policy and system changes, promote peer support services, enhance health equity approaches, and identify resources and technical assistance and capacity building needs. The subcommittee monitors the changing behavioral health landscape and informs policy decisions in response to identified needs. This includes policy surrounding opioids, emerging drugs, alcohol, and cannabis. The Subcommittee is guided by the HHS Overdose Prevention Strategy and the SAMHSA Strategic Prevention Framework and Harm Reduction Framework. Environmental Health The Environmental Health Policy Committee provides unique state and territorial-based expertise and leadership for environmental public health policy and practice. The Committee works in close collaboration with the State and Territorial Environmental Health Directors peer group to actively build and strengthen the infrastructure, capacity, and capabilities of state and territorial health agency-based environmental health programs to respond to issues including emerging food safety threats, increasing climate and health concerns, lead poisoning prevention, and drinking water safety and security, among other issues. Infectious Disease The Infectious Disease Policy Committee assesses policy and programmatic issues and provides subject matter expertise and strategic direction related to the state and territorial role in infectious disease prevention, surveillance, and outbreak response. The Committee’s interests and responsibilities encompass a range of legacy and emerging infectious disease policy and tactical issues including bio-surveillance; antimicrobial resistance; immunization access and financing; prevention, care, and treatment of infectious diseases; healthcare-associated infections and patient safety; and pandemic preparedness. Performance Improvement and Accreditation The Performance Improvement and Accreditation Policy Committee provides leadership and recommendations in the areas of policy, practice, and research to strengthen the ability of ASTHO members and partners to deliver quality public health services and improve health outcomes. The committee provides strategic direction in performance management, quality improvement, accreditation, data to action, financing, return on investment, and workforce research. Population Health and Informatics The Population Health and Informatics Policy Committee provides guidance and direction on policy and programmatic priorities that drive population health improvement strategies, advances in health equity, and a modernized public health data ecosystem. The Committee recommends policies to improve state and territorial readiness and capacity to advance population health for all, including (1) strengthening partnerships between public health and healthcare payers and providers to connect clinical and community settings, (2) improving health equity in all communities across the nation, and (3) enhancing state and territorial health agency capacity for adopting the most modern data standards, solutions, and systems to drive health improvement and public health decision-making and action. Public Health Preparedness The Public Health Preparedness Policy Committee provides a critical link with and represents ASTHO’s best interests to senior leadership of key federal agencies and programs responsible for preparedness, response, recovery, and community resilience. The Committee analyzes and provides insightful information to guide the formulation of national policy and strategy, with specific focus on all-hazards public health infrastructure needs, strengthening state and territorial public health readiness capacity and capabilities, and in fulfilling the goals of the National Health Security Strategy, among other issues.   Questions about ASTHO’s policy committees or the annual recruitment/appointment process? Executive Office Contact Us Button website

Affiliate Council

Discover ASTHO’s Joint and Affiliate Councils, collaborative networks of public health leaders and organizations working together to strengthen governmental public health systems, share expertise, and improve health outcomes nationwide.

Board of Directors

ASTHO is governed by several bodies of public health leaders that guide the organization’s work to advance health equity and provide optimal health for all.

Innovation Advisory Council

ASTHO Innovation Advisory Council fosters partnerships between state health agencies and industry leaders to drive public health innovation and data modernization.

Careers at ASTHO

Are you ready to join an organization that puts people first? ASTHO's commitment to its employees starts with our values and deep commitment to improving health for all.

State Approaches for Promoting Family-Centered Care for Pregnant and Postpartum Women with Substance Use Disorders

Opioid and substance use disorders (SUD) continue to affect families beyond pregnancy; in 2017, about one in eight U.S. children lived in a household where at least one parent had a SUD in the prior year.

Environmental Public Health

Environmental Public Health Prioritizing Environmental Public Health Association of state and territorial health officials, astho, environmental health, environmental public health, public health professionals, addressing climate change, environmental health directors, vector-borne disease control, vector-borne disease, climate and health, food and water safety, health in all policies, environmental health issue, environmental health policy Environmental public health is increasingly important — access resources that help care for our environment, from the air we breathe to the food we eat. ASTHO supports state and territorial health agencies in their work to protect the public’s health by addressing environmental health, or the intersection of people’s health with the environments in which they live, work, and play. Environmental health encompasses foundational factors of health like food and water safety, air quality, healthy and safe housing, and preventing disease carried by vectors like ticks and mosquitoes. Environmental health interventions can include lead prevention and surveillance, designing chemical safety standards, health inspections in food retail locations, addressing hazards from natural disasters such as hurricanes and wildfires, and more. ASTHO’s Environmental Health unit supports health agencies through several methods: Develop best practices and resources for health agencies to develop their own environmental public health programs. Provide temporary staffing and support fellowship programs for health agencies. Connect environmental health professionals through peer opportunities like the State and Territorial Environmental Health Directors peer network, the National Association of Vector-Borne Disease Control Officials, and the State Tribal Liaisons peer group. ASTHO also provides a comprehensive suite of actionable, capacity building resources that health departments can leverage to strengthen their environmental health programs. Explore these and more below. Related topics: Health in All Policies Tribal Health website

Climate for Health Ambassadors Training

Climate for Health Ambassadors Training ASTHO, Association of State and Territorial Health Officials, climate for health, ambassadors training, health agencies, ecoamerica training, public health, climate change, extreme weather, climate resilient communities, climate resilient, public health programs, impacts of climate, readiness and resilience, climate action, climate basics, human health, health equity, climate solutions, health benefits, communicating climate, advocacy and engagement, staff training ASTHO is excited to partner with ecoAmerica to provide Climate for Health Ambassadors training to state and territorial health agencies. ASTHO is excited to partner with ecoAmerica to provide Climate for Health Ambassadors training to our state and territorial health agency members and their staff at no cost — equipping them with specific resources and tools to address the impacts of climate change in their jurisdiction. Climate change and extreme weather events continue to threaten public health, safety, and quality of life. ASTHO supports building and sustaining healthy, climate-resilient communities that are prepared for climate change and extreme weather events. Implementing public health programs that increase the capacity to prevent, protect, and respond to the impacts of climate and extreme weather improve a community’s overall readiness and resilience. The training is online, self-paced, and includes six modules: The Health Case for Climate Action, Climate Basics Impacts on Human Health, Health Equity Climate Solutions & Health Benefits Communicating on Climate and Health Advocacy & Engagement Making a Difference as an Ambassador Watch the video to learn more about our Climate for Health Ambassadors training.<!-- and sign up for the program today.--> website no

Food and Water Safety

Food and Water Safety association of state and territorial health officials, astho, food and water safety, food safety, water safety, water preparedness, environmental public health, pfas, per and polyfluoroalkyl substances, pfas chemicals, pfas exposure, harmful algal blooms, HABs, risks of harmful algal blooms, state health, environmental agencies, foodborne disease, prevent foodborne disease, drinking water emergencies, state and territorial health agencies, drinking water emergency One of the most fundamental aspects of environmental public health is maintaining high standards of quality and care for our food and water sources. Consumers rely on safe food at home and in the retail environment, so food safety inspections are key to ensuring adequate food safety. Partnerships between local and state health agencies, departments of agriculture, and federal food safety agencies create a framework for a safer food system. Threats to drinking water as well as recreational water hazards come in many forms, with significant sources including per- and polyfluoroalkyl substances (PFAS), cyanobacteria, Legionella, and other waterborne contaminants. Strengthening wastewater surveillance programs and overall water infrastructure aids states in protecting the public from waterborne diseases. ASTHO’s Food Safety program, in partnership with CDC, includes assisting the Council to Improve Foodborne Outbreak Response and creating various resources for state and territorial health departments. article

Environmental Public Health Tracking Fellowship Program

Environmental Public Health Tracking Fellowship Program ASTHO's Environmental Public Health Tracking: Peer-to-Peer Fellowship Program, in partnership with CDC, offers non-funded health agencies the opportunity to conduct pilot projects on environmental health issues of importance to their communities, receive mentorship from current CDC grantees, and become familiar with CDC standards and resources for environmental public health tracking. On this page are ASTHO and partner resources highlighting the program’s successes. Tracking Resources Poster Overview of ASTHO's Tracking Fellowship Program (PDF) This poster provides an overview of the impact and successes of ASTHO’s Environmental Public Health Tracking Fellowship. Fellowship Program Factsheet (PDF) This factsheet highlights achievement and success stories from ASTHO’s Environmental Public Health Tracking Fellowship. Building Capacity, Building Community: ASTHO's EPHT Fellowship Reaches the U.S. Territories (PDF) This two-page fact sheet shares successes and lessons learned from the Program’s first reverse site-visit to a territorial health agency. <!-- ASTHO Environmental Public Health Tracking Fellowship Program: 2002-2019 Environmental Public Health Tracking 101 The National Environmental Public Health Tracking Network (Tracking Network) brings together health data and environmental data from national, state, and city sources and provides supporting information to make the data easier to understand. The Tracking Network has data and information on environments and hazards, health effects, and population health. Embed-EH PH Tracking Fellowship Program ARCGIS --> website no

Vector-Borne Disease

Vector-Borne Disease association of state and territorial health officials, astho, vector-borne disease, disease vectors, vector surveillance and control, vector-borne disease outbreaks, health agencies, insecticide resistance, threat of insecticide resistance, tick-borne disease, tick-borne disease prevention, vector-borne disease control, mosquito control, environmental public health There are many diseases in the world that are transmitted to humans through vectors such as mosquitos, fleas, and ticks. Some of the most notorious of these diseases include West Nile virus, Zika virus, and Lyme disease. To prevent and control these diseases, vector surveillance and control is critical for any public health department. Environmental public health programs at the state and local levels develop and use tools and outreach programs to provide education to the public, identify and respond to vector-borne outbreaks, and to reduce exposure to diseases. ASTHO’s Vector-Borne Disease program, in partnership with CDC, includes assisting the National Association of Vector-Borne Disease Control Officials (NAVCO) and creating various resources for state and territorial health departments. article

About Infectious Disease Prevention

About Infectious Disease Prevention About Infectious Disease Prevention Learn about infectious disease prevention and ASTHO’s role in supporting health agencies' efforts to protect communities from communicable diseases. Infectious disease prevention and control is a core responsibility of state and territorial public health agencies. These agencies implement interventions, policies, and programs to protect individuals, communities, and even the economy. Infectious disease prevention protects communities from communicable diseases, such as measles, tuberculosis, influenza, sexually transmitted infections (STIs), and emerging pathogens. Through surveillance, policy, outbreak response, and communication, state and territorial health departments safeguard not only health, but economic and workforce stability as well as community resilience through coordination at local, state, national, and global levels. ASTHO is committed to supporting the infectious disease prevention efforts of its members and other public health and healthcare professionals with expert insights on the latest information and innovations in the field. What Is Infectious Disease Prevention and Control? Infectious disease prevention and control encompass measures and interventions to limit the spread of communicable diseases. Transmission modes vary, but public health interventions focus on identifying and breaking the chains of transmission to: Prevent further spread of disease. Mitigate individual and community impacts. State and territorial health agencies are responsible for monitoring disease trends, implementing control measures, coordinating with federal and local partners, and ensuring compliance with health regulations. Tools to ensure effective detection, investigation, and response to communicable disease outbreaks include: Legal authority. Strong, coordinated data infrastructure. A well-trained workforce. Effective public health policy. Ericka McGowan - Page - About Infectious Disease How to Prevent Infectious Diseases Many factors contribute to preventing and controlling infectious diseases and protecting populations. Prevention measures help people stay healthy, and infectious disease prevention ultimately relies on individuals to take small but important actions that can influence individual, community, and population health. Individual measures may include staying current with vaccinations, proper hygiene, and handwashing. In addition, systems-level prevention strategies that state and territorial public health agencies may implement include: Immunization programs and vaccine policy implementation. Laboratory capacity. Epidemiologic investigation. Workforce capacity in disease intervention and contact tracing. Healthcare-associated infection prevention programs. Emergency preparedness and response coordination. Public and provider engagement and education. Policies and Programs Infectious disease policies are designed to prevent the spread of illness in places like school, childcare, work, community and religious organizations, and healthcare settings, providing guidance for: Hygiene: Standing up expectations for handwashing, cleaning surfaces, and other disease prevention behaviors. Sick leave: Outlining policies and expectations for reporting illness, staying home when sick, and safely returning to work. Vaccination: Requiring or recommending immunizations (i.e., vaccine requirements for healthcare, school, or childcare entry). Public Health Surveillance and Monitoring State, territorial, and local health departments, along with partners in healthcare, look for signals in the community that may indicate a potential increase in an infectious disease — also known as public health surveillance and monitoring. This is a tool that helps public health departments identify where, when, and how to prevent, control, or stop infectious disease outbreaks. Surveillance can include disease reporting by healthcare providers and laboratories, wastewater monitoring, and cross-jurisdictional data sharing. This data is collected and used to help identify cases and populations at risk for exposure or disease transmission. Communication and Education Communicating about new and emerging or re-emerging infectious disease threats and educating the public, healthcare providers, and policymakers are vital roles for state and territorial health agencies. Additionally, health agencies must work with medical professionals, the media, and community partners to raise awareness about infectious disease outbreaks in their communities. Why Is Infectious Disease Prevention and Control Important? Infectious disease prevention and control is an important function of public health agencies to preserve individual and community well-being, as many infectious diseases spread quickly and can have varying (but sometimes debilitating) impacts. Infants, the elderly, immunocompromised individuals, and other high-risk groups may be disproportionately vulnerable to infectious disease and suffer more severe complications if they contract an infectious disease. Infectious diseases can also have downstream social and economic impacts. For example, measles outbreaks lead to missed time at school for children infected with or exposed to the disease, which results in caregiver time, loss of productivity, and reduced income and spending. There are also financial and other associated costs to public health — with recent research estimating an average cost of $766,013.80 for public health agencies per measles outbreak (including the resources required to initiate an investigation and mobilize a response). Further, certain infectious diseases, such as those with the potential to become a pandemic, have global impacts that drive an even higher cost, in lives, money, and resources to control them. Fortunately, state and territorial public health efforts to prevent infectious disease result in huge savings across the board. Kate Petersen - Page - About Infectious Disease How Does ASTHO Support Infectious Disease Prevention and Control? ASTHO serves as a national voice representing state and territorial public health, ensuring federal policy, funding decisions, and national strategies reflect infectious disease priorities. It has multiple teams dedicated to supporting infectious disease prevention and control. Together, they play a crucial role in helping state and territorial health agencies track and respond to emerging infectious diseases, implement effective infectious disease infrastructure and policy, and more. Key activities include: Providing strategic guidance on emergency policy and programmatic issues affecting state and territorial public health infectious disease efforts, through ASTHO’s Infectious Disease Policy Committee, which: Evaluates federal, state, and territorial policy impacting national infectious disease programs. Elevates state and territorial perspectives in national policy discussions. Provides subject matter expertise and strategic insight on surveillance, outbreak response, immunization policy, workforce, and infrastructure. Offers perspectives from the field about emerging infectious disease topics. Maintaining crucial partnerships with the Association of Immunization Managers, the Council of State and Territorial Epidemiologists, and others in the field, to: Share situational awareness. Align and coordinate policy approaches. Enhance outbreak response capacity nationwide. Serve as a bridge between state public health and national funders/stakeholders. Co-leading and facilitating The Council for Outbreak Response: Healthcare-Associated Infections and Antimicrobial-Resistant Pathogens to improve practices and policies related to outbreaks of these pathogens. Supplying technical assistance and producing capacity building resources (e.g., INSPIRE: Readiness) around infectious disease prevention and control. Get in Touch Working to enhance your health department’s capacity to prevent and control infectious disease? ASTHO’s Infectious Disease unit is here to support your efforts. Take a look at ASTHO’s infectious disease prevention resources, and reach out for direct assistance by emailing infectiousdisease@astho.org. article