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Demonstrating the Impact of School-Based Health Centers | Key Measures That Highlight ROI Demonstrating the Impact of School-Based Health Centers Sophia Durant Learn about key measures to demonstrate the health, reach, and economic impact of School-Based Health Centers, with state examples. School-Based Health Centers (SBHCs) improve health and educational outcomes by reducing barriers to care, preventing emergency and hospital visits, and supporting student success. This report outlines key measures used to demonstrate the health, educational, reach, and economic impact of SBHCs, with a focus on illustrating ROI for states and school districts. Health Outcomes and Service Utilization: This section lists measures that illustrate how SBHCs reduce acute care use and strengthen connections to preventive and ongoing health services. Cost Savings and Economic Impact: This section details the measures that show how SBHCs reduce costly care and generate meaningful financial returns. Educational and Social Outcomes: This section focuses on measures that showcase the impact of SBHCs on student success in and out of the classroom. Reach and Access: This section highlights measures that demonstrate how SBHCs support health care access through insurance coverage, geographic reach, and more. Evaluation and Reporting Examples: This section offers examples of how jurisdictions have evaluated and reported on the impact of school-based health services (i.e., leveraging Medicaid reimbursement and reinvestment, standardized data collection, and sample measure utilization). By using cross-sector data and leveraging existing partnerships, state health agencies can strengthen evaluation efforts, inform program improvement, and build a compelling case for sustained investment in school-based health services. Get the Report (PDF) Reviewed by - Akbarali, Mackie article yes

Food System Resilience: A Planning Guide for State Governments Food System Resilience: A Planning Guide for State Governments Heather Tomlinson, Shihui Yang This adapted guide provides actionable strategies to support food systems in times of natural disasters and other disruptions. Environmental and human-made disasters and even seasonal changes affect people and the functioning of food systems. These shocks and stressors to food systems can be acute events such as extreme weather phenomena (hurricanes, earthquakes, etc.) or long-term political, economic, and/or environmental disruptions, during which food is not accessible, available, or acceptable. While these factors can impact everyone, those with the most vulnerabilities and who are the most marginalized are at the greatest risk. State governments around the United States are taking action to prepare for and prevent the consequences of these disruptions on their food systems, but there is limited guidance available to support states in this work. This planning guide provides actionable tools for developing strategies to create and support resilient food systems. This guide is an abridged adaption of the Food System Resilience: A Planning Guide for Local Governments, developed by the Johns Hopkins Center for a Livable Future and Bloomberg Center for Government Excellence with a local government community of practice. ASTHO has tailored this version to state governments. For more information on a specific topic, please refer to the local guide for additional context. Get the Report (PDF) article yes

Partnering to Address Health Risks and Expand Communication Before and During Prescribed Fires Partnering to Address Health Risks and Expand Communication Before and During Prescribed Fires Kerry Wyss, Ali Aslam Learn how states can use risk communications to safely and effectively implement prescribed burns in this report. Prescribed fires are a land management tool used to help maintain forest health by not only returning nutrients to the soil and reducing buildup of unwanted fuels, but also potentially reducing the risk of catastrophic wildfires and the resulting large volume of smoke emitted. USDA and the Forest Service have a long-term plan to increase the pace and scale of prescribed fire across the country to reduce the risk of catastrophic wildfire. This means that some areas of the country may experience an increase in prescribed fire, and the subsequent smoke, that they have not historically experienced. While smoke can negatively impact public health, the planned nature of prescribed burning presents an opportunity to prepare individuals and communities for reducing smoke exposure — especially those at-risk of experiencing health effects. To better understand the connected partners involved in responding to wildland fire (i.e., wildfire and prescribed fire), ASTHO held a focus group in March 2025 targeting environment and health agency staff, as well as others involved in wildland fire response at the state level. The group focused on reinforcing partnerships across state agencies and other stakeholders, designing strategies for minimizing smoke exposure through timely and effective communication with communities, and long-term planning for safe prescribed burns with minimal smoke exposure. Read the full report to learn how state agencies are preparing for increased smoke. Get the Report (PDF) article yes

Delve into the successes, challenges, and lessons learned to inform/advance FHIR adoption among state and local public health agencies and their health care partners.

Tobacco Use in King County Washington: A Medicaid Data Analysis Report ASTHO Staff, King County Staff, University of Washington Staff Washington state provides an excellent model for integrating Medicaid data to address tobacco use. Commercial tobacco use remains the leading cause of preventable disability and death in the United States, yet state tobacco control programs often lack adequate surveillance infrastructure to identify tobacco users and reach populations in greatest need. Medicaid beneficiaries in particular would benefit from targeted public health and tobacco control interventions as they bear a disproportionately high burden of tobacco-related illnesses. Washington state addresses this gap through integrating self-reported tobacco use data through Medicaid enrollment with claims data. This integrated data provides the opportunity for health agencies to better target their outreach and assess the impact of tobacco control programs in the Medicaid population. This report examines how Washington state structures its tobacco surveillance and how other state and territorial health agencies can model their own data systems after Washington state’s example. Get the Report (PDF) website yes

Assessment of Foundational Capabilities Assessment of Foundational Capabilities in Public Health Grace Gorenflo, Brian Lentes, Melissa Touma, Anna Bradley Learn how state health departments are implementing the Foundational Public Health Services model to bolster their public health work in this report. The Foundational Public Health Services model serves as the core framework for defining cross-cutting capabilities essential for public health departments to deliver a minimum standard of service. This report compiles examples and assessments from 25 states to illustrate the implementation and progress of these foundational capabilities. Highlighting the importance of public health infrastructure, the report also includes a summary of state activities, showcases models and strategies for modernization and transformation, and reference tools such as cost assessments, legislation, and funding mechanisms used to strengthen public health systems nationwide. Dive into the full report to access these resources. Download the Report (PDF) article yes

Data Modernization Primer and Tactical Guides Dive into these data modernization reports for strategies and detailed steps to move from siloed systems to a connected, resilient data ecosystem. Public health data modernization is a collective effort by federal, state, local, and tribal organizations to strengthen public health data and surveillance systems. The ultimate goal is to move from siloed public health data systems to a connected, resilient, adaptable, and sustainable “response ready” data ecosystem. The primer provides state and territorial health officials with a high-level understanding of the objective and significance of data modernization as well as the roles that they play in a successful data modernization initiative. The five tactical guides detail key strategies and tactics for implementing and maintaining data modernization initiatives within public health agencies. article yes

Learn about how public health is employing ethical frameworks to support and improve wastewater surveillance and other community health monitoring measures.

Learn effective strategies for addressing workforce challenges in the islands, including geographic isolation and underdeveloped academic pathways.

How the Washington State Department of Health worked with communities to amend rulemaking processes using a health equity lens to reduce disparities.

Learn how California and Rhode Island are using health equity and environmental justice to enhance their public health responses to natural disasters and climate change.

This resource provides a roadmap for developing health equity indicators and measures and tracking the progress of health equity efforts.

Supporting Incarcerated People’s Recovery: Linkage to Care Policies for People Entering and Exiting Incarceration with Substance Use Disorder Linkage to Care Policies for Incarcerated People with SUD Explore linkage to care policies for incarcerated people with SUD across states, including SUD screening upon entry, treatment referrals, linkage post-release, and naloxone access. Individuals with substance use disorder (SUD) are more likely to be involved in the criminal justice system and experience higher rates of incarceration. They also experience disproportionately high rates of death, and the risk of overdose death does not cease upon release. Jurisdictions looking to reduce the risk of recidivism, overdose, and premature death among this population can consider policies that improve linkage to care across all stages of the criminal justice system. This report delves into these policies by state, which include screening for SUD upon entry, treatment referrals, care linkage post-release, and naloxone access. Get the Report (PDF) website yes

A Framework for Linking PRAMS with Administrative Data ASTHO, Association of State and Territorial Health Officials, prams frameworks, prams data, PRAMS, administrative data, data linkages, pregnancy risk assessment monitoring system prams, pregnancy risk assessment monitoring system, data sources, prams jurisdictions, maternal and child health, health equity, health outcomes, maternal and child health issues, social determinants of health, data analysis, linkage preparation, data linkage readiness assessment, data linkage process map, data linkage process list, public health linkages, data preparation, data linkage, research dataset creation and analysis, public health challenges, documenting processes, secure storage, appropriate linkage methods, standardizing and aligning processes, public health data Jared Parrish, Stephany Strahle, Shannon Vance This five-phase framework for linking PRAMS data can help in the preparation, execution, and analysis of linked PRAMS data and the establishment of sustainable linkage. This report offers a framework for integrating the Pregnancy Risk Assessment Monitoring System (PRAMS) with administrative data sources. Comprised of in-depth tools and resources, it can help jurisdictions create a robust systematic approach to linkages, increasing understanding of maternal and child health outcomes. The framework is broken into five main phases: linkage preparation, data preparation, data linkage, research dataset creation and analysis, and sustainability. By following its guidance, public health agencies and researchers will be able to optimize integrated data to address pressing public health challenges effectively. Get the Report (PDF) website yes

Polysubstance Use During Pregnancy and the Benefits of Universal Verbal Screening polysubstance use, universal verbal screening, health equity, polysubstance use during pregnancy, public health, substance use disorder, health problems, health care, health outcomes, prescription medications, increase the risk, risk of overdose, pregnant women, treatment programs, health service, illicit drugs, birth defects, increased risk, neonatal abstinence syndrome nas, fetal alcohol spectrum disorder, prescription drugs, multiple substances, risk factors, prescription opioids Shannon Vance Polysubstance Use During Pregnancy and the Benefits of Universal Verbal Screening Polysubstance use, the use of two or more substances, during pregnancy is common and can result in negative outcomes for both mothers and infants. This report explores the occurrence of polysubstance use in pregnancy, details the advantages of universal verbal screening in pregnancy, and emphasizes the importance of health equity in providing this care to patients. Get the Report (PDF) website yes

How Pennsylvania Health Department’s Cross-Sector Partnerships Are Strengthening Climate and Environmental Justice health department, pennsylvania department of health, climate change, low income neighborhoods, heart disease, mental health, children of color, adverse health effects, racial disparities, health equity, people of color, communities of color, public health, higher risk, health risks, race and ethnicity, family history, risk factors, social determinants of health, astho, association of state and territorial health officials For decades, Pennsylvania has worked across state government agencies on environmental justice issues. Pennsylvania has prioritized environmental justice due to the ongoing challenges of pollution and climate change faced in environmental justice areas. The state has the third most Superfund sites on EPA’s National Priorities List, and many of these sites are in low-income neighborhoods. Climate change is likely to exacerbate existing racial disparities across a broad range of health outcomes, including death, respiratory and heart disease, mental health, and heat-related illness, especially among infants and children of color. In October 2021, the state formally established the Office of Environmental Justice (OEJ) and the Environmental Justice Interagency Council (EJIC). As the first EJIC member to develop an Environmental Justice Strategic Plan, other EJIC members are now using Pennsylvania's plan as a blueprint. The plan provides a framework for continuing and building on DOH’s efforts to address health disparities associated with environmental health hazards in vulnerable communities. The strategic plan integrates environmental justice into the DOH’s internal and external processes to prioritize the needs of residents living in Environmental Justice communities. Get the Report (PDF) website yes

Overdose Prevention Policy Considerations: A Policy Playbook for State and Territorial Health Officials and Agencies overdose prevention, drug checking equipment, syringe services, health equity, reducing stigma, discriminatory policies, marginalized groups, war on drugs, underfunded communities, people of color, health care, substance use disorders, department of health, social determinants of health, illegal drug, drug enforcement administration, drug treatment, prevention strategies, federal government, federal agencies, prescription opioid, person of color, public safety, astho, association of state and territorial health officials Victoria Pless, Kayley Humm, Kaela Hurd, Arieana Love The widening racial and socioeconomic disparities in drug overdose death rates underscore the pressing need for health equity and reduced stigma in overdose prevention strategies. In addition, ongoing challenges in the illicit drug supply necessitate adjustments to overdose response protocols. State and territorial health agencies can play a crucial role in these efforts. This report details four key policy considerations that can help to prevent overdose, with a special emphasis on addressing health equity and reducing stigma. Get the Report (PDF) website yes

How State Health Departments Can Reduce Stigma to Improve Care for Patients Taking Long-Term Opioid Therapy systemic stigma, opioid therapy, chronic pain, behavioral health conditions, prescription opioids, social identities, mental health, effective care, clinical practice guidelines, mental illnesses, substance use disorder, pain relief, side effects, primary care, behavioral therapies, opioid use disorder, prescribed opioid, mental health care, pain management, relieving pain, health care systems, mental health problems, people with mental health, opioid addiction, treatment programs, astho, association of state and territorial health officials Grace DeLeon, Richa Ranade, Jessica Pough Long-term opioid therapy (LTOT)—often prescribed for chronic pain when other options have proven ineffective—is associated with negative perceptions due to the history of widespread opioid overprescription and the current overdose crisis. This stigma poses a barrier to care continuity for these patients, which is particularly concerning, as abruptly discontinuing such medication can lead to adverse health effects due to physical dependency. This resource aims to assist state and territorial health departments in mitigating stigma affecting patients already on LTOT for chronic pain, emphasizing the importance of care continuity to prevent serious health risks associated with abrupt medication discontinuation. Get the Report (PDF) website yes

A Roadmap for Using a Public Health Approach to Prevent Firearm Injury public health approach, prevent firearm injury, firearm related death, firearm violence, prevention strategies, health equity, diverse communities, risk and protective factors, racism and discrimination, access to firearms, social determinants of health, criminal justice, risk factor, determinants of health, centers for disease control, social determinants, disease control and prevention, department of health, diverse communities, preventing firearm, police officers, suicide attempts, domestic violence, young adults, leading cause of death, firearm owners, death rates, criminal justice system, astho, association of state and territorial health officials How to Prevent Firearm Injury with a Public Health Approach Firearm-related injuries and deaths pose a significant public health concern, surpassing the annual mortality rate from car crashes in the United States. The widespread impact of such incidents includes not just the loss of lives and physical injury but the psychological trauma endured by millions who have lost loved ones to firearm injury or who live in constant fear of being shot. Recognizing the complexity of the issue, health agencies advocate for a public health approach to address firearm violence, aiming to target underlying factors contributing to the well-being of Americans and to prevent future harm. This roadmap outlines a step-by-step guide for jurisdictions to enhance their efforts in firearm injury prevention, aligning with a modified version of the public health approach model developed by CDC and WHO. By leveraging the successes of this approach in addressing various health issues, jurisdictions can strengthen their infrastructure to effectively integrate firearm injury and death prevention into broader public health initiatives. Get the Report (PDF) website yes