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ASTHO Statement on the Appointment of CDC Director, Robert Redfield ARLINGTON, VA—John Wiesman, ASTHO president and secretary of health at the Washington State Department of Health, issued the following statement on the appointment of Dr. Redfield as the director of CDC. “ASTHO looks forward to meeting and building a positive working relationship with Robert Redfield, MD, the new director of the Centers for Disease Control and Prevention (CDC). As the nation’s premiere resource for public health practitioners and their partners, CDC provides critical resources, scientific expertise, and technical assistance to state, local, and national programs to strengthen public health capacity, share timely and critical information, and improve health and save lives daily.” “ASTHO believes a strong CDC is essential to the strength, economic well-being, and productivity of the American public. We are eager to share the priorities and perspectives of state health leaders and continue to ensure the use of sound scientific evidence when making policy decisions to protect, improve, and promote our nation’s public health. We are confident that Dr. Redfield will value and draw upon the expertise of state and local public health leaders as he begins his tenure as director of the agency.” ASTHO Press Release Boilerplate website yes

Government Shutdown Puts Nation’s Health at Risk Government Shutdown in 2018 Puts Nation’s Health at Risk ARLINGTON, VA—Michael Fraser, executive director of ASTHO, issued the following statement on the federal government shutdown: “We are deeply disappointed that Congress and the Administration have failed to fund the federal government. This inaction means that 50 percent of HHS staff will be furloughed, which in turn will compromise public health professionals’ ability to rapidly respond to outbreaks, detect diseases, and provide the necessary support to state and territorial health departments. Health promotion and disease prevention activities require support from a robust federal, state, and local workforce and sustained funding. The longer the federal government is shut down, the more harmful the consequences. We strongly urge Congress and the Administration to develop a long-term budget solution so we can continue our mission with certainty and in partnership with our federal partners to improve the health and wellbeing for all.” ASTHO Press Release Boilerplate website yes

Public Health Organizations Unite in Call to Restore State and Local Emergency Funding and Approve Emergency Supplemental for Zika ARLINGTON, VA—As the weather warms and the threat of Zika virus intensifies, state and local health agencies are faced with the dilemma of a significant funding cut, as documented in two new reports released by the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), the Association of Public Health Laboratories (APHL), and the Council of State and Territorial Epidemiologists (CSTE). Absent dedicated funding from Congress to prepare and respond to the threat of Zika virus, the Centers for Disease Control and Prevention (CDC) last month announced it will need to reprogram $44.25 million from the Public Health Emergency Preparedness (PHEP) fund to help combat Zika. State and local health agencies depend on PHEP funding to prepare and respond to health emergencies, everything from natural disasters to terrorist or mass casualty events. Preparing for and responding to emerging infectious disease is also a primary use of PHEP funding, meaning state and local health agencies will have less capability to find, control, and mitigate localized outbreaks of Zika as a result of the reallocation. ASTHO, in cooperation with CSTE, APHL, and NACCHO, asked their members what the consequences of the PHEP reprogramming would be, should the cuts take effect on July 1. The results raise significant concern showing that state and local emergency response will be compromised. Major findings from the surveys include the following. Community Preparedness Will Suffer the Most Both state (77%) and local (75%) respondents listed “Community Preparedness” as the area that will be most negatively affected. Scenario planning and training exercises will be curtailed or eliminated. Volunteer recruitment and training will slow or cease. Community partnerships and contracts with specialized vendors will be compromised. Laboratory Testing and Surveillance Capacity Will Diminish More than 70 percent (72%) of state respondents said they expect that functional preparedness programs, including disease surveillance, epidemiology, lab services, and mosquito control, would be negatively affected. Labs would be forced to delay or eliminate new equipment purchases or scheduled equipment maintenance. Public Health Staff Cuts State and local agencies suffered significant job losses—up to 20 percent—during and after the Great Recession that started in late 2007, and they have not come close to adding that number back since. Both state and local survey respondents report likely staffing cuts as a result of the PHEP reprogramming. Almost two-thirds (64%) of local health agencies responding to the survey said they expect to lose at least one health preparedness staff person. There is significant fear that this could worsen significantly if the reprogramming continues in future years as the threat of Zika is not expected to abate in the short term. Zika Response at State and Local Level Will Be Compromised as a Result of the Reallocation State and local health agency leaders are unified in saying the reduction of PHEP funding will harm their ability to respond to and control Zika once it establishes itself in the U.S. Our capacity to identify localized outbreaks and our capability to control and eliminate virus transmission will be slower. Local agency responders cited the following concerns: A decrease in staffing, Medical Reserve Corps (MRC) unit, or volunteer sustainability. A reduction in opportunities to provide staff trainings as well as plan and conduct exercises. An inability to conduct surveillance or epidemiologic investigations. At the state level, 61 percent of respondents say decreased PHEP funding in their state will significantly harm their ability to prepare for and respond to Zika. One respondent wrote: “The PHEP funding in [our state] is the resource we have for providing a response to Zika, and any other novel communicable disease. By reducing this funding you are reducing our ability to respond to a Zika event in [our state].” All public health sectors—federal, state, and local—have worked hard to build and sustain an all-hazards preparedness infrastructure that can deliver on their mission to protect and enhance the health and well-being of their constituents. However, large-scale emergencies, such as the 2009 influenza pandemic, Ebola, and Zika, require sufficient and reliable core funding to maintain a solid and ready public health infrastructure and additional emergency funds to provide the enhanced protections and services those living in the United States deserve and expect. Robbing the fund that sustains the all-hazards infrastructure to pay for large, widespread emergencies, no matter how necessary, ensures that infrastructure will deteriorate. Dedicated emergency funding that will enable all public health sectors to prepare for and respond to Zika is essential. ASTHO Press Release Boilerplate NACCHO Boilerplate APHL Boilerplate CSTE Boilerplate website yes

State and Territorial Health Officials Respond to New CDC Report That Finds Zika Infection During Any Trimester Can Lead to Severe Birth Defects ARLINGTON, VA—In response to a new CDC report on the impact the Zika virus may have on pregnancy outcomes, the Association of State and Territorial Health Officials (ASTHO) calls on public health leaders nationwide to remain vigilant and focused on preventing the risk of Zika infection in the continental United States and the U.S. territories. The report includes data from pregnancy registries in the U.S. territories and Pacific freely associated states, including American Samoa, Puerto Rico, the Federated States of Micronesia, the Republic of Marshall Islands, and the U.S. Virgin Islands, and is the largest study of its kind to look at completed pregnancies with laboratory confirmation of Zika virus infection. Five percent of women in the U.S. territories who had a confirmed Zika virus infection during their pregnancy had a baby or fetus with Zika-related birth defects, consistent with the findings of a similar CDC study on Zika-related birth outcomes in the continental United States. “Our territorial health officials have unique public health needs and budgetary challenges that make addressing major public health threats different in many ways from those of the fifty states, even though we see similar rates of Zika-related birth defects,” says Michael Fraser, ASTHO’s executive director. “The new CDC study shows how Zika virus infection in the territories remains a concern and we must support our territorial health officials to sustain their responses to this public health threat.” Health officials say robust reporting, monitoring, and birth defects surveillance systems are key to understanding the magnitude of the risk of Zika infection during each trimester. The effects of Zika during pregnancy are not always recognizable at birth, and these systems provide important data to help identify and facilitate access to clinical care and support services for infants and their families. With this latest study, states and territories now have sufficient data to begin to develop preliminary estimates of risk for each trimester. Among the women with confirmed Zika infection during the first trimester, nearly 1 in 12 (8%) had a baby or fetus with Zika virus-associated birth defects. About five percent of women infected during their second trimester and four percent infected in their third trimester had babies with Zika-related birth defects. Zika poses a serious threat to pregnant women and their babies, regardless of when the infection occurs. Currently, CDC’s National Center on Birth Defects and Developmental Disabilities is operating the U.S. Zika pregnancy registry using FY17 emergency funds allocated for Zika response. States and territories report data from their registries to the CDC, which aggregates and publishes data for the nation. The Center’s emergency funding to states and territories for birth defects surveillance—a separate funding stream from pregnancy surveillance—expires July 31, 2017. Pregnancy surveillance funding, as well as emergency funding for additional epidemiology, laboratory services, and mosquito control, expires July 31, 2018, although states may expend those dollars sooner based on what occurs during this summer’s potential outbreak. Ensuring robust surveillance capacity is essential for local, state, territorial, and federal public health officials and healthcare providers to direct efforts to monitor and provide care for infants affected by Zika virus and their families. “It is too early to say that the threat of a major Zika virus infection outbreak this summer has passed,” Fraser adds. “Even though Zika cases have been on the decline, the conditions for increased local transmission this summer are good—and that should concern us all. A mild winter in many states and an active mosquito season early this year means we must be very, very vigilant in our surveillance and prevention efforts. We have models of mosquito-borne virus infection and models of sexually-transmitted virus infection. Zika involves both, which makes modeling very difficult. State and territorial health departments rely heavily on data to deploy coordinated public health responses to Zika virus, but the current funding landscape potentially jeopardizes these efforts, especially in the territories that have different needs, unique geographies, and a very different interface with CMS through their jurisdictions’ Medicaid programs.” ASTHO commends Congress for providing supplemental funding for FY17 to ensure rapid response capabilities to address the Zika crisis and health officials are concerned by the President’s FY18 proposed budget cuts to the CDC and other federal agencies that support public health efforts, including Zika response. ASTHO urges Congress to provide adequate funding in the FY18 appropriations bills to address this ongoing public health threat in our states and territories. ASTHO Press Release Boilerplate website yes

ASTHO Recognizes Georgia’s Public Health Champions ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) is honoring 15 Georgians who are world-renowned public health leaders during an event today hosted by Emory University’s Rollins School of Public Health, and supported in part by the Healthcare Georgia Foundation and the CDC Foundation. Each of these outstanding “Georgia Giants in Public Health” honorees is being recognized for their leadership and dedication to improving the lives and well-being of not just communities in Georgia, but across the nation and around the world. “I am not sure every Georgian knows the rich history of public health that Atlanta has served to nurture, but they should be proud of Georgia today,” says Michael Fraser, ASTHO’s executive director. “This state is home to leaders that helped end smallpox, eradicated Guinea worm, developed the national strategy to control HIV/AIDS, cut tobacco use to record lows, reduced health disparities, and established global immunization programs. In short, the work of these committed Georgia Giants has improved the lives of millions—even billions—worldwide. For that, our nation is truly grateful and our leaders are here today in Atlanta to share our thanks and recognize Georgia’s many contributions to public health.” As ASTHO celebrates its 75th anniversary this year, we reflect on how Atlanta-based institutions like the CDC have shaped generations of public health leaders, contributing to ASTHO’s legacy and commitment to advancing the important work of public health. The Georgia’s Giants in Public Health awards honor transformational state and territorial government leaders and alumni, along with those working at the federal level and with non-governmental organizations to protect and promote our nation’s health. The Georgia Giants in Public Health honorees include: Former U.S. President Jimmy Carter and Former First Lady Rosalynn Carter. James W. Curran, MD, MPH, for his many contributions to disease prevention and epidemiology, as well as his leadership in the field of HIV/AIDS research and outreach. Michael P. Eriksen, ScD, for his contributions to tobacco control, social and behavioral science, and urban and global health. Brenda Fitzgerald, MD, for her leadership as commissioner of the Georgia Department of Public Health, directing the state’s 18 public health districts and 159 county health departments. William H. Foege, MD, MPH, for his many achievements as a champion of child survival and development, as well as contributions to domestic and international health policies, disease eradication and control, and reducing the impact of smallpox. Tom Frieden, MD, MPH, for his numerous achievements in a career dedicated to public health, including leadership as CDC director. Jeffrey P. Koplan, MD, MPH, for his many achievements in epidemic intelligence and infectious disease. Judith Monroe, MD, for her many contributions and continued focus on strengthening public-private partnerships, as well as her leadership as chief executive officer of the CDC Foundation, director of CDC’s Office for State, Tribal, Local and Territorial Support, and her service as a state health official in Indiana and president of ASTHO. Gary Nelson, PhD, for his many contributions to health improvement and healthy aging, as well as his leadership in cancer prevention and control. David A. Ross, ScD, for his pioneering career in public health informatics, as well as his leadership as chief executive officer for the Task Force for Global Health and director of the Public Health Informatics Institute. David Satcher, MD, PhD, for a career dedicated to public health, including numerous contributions in disease prevention and multicultural health disparities, and leadership as the 16th Surgeon General of the United States, assistant secretary for health at HHS, and CDC director. C. Wade Sellers, MD, MPH, for his distinguished public health career, as well as the career of his grandfather, Thomas Fort Sellers, who served as director of the Georgia Department of Public Health from 1948 to 1960, where he developed the tool for rapid diagnosis of rabies. Louis W. Sullivan, MD, for his efforts to enhance health literacy and advance healthy behaviors, as well as his leadership as the 17th HHS secretary and founding dean of the Morehouse School of Medicine. Phillip L. Williams, PhD, for his many achievements in research and toxicology, as well as his leadership as founding dean of the College of Public Health at the University of Georgia. “It is truly wonderful to have an opportunity to celebrate the achievements of Georgia’s public health champions,” says Brenda Fitzgerald, MD, commissioner of the Georgia Department of Public Health and ASTHO’s president-elect. “The men and women honored here inspire us all as they continue to transform public health. I am privileged to serve as the public health commissioner in a state with such incredible resources and leadership.” ASTHO Press Release Boilerplate website yes

State Health Officials to Congress: Act on Zika Funding Now ARLINGTON, VA—While Congress debates the future of federal funding for Zika preparedness and response, the Zika virus continues to spread. Rising case numbers and new information about long-term consequences of the infection highlight the urgency of mounting a major response. For the sake of our nation’s health, our representatives in Washington must come together and approve a bill to fund needed Zika preparedness response efforts and keep our nation’s public health infrastructure strong and secure. This national and state public health emergency requires a coordinated and properly resourced effort at the federal, state, and local levels. The nation’s state and territorial health officials stand ready to be part of that effort.   Zika virus is likely to continue to spread and is here to stay. While there is still much to learn about the virus and its health impacts, what we know already justifies an aggressive response. The virus has a potentially devastating impact on fetal development, and we are learning more about the risk of long-term health impacts for adults who become infected. We also know that federal agencies and state and territorial health departments are inadequately funded to respond to this crisis. There is an urgent need for additional resources to shore up mosquito control efforts, educate the public, increase public laboratory capacity, provide help to families with infants exposed to Zika, and follow up with pregnant women who may have been exposed to Zika at home or abroad. Due to the urgency of this threat, state and federal health agencies have been forced to divert resources from other critical public health programs to pay for Zika response. We agree that this robbing-Peter-to-pay-Paul approach, described by Centers for Disease Control and Prevention Director Dr. Tom Frieden and National Institute of Allergy and Infectious Diseases Director Dr. Anthony S. Fauci in their August 31 Washington Post editorial, is the wrong way to fight the Zika epidemic. We need a focused, coordinated, and adequately funded response to Zika while continuing to support the other essential work health agencies do to protect the public. For this to happen, Congress must act now. “We urge Congress to recognize that this is a serious, nonpartisan threat and to come together to pass emergency funding so that the public health system can effectively respond to Zika while simultaneously preparing for myriad other health threats like Ebola, natural disasters, and the upcoming influenza season,” said ASTHO President and Minnesota Commissioner of Health Edward P. Ehlinger, MD, MSPH. In the absence of dedicated funding for Zika response, public health officials must fund Zika efforts by redirecting funds away from other important functions such as the all-hazards preparedness efforts of state and territorial health agencies that enable them to rapidly respond to public health emergencies of all kinds. This approach leaves us in a precarious position as Zika will not be the only public health emergency that state and territorial health agencies face. States are tasked with minimizing and mitigating the health effects of hurricanes, tornadoes, terrorist attacks, chemical spills, and all kinds of other manmade and natural emergencies. Preparation and response to Zika is a massive undertaking, and Congressional inaction is handcuffing states, limiting their ability to prepare and respond to emergency situations. It has been months since public health officials first began calling for Zika funding, and Congressional delay lays bare the inadequacy of America’s piecemeal approach to funding public health emergency responses. In addition to properly funding a Zika response, we also need to create a permanent, FEMA-style Public Health Emergency Fund to facilitate an immediate response to public health emergencies. Public health crises arise independent of the Congressional calendar, and such a fund would allow for a rapid response rather than redirecting public health funding from other critical priorities. Federal and state health agencies are obligated to protect health and wellness nationwide. We believe Congress is similarly obligated to support the critical health protection efforts in partnership with the states. As Drs. Frieden and Fauci stated, we should be working tirelessly to respond to and slow the spread of Zika infections and support those families whose newborns have been affected by this virus. We are ready to do that, but we need support from Congress now to make it happen. ASTHO Press Release Boilerplate website yes

On March 3, 2025, ASTHO announced that Susan Kansagra would be joining the organization as Chief Medical Officer.

Recording Available: State Health Leaders Outline Respiratory Virus Season Strategies During ASTHO Briefing ARLINGTON, VA — Ahead of the fall respiratory virus season, the Association of State and Territorial Health Officials (ASTHO) hosted a deskside media briefing with public health leaders to discuss the importance, efficacy and safety of vaccines and the role they play in reducing the burden of respiratory illness. "Reliable studies show that vaccines are critical tools which offer protection against serious respiratory illnesses such as seasonal influenza, COVID-19, and RSV. Vaccines and boosters strengthen protection and improve the chances that any infections will be less severe in children and adults this fall and winter,” says Scott Harris, MD, MPH, ASTHO president and state health officer, Alabama Department of Public Health. “Routine childhood vaccination has been proven safe and effective, flu shots are recommended for everyone age 6 months and older with a few exceptions, and RSV vaccine helps protect pregnant women and older adults against hospitalization and death.” “Connecticut ranked highest in the country for two-dose measles vaccination rate among kindergarteners and our other increasing immunization rates stand in contrast to the national decline," says Manisha Juthani, MD, ASTHO president-elect and Connecticut Department of Public Health commissioner. "Our high vaccination rates have helped Connecticut remain one of nine states that has not had a case of measles yet as cases continue to accumulate around the country. Staying up to date on routine vaccines, particularly as we head into back-to-school and cold and flu season, is crucial for protecting families from preventable diseases and maintaining community-level immunity. We cannot predict which respiratory viral infection will be most prevalent this season, but we can protect our families against them and potential severe complications by getting vaccinated this fall." “There are signs that disinformation and confusion have impacted how parents have vaccinated their kids both for regular school-based vaccines and for respiratory viruses. This is a trend we need to really be concerned about,” says Ayanna Bennett, MD, MSPH, director of the District of Columbia Department of Health. “Children have special vulnerabilities, and we want to be sure that if we have protection, we are delivering it to them.” View a recording of ASTHO’s deskside media briefing. ASTHO Press Release Boilerplate website yes

Recording Available: State Health Leaders Convene During ASTHO Deskside Briefing to Rally Behind Chronic Disease Prevention in U.S. ARLINGTON, VA — On June 24, the Association of State and Territorial Health Officials (ASTHO), convened state health officials for a deskside media briefing focused on the impact of nutrition on chronic disease prevention in the United States. The event highlighted how strategic public health investments can help reduce chronic disease nationwide and help Americans lead healthier lives. “We know chronic disease is a leading cause of death in the United States. It’s something that state health departments have particularly been working on for a long time," says ASTHO Chief Medical Officer Susan Kansagra, MD, MBA, who moderated the discussion. “Obesity makes every chronic disease harder, it just makes life harder. I’m thrilled that this is a national priority. I welcome it,” says James McDonald, MD, MPH, commissioner of health, New York State Department of Health. “I think if we can get our handle on obesity as a nation then this is just one of the ways you can make us all healthier again.” “I am ecstatic that we as a nation and here in the state of Indiana with our Make Indiana Healthy Again plan are talking about nutrition and physical activity,” says Lindsay Weaver, MD, state health commissioner, Indiana Department of Health. “Frankly, it’s going back to the basics. It’s educating new moms and families. It’s working closely with our schools and education.” “Our legislators see the problem in their communities and we are working with them to be a part of the solution. Here in Tennessee, the General Assembly recently passed a law to expand the amount of time children have to be physically active at school,” says Ralph Alvarado, MD, commissioner, Tennessee Department of Health. Dr. Alvarado also discussed valued partnerships with faith-based communities, volunteer Health Councils which exist in every county in Tennessee, and the growing interest in ‘Blue Zone’ concepts -including in many rural parts of the state.” View the recording of ASTHO’s deskside media briefing. ASTHO Press Release Boilerplate website yes

Public Health Leaders’ Joint Statement in Response to the Attack on CDC In response to the horrific shooting that occurred on Friday, August 8, targeting the Centers for Disease Control and Prevention (CDC), the public health community stands in solidarity with our CDC colleagues. We denounce acts of harassment, terror, and violence against the public health workforce. Our hearts break for the family of police officer David Rose who lost his life protecting his community. Two hundred bullets struck and caused damage to six federal buildings and over 500 rounds were fired at the CDC campus. We are saddened, alarmed, and deeply concerned about the health and safety of our colleagues. The shooting was an attack on an American workplace and on the people and infrastructure that keep us all healthy and safe. We are committed to working together to support our nation’s dedicated public servants who comprise the public health workforce and call on others to do the same. It is critical to the health of all communities that CDC and all people working in public health across the country are able to continue to make their invaluable contributions to advancing health and well-being without the fear of harassment or violence. People choosing public health as a profession are committed to advancing our nation’s health and recognize that good health in every community benefits everyone. It is our hope that all Americans will stand with us to support the vital role that CDC and the entire public health workforce play in supporting safety and well-being in every community. Their expertise and commitment to advancing health deserves all Americans’ unwavering support. American Public Health Association Association of Maternal and Child Health Programs Association of Public Health Nurses Association of State and Territorial Dental Directors Association of State and Territorial Health Officials Association of State and Territorial Public Health Social Workers Association of Public Health Laboratories  Association of Schools and Programs of Public Health Big Cities Health Coalition CDC Foundation Council of State and Territorial Epidemiologists de Beaumont Foundation National Association of Chronic Disease Directors National Association of County and City Health Officials National Network of Public Health Institutes Prevention Institute Public Health Accreditation Board Safe States Alliance The Kresge Foundation Trust for America’s Health website yes

ASTHO Honors 2015 Public Health Heroes SALT LAKE CITY—The Association of State and Territorial Health Officials (ASTHO) is pleased to announce the winners of the 2015 ASTHO public health heroes awards. Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases and assistant surgeon general, was awarded the National Excellence in Public Health Award. Schuchat has made vital contributions to preventing infectious diseases in children. She led the development of CDC′s guidelines on perinatal group B streptococcal disease, which resulted in an 80 percent reduction in newborn infections and a 75 percent narrowing of racial disparities among sufferers. She previously worked in West Africa on meningitis vaccine studies, South Africa on surveillance and prevention projects, and China on SARS emergency response. Sylvia Pirani, director of the Office of Public Health Practice within the New York State Department of Health, received the State Excellence in Public Health Award. Pirani has been a driving force behind the New York State Prevention Agenda 2013-2017, the five-year state health improvement plan to make New York the healthiest state in the nation, and was instrumental to assembling a large network of partners across the state to improve understanding of the social determinants of health and promote the Health in All Policies approach. José T. Montero, vice president of population health and health systems integration at Cheshire Medical Center/Dartmouth-Hitchcock Keene, is the 2015 McCormack Award winner. Established in 1950 to honor Arthur T. McCormack, a Kentucky state health official, the McCormack Award is presented each year to a current or former public health official who has served for at least 10 years, been a chief state health official for at least five years, demonstrated excellence, and made a significant contribution to the knowledge and practice of the field. From 2008 to 2015, Montero was the public health director at the New Hampshire Department of Health and Human Services, Division of Public Health Services, and served as ASTHO president from 2012-2013. He is a leader in developing population health at the national level and integrating public health and healthcare to improve population health outcomes. The Noble J. Swearingen Award was awarded to Guthrie S. Birkhead, deputy director of New York State Department of Health. Since 1979, the Swearingen Award, named for a former ASTHO executive director, has been bestowed on one individual in public health administration who has five or more years of experience in a state health agency, and five or more years in service to the ASTHO Senior Deputies Committee or in some other capacity. Birkhead is a communicable disease epidemiology specialist whose work in New York includes directing the Center for Community Health, AIDS Institute, Center for Environmental Health, Wadsworth Center Laboratory, Office of Public Health Practice, Office of Health Emergency Preparedness, and Office of Public Health Informatics and Project Management. The Presidential Meritorious Service Award is given by the ASTHO president to honor a health leader who has made outstanding contributions to ASTHO and state public health. This year, ASTHO President Jewel Mullen recognized Joycelyn Elders, the sixteenth Surgeon General of the United States. Elders was the first African American and second woman to head the U.S. Public Health Service. Elders grew up in a rural, segregated, poverty-stricken pocket of Arkansas before becoming the first person in Arkansas to be board-certified in pediatric endocrinology. She is a professor emeritus at the University of Arkansas for Medical Sciences, and remains active in public health education. ASTHO’s Alumni Award is presented to a former chief state health official who has demonstrated his or her continued commitment to public health. This year’s Alumni Award winner is Bob Harmon, a physician executive at Cerner Corporation and director of the Missouri Department of Health from 1986 to 1990. Harmon has authored more than 70 publications dealing with health information technology, quality improvement, managed care, primary care, public health administration, and health policy. ASTHO in honored to recognize these public health leaders for their dedication and service to improving health and wellness. ASTHO Press Release Boilerplate website yes

The Association of State and Territorial Health Officials Challenges Members to Promote Health Equity and Health in All Policies ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) and ASTHO President and Minnesota Department of Health Commissioner Edward Ehlinger have issued the 2016 ASTHO President’s Challenge: Advancing Health Equity and Optimal Health for All. The challenge is based on the Triple Aim of Health Equity, a framework weaving together three core elements of public health practice and policy which recognize that health status is influenced by a host of factors—most of them outside the healthcare system. The 2016 challenge calls upon states and territories to: (1) expand their understanding of what creates health, (2) implement a Health in All Policies (HiAP) approach with health equity as the goal, and (3) strengthen community capacity to create their own healthy future. The challenge encourages states and territories to broaden their approaches to advancing health equity and improving the health of all their residents by adopting the foundational public health practices embodied in the Triple Aim of Health Equity. The challenge will be to use these practices to address a policy, program, or activity issue within their jurisdictions in the next year. “The dominant narrative in America is that health is the responsibility of individuals until they get sick, and then health becomes the responsibility of the healthcare system,” Ehlinger says. “This outdated narrative allows little room for community or social influences, and its deficiency is clear when you look at the health disparities in this country and our overall health outcomes relative to other developed nations.” The challenge specifically targets health inequities that plague a number of groups that have been disadvantaged in America. As the nation becomes more diverse, the impact of unaddressed inequities will become more evident and alarming. According to the U.S. Census Bureau, 50.4 percent of children 1 year of age and younger belong to a minority group as of July 2011. By 2044, a majority of the entire U.S. population will belong to a minority group. Yet research shows that minority populations are disproportionately affected by higher rates of poverty, decreased graduation rates, and food and housing insecurity—factors that decrease their opportunities to be healthy. The new challenge will use three core elements of public health practice that make up the Triple Aim of Health Equity approach to elevate the profile of advancing health equity and creating optimal health for all. ASTHO will support state and territorial health officials and partners who accept the challenge by providing technical assistance and support, sharing best practices and success stories, and facilitating information exchange and opportunities for collaboration around health equity and HiAP approaches. Ehlinger has recently presented on the challenge to CDC, the Institute of Medicine Committee on Community Based Solutions to Promote Health Equity in the United States, and multiple professional groups around the country. “The 2016 ASTHO President’s Challenge recognizes that good health does not begin with treating illness. Our health status arises from our everyday environments, activities, and the people around us,” says Sharon Moffatt, ASTHO interim executive director. “We are proud to work with Dr. Ehlinger to promote health equity and optimal health for all. When we build healthier communities, we all benefit.” In November, U.S. Surgeon General Vivek Murthy joined Ehlinger during the Health Equity in All Policies panel at the American Public Health Association’s 2015 Annual Meeting, where Murthy voiced his support for the new President’s Challenge. “Reducing disparities in health will give everyone a chance to live a healthy life and improve the quality of life for all Americans,” says Murthy. To learn more about the 2016 ASTHO President’s Challenge, visit: www.astho.org/Health-Equity/2016-Challenge. ASTHO Press Release Boilerplate website yes

New platform will provide forum for data exchange, analysis, and visualization to support public health work

Multistate Measles Outbreak Drives Up State Health Agency Costs and Points to Importance of Quality Immunization Communication ARLINGTON, VA—With the Disneyland measles outbreak up to 87 cases in seven states as of Jan. 26, state health departments are responding to the disease by educating primary care providers and the public about measles and conducting contact tracing. Measles is airborne and one of the most contagious diseases in existence-it can linger in a room for up to two hours after the infected person has left. It also remains pervasive around the world and can easily be imported into other countries. WHO reports that although measles deaths decreased by 73 percent worldwide between 2000 and 2013, measles still caused 145,700 deaths globally in 2013. "Measles was declared eliminated in the United States in 2000. Sadly, this status is endangered," says Paul Jarris, MD, MBA, Association of State and Territorial Health Officials (ASTHO) executive director. "Many parents and physicians have never seen a case of measles before. This outbreak demonstrates why we can never let our guard down against vaccine-preventable diseases." Due to its highly infectious nature, health departments have to respond rapidly and thoroughly to contain outbreaks and save lives. If a measles patient has traveled to school, the grocery store, or any other public space, a large group of people may have been exposed to the disease. State health departments are responsible for ensuring that patients are isolated to prevent further spread. They then identify potential contacts, educate them about measles symptoms, advise them on when to go to the doctor, and encourage them to become immunized if they aren't already. "At ASTHO, I'm proud of the work that the California Department of Public Health and other states are doing to protect our children by containing this outbreak, preventing future ones, and bringing us closer to maintaining full elimination status," Jarris says. In addition to the time spent containing a measles outbreak, responding to them is expensive for state and local governments. A March 2014 study found that there were 16 measles outbreaks in 2011 that resulted in 107 cases, which cost local and state public health departments an estimated $2.7 million to $5.3 million. However, these outbreaks and their time and economic burdens are preventable. Every dollar spent on the child measles, mumps, and rubella vaccine saves $23.30, according to CDC. "This is an important opportunity for public health to continue to articulate the benefits of immunization," says Kathy Talkington, ASTHO's senior director of immunization and infectious disease. "This measles outbreak illustrates that we live in a global world, and as long as these diseases exist in other countries, we must continue to protect ourselves in all communities through high immunization rates." See ASTHO's blog StatePublicHealth.org for the full article on the measles outbreak, as well as tips on how public health professionals can communicate with the public and primary care providers about how vaccines can prevent outbreaks and save lives. ASTHO Press Release Boilerplate website yes

ASTHO Announces Top Five Public Health Legislative Priorities for 2026 ARLINGTON, VA — The Association of State and Territorial Health Officials (ASTHO) released its top five state public health policy issues for 2026, which provide expert analysis on legislative priorities that will shape public health in the coming year. ASTHO’s annual Legislative Prospectus Series provides concise, evidence-based policy guidance for public health leaders, lawmakers, and other decision makers preparing for state and territorial legislative sessions. “ASTHO’s Legislative Prospectus Series equips policymakers and public health leaders with clear, data-informed guidance that allows them to effectively address the nation's and territories’ most urgent health challenges,” says ASTHO CEO Joseph Kanter, MD, MPH. “This work is central to ASTHO’s mission to advance the public’s health and well-being. In 2026, infectious disease control and access to behavioral health services are among the most pressing issues. Strengthening public health funding and closing care gaps across populations also remain key legislative priorities." ASTHO’s top five public health policy issues to watch in 2026 include: Public Health Funding and Administration Long-term funding stability for public health agencies will remain a priority. In 2026, ASTHO expects lawmakers to create contingency or rainy-day funds in the event of reduced federal support. Other legislation may focus on promoting regionalization and forming partnerships across state lines to improve data sharing as well as shared service and resource models within local health departments. Behavioral Health States and territories will continue to advance policies that prevent substance misuse and reduce mental health-related harms. Legislatures may increase support for mobile crisis units, improve coordination across the crisis care continuum and invest in long-term funding models. States are also expected to pursue laws that reduce barriers to medications for opioid use disorder, expand coverage for peer support specialists and connect individuals leaving incarceration to treatment services. Infectious Disease Prevention Policymakers in 2026 will continue to weigh public health authority changes and laws that impact vaccination access and sexually transmitted infections (STIs) prevention strategies. States may consider legislation that affects school immunizations, state vaccine purchasing programs, and insurance coverage mandates. Legislation may also include increasing routine testing for STIs in high-risk communities and expanded distribution of prevention tools like doxy-PEP. Access to Care ASTHO anticipates states and territories to consider legislation that addresses access to care across populations. Policies may support coverage and sustainable financing for community-based health professionals such as community health workers, doulas, and peer support specialists. Lawmakers may also pursue measures that support access to over-the-counter contraception and reproductive care as well as ensure the continued availability of remote care through telehealth, particularly in rural areas. Healthy Food and Chronic Disease Prevention In 2026, ASTHO expects increased legislative activity that aims to expand access to healthy food and reduce the prevalence of chronic disease. Legislation may focus on combating food deserts, reducing sugar consumption, and promoting nutrition through public procurement policies. Legislators may also support broader insurance mandates to cover chronic disease screenings and treatments. For more analysis and policy trends, visit ASTHO’s Legislative Prospectus Series. ASTHO Press Release Boilerplate website yes

State and Territorial Health Agencies Play Critical Role in Addressing Antimicrobial Resistance ARLINGTON, VA — As the threat of antimicrobial resistance (AMR) rises throughout the world, the White House has convened more than 150 major food companies, retailers, and human and animal health stakeholders to commit to implementing changes over the next five years to slow the emergence of antibiotic-resistant bacteria, detect resistant strains, preserve the efficacy of our existing antibiotics, and prevent the spread of resistant infections. In recognition of today’s White House Forum on Antibiotic Stewardship, ASTHO commits to supporting the state and territorial health agency role in operationalizing the White House’s five-year National Strategy for Combating Antibiotic-Resistant Bacteria. “State health agencies are poised to play a crucial role in the prevention of antimicrobial-resistant organisms due to our long history with infectious disease surveillance and control,” says Arkansas Director and State Health Officer Nathaniel Smith, who represents ASTHO at the forum. Antimicrobial resistance is one of the most pressing public health concerns today, and there is a critical need for comprehensive programs to address this threat. CDC’s report Antibiotic resistance threats in the United States, 2013 provides an overview of the burden that AMR poses to the United States, including over two million illnesses and 23,000 deaths annually. “If we're not careful, we will soon be in a post-antibiotic era,” CDC Director Tom Frieden says. “For some patients and some microbes, we are already there.” State and territorial health agencies play an essential role in addressing resistance because they are responsible for protecting patients across the healthcare system and serve as a bridge between healthcare organizations and the community. With adequate capacity and resources, they can help fight AMR by coordinating and facilitating prevention activities, monitoring resistance across the state, leveraging existing partnerships and resources, and developing policies to improve antimicrobial stewardship through prescribing and use best practices. ASTHO’s stewardship report Combating Antibiotic Resistance: Policies to Promote Antimicrobial Stewardship Programs and web pages describe current state activities across the spectrum of healthcare settings and present a range of opportunities for health agencies to develop or enhance stewardship policies and activities. In a July 2013 survey of healthcare-associated infection coordinators, 69 percent of respondents reported conducting antimicrobial stewardship activities. A May 2014 inventory of state health agency activities found that 33 percent have conducted antimicrobial stewardship needs assessments and 52 percent have partnered to provide antimicrobial stewardship education. State and territorial health agencies are critical to addressing AMR and implementing stewardship activities. They can capitalize on new opportunities through the National Strategy, establishing themselves as leaders in this area and building capacity to engage in antimicrobial stewardship needs assessments, education, and implementation. These activities will protect patients across the continuum of care as well as the community, and will preserve the effectiveness of antibiotics for the future. ASTHO is honored to further this work through the White House Forum on Antibiotic Stewardship and supporting the National Strategy. See ASTHO's blog StatePublicHealth.org for the full article on state and territorial health agencies’ AMR activities. ASTHO Press Release Boilerplate website yes

Utah, Colorado, Tennessee, and Missouri Win ASTHO Vision Awards for Innovative Projects SALT LAKE CITY—Today the Association of State and Territorial Health Officials (ASTHO) presented its 2015 Vision Awards to the Utah Department of Health, Tennessee Department of Health, Colorado Department of Public Health and Environment, and Missouri Department of Health & Senior Services. The ASTHO Vision Awards are presented annually to recognize outstanding state and territorial health department programs or initiatives that demonstrate creative and innovative approaches to address public health needs or challenges. The Vision Awards promote awareness and provide peer recognition to successful state and territorial health programs. ASTHO presents Vision Awards in two categories: programs with budgets greater than $250,000 and programs with budgets less than $250,000. Applications are judged by experts and leaders in state public health based on innovation, program effectiveness, and potential for replication. This year, Utah’s Electronic Message Staging Area (EMSA) Program won first place in the Vision Award category for programs with budgets greater than $250,000. EMSA is an extensive rules engine that automatically processes incoming reportable disease laboratory data and manages how the data is processed and inserted into Utah’s disease surveillance system. Since its implementation, the volume of lab results that public health receives has increased by 400 percent. Colorado’s Retailing Marijuana Health Monitoring and Prevention Program won second place for programs with budgets greater than $250,000. As the first state to allow sales of retail marijuana, Colorado developed the first systematic literature review on the potential public health impacts of marijuana, guidance for public health surveillance, and an education and prevention campaign to focus on public health impacts, such as preventing or delaying youth initiation, preventing use among pregnant and breastfeeding women, and reducing secondhand marijuana smoke exposure. The first place Vision Award winner for programs with budgets less than $250,000 is Tennessee’s Innovate to Accelerate: Achieving Excellence in Public Health program, a continuous quality improvement (QI) program designed to align all of the Tennessee Department of Health’s work processes with the agency mission. It addressed core public health functions through the lens of the six-process criteria of the Baldrige Framework: training staff in rapid cycle improvement tools, supporting staff to achieve QI utilizing the Baldrige Framework, and building a network for training utilizing experienced examiners. Missouri’s Disease Electronic Surveillance with Trigonometric Models (DESTEM) won second place in the category for programs with budgets less than $250,000. DESTEM is an interactive visual analytical system that allows for accurate and timely detection of the communicable disease outbreaks. The system produces the typical epidemiological graphs and reports, but also allows an epidemiologist to tailor disease surveillance parameters to see data from different angles. Unlike a static report, its interactive approach to surveillance analysis gives epidemiologists the ability to perform more in-depth analysis, enabling them to make better-informed decisions. ASTHO Press Release Boilerplate website yes

Association of State and Territorial Health Officials Announces New Leadership Appointments SALT LAKE CITY—Edward Ehlinger, commissioner of the Minnesota Department of Health, was elected president of the Association of State and Territorial Health Officials (ASTHO) during the association’s annual meeting. Brenda Fitzgerald, commissioner for the Georgia Department of Public Health, was elected as secretary-treasurer at the same meeting. Jay Butler, chief medical officer and director of the Division of Public Health at Alaska Department of Health and Social Services, became president-elect. All appointments take effect immediately. Ehlinger has served as Minnesota’s health commissioner since January 2011. Previously, he was the director and chief health officer for Boynton Health Service at the University of Minnesota, as well as director of personal health services for the Minneapolis Health Department. He has been honored with the Albert Justus Chesley Award from the Minnesota Public Health Association, the Advancement of Justice Award from the Hennepin County Bar Association, the first Ed Ehlinger Award from CityMatCH, and the Physician Communicator Award from the Minnesota Medical Association. In Minnesota, he is famous for his “Pitch the Commissioner” tours, where he travels to different counties and invites their citizens to join him in a game of horseshoes as they share ideas about what their communities need to be healthy. Fitzgerald is a board-certified obstetrician-gynecologist and a fellow in anti-aging medicine. Prior to her current role as George’s health commissioner, Fitzgerald served on the Georgia OB-GYN Society’s board and as its president. She also worked as a healthcare policy adviser with House Speaker Newt Gingrich and Sen. Paul Coverdell. As a major in the U.S. Air Force, Fitzgerald served at the Wurtsmith Air Force Base in Michigan and the Andrews Air Force Base in Washington, D.C. In 2012, Fitzgerald led the launch of Georgia SHAPE, a childhood fitness and obesity reduction program that received formal commendation from the President’s Council on Fitness, Sports & Nutrition in 2014. Butler was appointed chief medical officer and director of the Division of Public Health at Alaska Department of Health and Social Services in 2014. Previously, he was senior director for community health services at the Alaska Native Tribal Health Consortium in Anchorage, where he was also a clinical infectious diseases consultant and medical director for infection control and employee health. Butler served as a U.S. Public Health Service medical officer for more than 23 years, and participated in a number of emergency deployments, such as heading the H1N1 Vaccine Task Force at CDC and being a team co-leader during the CDC responses to the SARS outbreak of 2003, avian influenza in 2004, and Hurricanes Katrina and Rita in 2005. In 2010, he received ASTHO’s National Excellence in Public Health Award.    Jewel Mullen, commissioner of the Connecticut Department of Public Health, became immediate past president; and Terry Cline, commissioner of the Oklahoma State Department of Health, became past president. All ASTHO offices are one-year positions. ASTHO Press Release Boilerplate website yes

Recording Available: ASTHO Members Discuss Rural Health Improvement Strategies During Deskside Media Briefing ARLINGTON, VA — On November 17, the Association of State and Territorial Health Officials (ASTHO) convened members from Iowa, Maine, and Mississippi to discuss rural health. Residents living in rural areas face many health challenges including access to care, transportation, workforce development, outdated infrastructure and technology, and more. With a recent spotlight on rural health due to the Rural Health Transformation Program, officials discussed successes and challenges tied to rural health setting the stage for a healthier future. “Targeted investments in rural healthcare are essential for improving outcomes in Mississippi communities,” said Daniel Edney, MD, state health officer for the Mississippi State Department of Health and ASTHO president-elect. “We are so excited in Mississippi to have this incredibly important opportunity to invest in rural health care. Over half of Mississippians live in rural areas. We know, as we invest and make the strategic, meaningful investments into rural health care in our state, we will improve rural health outcomes, which is really what is important for us.” “One of the most important parts of rural health transformation efforts is that rural health challenges don’t follow state borders,” said Robert Kruse, MD, MPH, state medical director for the Iowa Department of Health and Human Services. “Patients cross county and state lines for care needs, our workforce moves across regions, and the issues we are addressing whether chronic disease, behavioral health, maternal health... these challenges are shared not just in the Midwest but across the nation.” “As one of the most rural and oldest states in the nation, Maine has made meaningful progress expanding telehealth and strengthening care in the community,” said Puthiery Va, DO, director of the Maine Center for Disease Control and Prevention. “We’re building on that momentum to close remaining gaps and support resilient ecosystems of care—so that every rural community has access to a modern, connected health system that promotes wellness, prevents illness, and advances population health across the lifespan.” ASTHO plays an important role in facilitating collaboration between states on vital issues such as rural health, Dr. Edney noted. “This is the strength of ASTHO. The three of us know each other and have been working with each other all along. I respect my colleagues and what they are doing in their states. We are all having the same challenges and the need for rural healthcare is ubiquitous across the country.” View a recording of ASTHO’s deskside media briefing. ASTHO Press Release Boilerplate website yes

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