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Learn about the role and impact of State offices of Rural Health in a Q&A with Alisa Druzba.

Partnering with Community Action Agencies Can Improve Trust in Vaccines astho, association of state and territorial health officials, association of state and territorial health officials astho, state health official, public health official, territorial health official, island jurisdictions, state health, health department, public health, state and territorial health, social determinants of health, johns hopkins, advance health equity, socially determined, health inequities, race ethnicity, covid-19 vaccines, health disparities, vaccine supply, high income countries, vaccine equity, vaccine distribution, vaccine hesitancy, immunization, centers for disease control, community action agencies, covid19 pandemic, at-risk populations, healthy equity Geetika Nadkarni Learn how community action teams are working to improve COVID-19 vaccine acceptance and uptake in their own communities. In the current climate surrounding vaccinations and other large-scale public health measures, it’s more important than ever for public health to engage communities. One way to do this is through working with community action agencies (CAAs), local entities that work to reduce poverty and reduce disparities among the populations they serve. Funded through the Community Services Block Grant (CSBG), CAAs are an ideal complement to public health’s mission to address the social determinants of health and achieve greater equity. With support from CDC, ASTHO is working with the National Community Action Partnership and five CAAs in the Partnering for Vaccine Equity project, which aims to increase acceptance and uptake of vaccines among racial and ethnic minority groups and in rural communities. ASTHO chose to partner with CAAs as trusted community agents for this project because of their existing relationships within communities through programs such as Head Start, food banks, federal nutrition programs, and employment and housing assistance. Through their internal and external partnerships, they can reach people who may be concerned about vaccine safety and/or lack access to vaccination sites. Through this project, CAAs are partnering with residents, faith-based organizations, local schools and universities, state and local public health departments, and non-profits active in the community. They are also engaging a range of local providers, such as federally qualified health centers (FQHCs), physicians, community health workers, medical and nursing students, and emergency medical technicians (EMTs). These community action teams are working together to improve vaccine acceptance and uptake and to customize evidence-based strategies to their own communities and neighborhoods. article yes

SepticSmart Week is an annual opportunity for health agencies at all jurisdictional levels to share educational resources about onsite wastewater treatment system upkeep. This post highlights efforts in North Carolina and Virginia to promote safe septic system practices.

An interview with DELPH scholars Halina Palacios and Nathifa Miller about the importance of developing a strong leadership style, advice for future public health leaders, and using the DiSC Personality Assessment.

A Q&A with DELPH participants James Bell III and Sandy Noel about their experiences in the program and why it is so important to develop your own brand as a leader.

The COVID-19 pandemic highlighted the importance of having in-house skills to respond to worldwide public health emergencies. Because of this, the American College of Preventive Medicine recommends that health departments consider bringing a board-certified preventive medicine physician on staff or to have one available to assist with preparedness and population health interventions.

Academic Health Partnership Prioritizes Workforce Development in Florida Florida Academic Health Partnership Prioritizes Workforce Development Mayela Arana Learn how an Academic Health Partnership in Florida focuses on workforce development and get inspired. In Hillsborough County, the Florida Department of Health (DOH-Hillsborough) and the University of South Florida (USF) have a long history of working together. Their partnership took on a new level of structure and purpose in 2022 when they formalized an Academic Health Department (AHD) partnership agreement, focused largely on workforce development. This collaboration, supported by the Public Health Infrastructure Grant (PHIG), creates opportunities for DOH-Hillsborough staff to enhance their skills through USF’s public health programs. By providing structured training and education, the partnership is helping to build a stronger, more prepared public health workforce to serve the county’s 1.5 million residents. A Longstanding Partnership Embraces a New Opportunity When CDC released a notice of funding opportunity for PHIG in 2022, the DOH-Hillsborough health officer and the dean of USF’s College of Public Health (COPH) worked together to co-write a successful proposal. One of the resulting contracts formalized their partnership in the name of strengthening the public health workforce through recruitment, training, and retention. Like many public health agencies, many of DOH-Hillsborough’s employees do not have degrees in public health. The health department is focused on upskilling through coursework and certificate/micro-certificate programs directly related to job tasks. These opportunities are available to every staff member including those categorized as “other personnel services,” non-career services, and certain contracted employees — as DOH-Hillsborough recognizes the importance of extending these educational opportunities to all employees. Initial PHIG funding was critical in establishing the necessary dedicated staffing and infrastructure for workforce development program offerings at the health department. Current funding continues to support infrastructure, new custom program development, and the educational offerings. Infrastructure: USF works with DOH-Hillsborough to conduct staff training needs assessments and has provided training at agency-wide “all-staff” meetings. USF also developed and provides a Certified in Public Health (CPH) exam preparatory course that is open to any health department employee who is eligible to sit for the exam, at no cost to them. Custom program development: Additionally, the university, in collaboration with DOH-Hillsborough and two other local county health departments, developed a custom leadership program that groups emerging health department leaders with community partners of their choice (e.g., Healthy Start, Homegrown Hillsborough) and includes two full days of instruction over a six-month period. Educational offerings: The health department is also using PHIG funds to cover tuition for current staff to take graduate and undergraduate courses at USF’s COPH and across the university. Representatives from DOH-Hillsborough and USF hold virtual information sessions for staff about available educational offerings, the university enrollment and registration process, and completing internal agency requirements for pursuing and participating in the PHIG-funded opportunities. Measuring Impact and Continuous Improvement Given that the bulk of activities in this AHD partnership are currently PHIG-funded, PHIG performance measures provide a clear and valuable opportunity for evaluation. DOH-Hillsborough is focused on three of the PHIG measures that address hiring and retention: Number of PHIG-funded positions filled by job classification and program area. Overall agency staff retention rate. Median number of days to fill a position. Tracking performance of these measures both contributes to the agency’s overall PHIG evaluation and provides the AHD partnership with a clear process for quality improvement. Advice for Others Seeking to Establish AHD Partnerships Learning from the success of USF and DOH-Hillsborough’s partnership, considerations in developing or expanding AHD partnerships include: Appreciate the unique nature of each organization. For example, while the health department and university may have a common vision, they may also have different funding category restrictions to consider prior to solidifying the partnership. Be mindful that each organization has its own legal considerations. Allow ample time for the proper review of contracts, agreements, and external communication about the joint endeavor. Know that, at times, the collaborative process can be complex and challenging. Take a few steps back. Work together to find solutions, and don’t give up. Be flexible, humble, and willing to pivot, remaining confident that the partnership will have a bigger impact than your organization would alone. Learn more about AHD partnerships or explore other workforce development resources from the Public Health Foundation (PHF). If your health agency wants more information about planning support, please submit a PHIG technical assistance request through PHIVE or contact performanceimprovement@astho.org. Special Thanks - Blog - AHP Prioritizes Workforce Development in FL article yes

Each year, ASTHO tracks and analyzes key legislation that impacts public health, and highlights the emerging trends for our members. While the bulk of the tracked legislation arises in state legislatures, ASTHO also follows legislation from the territories and Freely Associated States, jurisdictions collectively referred to as the insular areas. The insular areas often face different challenges than the states, while also sharing many common concerns. This post contains a brief look at some of the public health related legislation introduced in the insular areas during their current legislative sessions.

While governments have faced challenges in adopting a Health in All Policies (HiAP) approach to respond to COVID-19, the impact of the public health emergency across sectors such as housing, transportation, and employment has created a unique opportunity for stakeholders to build and strengthen collaborative systems to address the inequities exacerbated by COVID-19.

Health agencies play a key role in preparing for and responding to hurricanes and other severe weather events.

Six questions with Scott Becker, CEO of the Association of Public Health Laboratories. Becker is active in national and international public health initiatives. He chairs the Governance Working Group for the Global Laboratory Leadership Program, a collaboration with the World Health Organization, CDC, and others to develop a competency-based curriculum for laboratory leaders. Additionally, Becker is a member of the Affiliate Council of ASTHO, which he formerly chaired.

In 2020, the COVID-19 pandemic exacerbated barriers to care and treatment for individuals experiencing opioid use disorder. Experts estimate a record-setting 90,000 people died of a drug overdose in 2020. Additionally, as the pandemic continues, it has understandably diverted attention, funds, and personnel usually focused on the opioid crisis. State and local public health departments are experiencing an all-time low in staffing, especially among Maternal and Child Health programs.

Pharmacies have long been instrumental partners in providing lifesaving vaccines nationwide. As state and territorial health officials evaluate their COVID-19 response, planners must include input from the pharmacy community when identifying areas for improvement, as well as best vaccination practices in advance of future public health emergencies.

Although suicide was a critical public health issue in the U.S. long before the COVID-19 pandemic began, Americans are now reporting increased mental health challenges like depression, anxiety, and suicidal behaviors. In addition, millions have experienced financial hardships, social isolation and loneliness, and increased stress—all of which are shared risk factors for mental health conditions, suicidal behaviors, and substance misuse. State public health officials have taken bold action over the past 12 months to mitigate the physical impacts of COVID-19, and the same swift action should be applied to mitigate the acute and potential long-term mental health, suicide, and substance use impacts. The National Response’s "An Action Plan for Strengthening Mental Health and Prevention of Suicide in the Aftermath of COVID-19" provides a roadmap for addressing the mental health, suicide prevention, and substance misuse prevention needs spurred by COVID-19.

May is Mental Health Awareness Month and the importance of continued mental health promotion and suicide prevention efforts during the COVID-19 pandemic. As we address the physical effects of COVID-19 through social distancing, mask wearing, and vaccination, we still need to prioritize mental health and well-being during and after the pandemic. A recent Morbidity and Mortality Weekly Report found increases in adults reporting symptoms of anxiety or depression (36.4% to 41.5%) and unmet mental health care need (9.2% to 11.7%) between Aug. 2020 to Feb. 2021.

In recognition of National Infant Immunization Week, ASTHO and AMCHP interviewed Michael Warren, MD, MPH, FAAP, and Associate Administrator of the Maternal and Child Health Bureau (MCHB) at the Health Resources and Services Administration (HRSA), for his thoughts on how we can protect our infants and children from vaccine-preventable diseases during this extraordinary time. Especially now, as COVID-19 vaccination expands across the country—including the hope for a vaccine for children (five years and older), and with the promise of a return to in-person education, families and communities must quickly catch up on missed vaccinations.

Economic security and well-being, job stability, access to safe and affordable housing, access to healthy and nutritious foods, and access to resources to manage mental and physical health—all of these things impact individual, family, and community health. The COVID-19 pandemic has fundamentally impacted each of these social determinants of health for many Americans. Furthermore, some communities and industries have faced harder economic impacts than others, including households with low incomes, non-white households, and households with children. Human services and public health leaders can collaborate to make sure we are rebuilding systems and programs in a way that creates healthier, more resilient families and communities.

The opioid crisis continues to claim the lives of thousands across the United States and has cost the economy billions in health care, mortality, and criminal justice costs. In 2018, it’s estimated that 67,367 people died of overdose, with opioids (prescription opioids, heroin, and other synthetic opioids other than methadone) made up almost 70% of overdose deaths. Provisional data for the twelve-month period ending December 2019 shows that there were 71,130 overdose deaths, with 50,178 overdose deaths attributed to opioids. The COVID-19 pandemic has also exacerbated the drug overdose crisis. Data shows that in the time of continued lockdowns and social distancing that overdose rates have increased, indicating a sustained need to support people with substance use disorder.

Over the years evidence has expanded on community health workers (CHWs) improving outcomes and even reducing disparities in heart disease and many other public health priority areas. However, their presence in state and local public health workforce is still modest. A number of efforts have sought to expand the role of CHWs in medical care settings by developing reimbursement through third party payers, along with including them in managed care contracts and incorporating them in state Medicaid plans. The experience and lessons of the COVID-19 pandemic could substantially change the way we practice public health in the future, and provides opportunities to expand the role and presence of CHWs in the state and local public health workforce.

Guest post by Jennifer Orme-Zavaleta, PhD. Last month, I had the pleasure of joining ASTHO’s Vice President for Health Security, Meredith Allen, EPA Administrator Michael Regan, and the president of the Environmental Council of States (ECOS) Patrick McDonnell at the ECOS Spring Meeting. The event marked the start of a strong state-federal relationship under the new EPA leadership, highlighted by the extension of a formal Memorandum of Agreement (MOA) reaffirming a partnership between our three organizations to advance cooperative initiatives in pursuit of environmental health.