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The COVID-19 pandemic has impacted both the physical and mental health well-being of youth. Disruptions in both their home and school life have put youth at risk for poor mental health outcomes that include increased anxiety, depression, and risk of suicide. This Mental Health Month we examine state and territorial legislation that addresses youth mental health.

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.

All too often, work in health, housing, and human services systems is siloed. However, when you move upstream and work together, these industries can address the root causes of health and social issues. If we continue to operate our systems in silos, responding with a crisis orientation, we will be unable to fundamentally improve the challenging conditions our communities face. We may be able to create the conditions for strong, thriving families and communities if we focus on strengthening community leadership and working across systems.

Though COVID-19 has dominated public health over the past year, other communicable diseases are still occurring at troubling rates. The CDC recently released data in their Sexually Transmitted Disease Surveillance, 2019 report, showing that the reported cases of chlamydia, gonorrhea, and syphilis continued to increase for the sixth consecutive year and are among the most reported diseases in the United States. As STD Awareness Month comes to a close, below is a breakdown of key takeaways from CDC’s surveillance report and tips for how state health officials can address rising STD rates through leadership, communications, and policy.

When rural hospitals close, it increases the distance people must travel for essential healthcare services. The COVID-19 pandemic has highlighted and magnified the factors leading to rural hospital closures across the country. Many healthcare facilities suspended elective procedures to conserve critically needed personal protective equipment and reduce the risk of exposure to COVID-19 by patients and hospital staff. For many rural hospitals, however, the suspension of elective procedures with the reduced the use of non-urgent services by apprehensive patients meant a loss of revenue and the furloughed healthcare staff. Since the onset of the COVID-19 pandemic, approximately half of all rural hospitals are experiencing negative operating margins due to reduced outpatient revenue. The rate increases in states that have not expanded Medicaid. Unfortunately, these kinds of challenges are not new to rural hospitals.

An increasing body of research finds racism can have a significant impact across one’s lifespan. Research shows that persistent exposure to racial discrimination may result in premature aging, poor health outcomes, and increased prevalence of certain chronic diseases. At every level of government, policymakers are seeking to acknowledge the systemic oppression of people of color that persists and to elevate racism as an urgent public health crisis comparable to other public health emergencies.

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.

On Dec. 3, the International Day of People with Disabilities commemorates disability rights and brings awareness to essential issues for those with disabilities by promoting the “well-being of persons with disabilities in all spheres of society.” While the ADA laid a critical foundation for disability rights, the work to ensure equitable access to services and needs continues, including access to state and local emergency preparedness and response activities like crisis communication, access to resources, allocation of vaccine and other medical countermeasures, and transportation.

As we celebrate National Rural Health Day this year, we are reminded of how important telehealth can be for public health and healthcare. Telehealth can minimize challenges faced by rural patients and communities—such as transportation, provider shortages, etc.—manage volume, increase the quality of healthcare, and lower overall costs by reducing readmissions and avoidable emergency department visits. However, the COVID-19 pandemic has shown that access to reliable broadband is still a challenge and is a key social determinant of health for rural Americans.

On this bonus episode, Jim Ivey, chief operating officer at Chexout, discusses the importance of interoperability and makes the case that public health organizations need to invest in software that will adapt to their changing needs in both ongoing disease outbreaks and emerging infections.

While COVID-19 remains a top public health priority, the pandemic has also intensified the need for strong tobacco control policies and marketing campaigns. CDC recognizes current or former tobacco users as one of several groups at higher risk of severe illness, including hospitalization and death, after contracting COVID-19. It is distressing to see signs that our success in encouraging tobacco users to quit has been slowed over the course of the pandemic. Fortunately, amid these challenges, many tobacco control groups have stayed focused.

One of the major disruptions to daily life caused by the COVID-19 pandemic was the rapid shift from in-person K-12 education to virtual learning. While necessary for social distancing and slowing the spread of disease, there is a concern that time away from traditional classroom environments has slowed student’s anticipated learning trajectory and milestones, resulting in what is referred to as learning loss. If left unmitigated, learning loss may result in lower educational achievement and poorer health outcomes in the future for current students, particularly students with disabilities.

Access to quality internet may not be the first thing you think of when you think about health equity, but it is something that impacts many communities. In this interview, ASTHO chats with Craig Settles on ‘broadband redlining’, how pervasive it can be, and why the solutions will need to be community driven.

While the Biden Administration and Congress have no shortage of immediate health issues to focus on, improving maternal health outcomes—particularly Black maternal morbidity and mortality—have become a priority for federal lawmakers. To make sense of what’s going on, ASTHO staff partnered with the Association of Maternal and Child Health Programs (AMCHP) to outline the seven things to know happening on the federal level right now.

A year ago, it was unthinkable that we would have 600,000 cases and more than 17,000 deaths from COVID-19 in the state of Massachusetts. Many of us know someone who has become ill or has died from COVID-19 and the toll in suffering is immense. I am hopeful that the distribution of COVID-19 vaccine will be a light at the end of this long pandemic tunnel. In Massachusetts, the three pillars of our vaccine effort are to preserve life, preserve our healthcare system, and prioritize equity by focusing on reaching our hardest hit communities. So, equity is at the core of our vaccine allocation work.

Though we’ve made progress on the number of HIV cases in the U.S, tens of thousands of Americans are diagnosed with HIV each year—a disproportionate number being people of color. In 2019, the federal government launched the Ending the HIV Epidemic: A Plan for America (EHE) with a goal of ending the HIV epidemic by 2030. EHE leverages four strategies to reduce the prevalence of HIV: diagnosis, treat, prevent, and respond. State efforts to reduce the incidence of HIV align with the federal plan, with many states passing legislation to enhance prevention and harm-risk reduction efforts.

As Black History Month comes to a close, we wanted to reflect on racial equity and how it is intrinsically connected to the work ASTHO does every day in public health. We spoke to our CEO Michael Fraser and Gail Christopher, DN, the executive director of the National Collaborative for Health Equity, to get their thoughts on the month and how we can prioritize diversity and inclusion year-round.

COVID-19 has revealed the stark reality of racial and ethnic health disparities that exist nationally. Black and Hispanic Americans were nearly three times more likely to die from COVID-19 than white Americans. Black and Hispanic Americans experience a greater prevalence of underlying risk factors such chronic disease and co-morbidities, access to health care, lower socioeconomic status, and others. The root causes of these disparities can be attributed to structural racism and the legacy of policies that perpetuates health inequities. As we commemorate Black History Month throughout the month of February, it is imperative that we work to correct the wrongs of the past and address structural racism and health inequities to build a healthier future.

This week has been both exhilarating and poignant. Almost surreal. We started the week by pausing to celebrate and reflect on the life and legacy of one of America’s greatest sons, Dr. Martin Luther King, Jr. On Tuesday, ASTHO participated in the National Day of Healing, which provided opportunities for our staff to engage in conversations with one another, seeing one another’s humanity, as well for individual mediation, reflection and learning. On Wednesday, we were honored to witness the inauguration of President Joe Biden and Vice President Kamala Harris—the first woman, first Black and first Asian American person to serve in this role. This week also marked one year since we learned of the first known case of COVID-19. Despite these challenges, I am more optimistic now than ever that our collective impact and commonsense recovery response will help guide our successful return to safety and normalcy.

A discussion with Meredith Allen, ASTHO’s Vice President for Health Security, about how the first shipments of the COVID-19 vaccinations have been a major turning point for the pandemic and a milestone moment for U.S. public health history.