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Learn how the U.S. Government has responded to Long COVID to reduce cases and mitigate the effects, common among women, Hispanic persons, and other groups.

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Strengthening Public Health Communication: Oklahoma’s Strategy and Lessons Learned ASTHO Staff Communications is a foundational capability for all health departments, essential for supporting public health protections, programs, and activities that ensure community well-being and promote equitable outcomes. To educate their communities and encourage healthy behaviors, health departments must communicate clearly and effectively. After COVID-19, the Oklahoma State Department of Health revisited and modernized its communication strategies. This video shares their journey, including the process they followed, best practices they adopted, outcomes achieved, and lessons learned—offering valuable insights for other Public Health Infrastructure Grant (PHIG) recipients aiming to enhance their communications capabilities. OE22-2203 PHIG article yes

An analysis of the state of the federal budget in the wake of the May 2023 agreement between lawmakers and President Biden, who struck a last-minute deal to raise the nation’s debt limit until 2025.

Several states and territories, as well as many local governments, are going beyond recommendations and requiring individuals to wear face coverings when they are in public settings and spaces (i.e. grocery stores, retail stores, restaurants, public and private transportation services, parks, etc.). Ongoing research and evidence suggests the relationship between mandatory face coverings and declines in daily COVID-19 growth rates is statistically significant.

More than 100 rural hospitals have closed since 2010, and an additional 25% are at high risk of closure, and COVID-19 has magnified the existing stressors on rural healthcare. As a result, states are using a variety of measures to address and prevent more rural hospital closures.

The COVID-19 pandemic has exasperated challenges around access to nutritious and affordable foods. In response, the federal government has taken action to increase funding and access to programs to strengthen food security.

How to Support Youth Post COVID-19 With More Flexible Policies Caitlin Langhorne Griffith, Victoria Pless, Martha Yeide Over the past few months, COVID-19 has highlighted how current policies and funding do not support an equitable approach to health. However, states and territories have begun to leverage statutory and regulatory flexibilities to improve health outcomes for the disproportionately affected during this pandemic. One of the ways that states and territories can support these groups and maximize these flexibilities during and post-COVID-19 is by deploying a Shared Risk and Protective Factor (SRPF) Framework to address negative health outcomes. Research has demonstrated that addressing both the risk and protective factors across sectors can lead to multiple improved health outcomes, including heart disease, asthma, depression, and substance use. Because youth are at increased risk of exposure to Adverse Childhood Experiences (ACEs), and have fewer supportive resources, they are a particularly vulnerable group potentially affected by COVID-19 policies and funding. ACEs are a risk factor shared across numerous health outcomes, such as substance use disorder, chronic disease, and mental health. However, implementing the SRPF Framework can promote protective factors in upstream ways, like reducing and mitigating the impact of ACEs. During the COVID-19 response, some areas where state officials can take advantage of policy flexibilities to better support youth and reduce some ACEs include youth experiencing food insecurity, youth with incarcerated parents, and youth witnessing violence in the home. Ultimately, these examples illustrate the benefits of extending innovative policies to decrease negative outcomes and promote health across the lifespan beyond COVID-19. Youth and Food Insecurity Food insecurity is a public health issue that plagues the United States and has been associated with negative health outcomes including obesity and unhealthy brain development. More than 11 million children in the U.S. live in food insecure homes, with an estimated 11 percent of households reporting food insecurity at least some time during 2018. New data show that food insecurity has increased for youth during the COVID-19 pandemic, with almost one in five of mothers — 17.4 percent —with children ages 12 and younger reporting their children were undereating because they could not afford enough food. When state officials closed schools to prevent the spread of COVID-19, food access was upended for youth who participate in free-or-low-cost school meal programs. States can mitigate this disruption by safeguarding access and expanding these programs to ensure the continued physical and mental development of youth. Jurisdictions have implemented innovative practices allowed under expanded flexibilities to ensure that youth receive regular nutrition during COVID-19. Vermont is conducting telephone appointments for the Women, Infants and Children (WIC) nutrition program due to social distancing, and has also expanded the list of foods available through WIC during the COVID-19 pandemic. Forty-seven states and territories have implemented the Pandemic Electronic Benefit Transfer (EBT) benefit passed as part of the CARES Act. This allows households to offset the cost of meals that would have been consumed at school by youth. Wyoming has adapted its WIC program services, which includes providing curbside deliveries and conducting phone screenings. Youth with Incarcerated Parents It is estimated that between 1.7-2.7 million youth have incarcerated parents. This leaves them at a higher risk of adverse outcomes, including mental health problems, poor school-based outcomes, and increased antisocial behavior later in life. Parental closeness between incarcerated parents and youth can be an effective strategy to promote resiliency, and jurisdictions are implementing programs focused on connecting the incarcerated individuals with loved ones. The Pennsylvania Department of Corrections has created a virtual visitation program for all state-run facilities, and all inmates are eligible to participate. In Connecticut, organizations such as Children with Incarcerated Parents have created programs that provide free calls with incarcerated parents each month during the COVID-19 pandemic. Other innovative avenues to connect children with incarcerated parents include the Governor of Illinois issuing an executive order suspending the transfer of some inmates from county jails into the Illinois Department of Corrections during the public health emergency. This approach may increase the likelihood that inmates remain geographically closer to home. Washington executive order 20-47 suspended statutes that limit an individual’s ability to receive post-conviction relief, as well as prosecutors’ and courts’ ability to file and process criminal cases. Washington executive order 20-50 broadened the Governor’s authority to grant clemency to reduce the prison population. New Jersey Gov. Phil Murphy issued an executive order establishing an Emergency Medical Review Committee, which will review which inmates can be released to home confinement—identified by the Board of Parole—and outlined the process for ensuring those who are released are aware of reentry benefits. Youth Witnessing Violence in the Home Witnessing violence at home also is associated with a higher risk of negative health outcomes, as well as experiencing or perpetrating violence later in life. "Stay at home" or "shelter in place" orders during the COVID-19 response has corresponded with increased risk of family violence and increased calls to domestic violence hotlines, posing another public health crisis as many children have been exposed to violence in their homes. While trends also show a decrease in reports of child neglect and abuse, this decline may be due to restrictions on the child welfare surveillance systems that monitor and intervene in situations of abuse and neglect. State lawmakers have offered help to those experiencing domestic violence, despite restrictions on travel. Massachusetts and Maine ordered all state hotels to only provide rooms for vulnerable populations or essential workers, including those that may be experiencing domestic violence. New Hampshire established the COVID-19 Emergency Domestic and Sexual Violence Services Relief Fund for shelters across the state to aid those who may be experiencing domestic or sexual violence. Nevada developed a process for individuals to file online temporary domestic violence protective orders. The District of Columbia developed a process so individuals can file an extreme risk protection order through an online form and phone call, which can remove firearms from individuals who may be dangerous. Finally, California released a safety planning guide for those who may be experiencing domestic violence. The COVID-19 response has prompted states to provide flexibilities in funding and suspend or modify policies that would have made it more difficult to protect the public’s health — and in turn would have exacerbated negative health outcomes among youth. Through innovative practices these efforts have worked to mitigate the negative impacts of food insecurity, youth with incarcerated parents, and youth experiencing violence in the home. Health officials can be at the forefront of this innovation to ensure that protective factors are leveraged to reduce disparities and impact multiple outcomes with upstream approaches for youth. website

The adage “what gets measured, gets done” has had staying power for a reason. When we can accurately describe conditions, quantify impact, and elucidate connections, we have a better chance at taking collective (and effective) action to tackle even the most challenging problems facing our communities. The National Survey of Children’s Health is a powerful tool to provide this critical information to researchers, policymakers, and state-level decision makers.

Responsible for planting, growing, harvesting, processing, and preparing the food we eat, agricultural workers are essential workers during the COVID-19 response to keep the U.S. food supply chain operating efficiently. But farmworkers are particularly vulnerable to COVID-19 due to lack of physical distancing, lack of access to health insurance and sick leave, and poor access to clean water for handwashing throughout the work day.

A New Normal for Public Health Agencies Association of state and territorial health officials, astho, states and territories, covid-19, covid-19 pandemic, immunization, vaccination, influenza vaccination, chronic disease, opioid epidemic, behavioral health, public health, public health agency Marcus Plescia Public health agencies have had to face the challenge of managing the COVID-19 pandemic while also continuing to conduct their normal duties in maintaining the public’s well-being. As states and territories prepare to reopen many of the functions of their economies and communities, it is also time to pivot to a new normal at health departments nationwide. COVID-19 has been the most substantive threat facing public health in decades and required an urgent mobilization and redirection of resources for all public health programs. A crisis of this proportion would stress any agency, but following a steady decrease in workforce over the past decade, public health has been hit particularly hard. We cannot expect health departments to continue pre-COVID work and continue to sustain the COVID-19 response without adequately scaling up our resources. Many vital public health functions such as immunizations, chronic disease prevention, STI/HIV prevention, and the opioid overdose response have had to be scaled back in response to COVID-19. If this continues, it will soon have profound effects on the public’s health, even in areas where we have previously been successful, such as tobacco cessation and childhood immunizations. The new normal in public health must be an adaptation to the need to contain and control COVID-19 while simultaneously addressing the many other public health needs in a jurisdiction. We need to adapt to the new normal, but we cannot continue to do more with less. Scale Up Vaccination Campaigns The threat of other infectious disease outbreaks is an immediate concern for public health. As we desperately seek a vaccination for COVID-19, it should remind us of the important function of health departments in assuring access to existing vaccination schedules. Under current "stay at home" orders, many families have not participated in well-child visits. According to the Association of Immunization Managers, activities involving going out in the field have been suspended in most health departments. As a result, studies have estimated that the administration of the MMR vaccine has dropped substantially. The new normal means we must address this issue prior to the likely resumption of the school season this fall. Adult and child influenza vaccinations will also be far more important. If a predicted second wave of COVID-19 this fall is accompanied by a serious flu outbreak, the impact on the medical system could be catastrophic. Our vaccination efforts need to resume soon and go beyond traditional public health campaigns—like increased opportunities for large-scale immunization in non-clinical settings like parking lots, summer camps and workplaces. Prevent a Resurgence of Other Chronic Diseases It is never useful to pit one public health problem against another. But it is important to recognize that despite the substantial death toll of COVID-19 over a short period, heart disease and cancer continue to be the top killers in America. Last year there were 269,000 cancer deaths and 525,000 deaths from heart disease. State and local tobacco control programs have had a profound effect on reducing the incidence of these diseases, but tobacco-use trends that were concerning prior to the pandemic have worsened. COVID-19 has shifted public health’s attention from the concerning implications of the EVALI outbreak, and efforts to address e-cigarette use have been undermined in the last three months. The Food and Drug Administration (FDA) has now delayed the premarket review deadline for e-cigarettes because of COVID-19, and significant reductions in charitable giving have diminished the capacity of important tobacco control advocacy groups. Refocus on Diseases of Despair This pandemic came during an existing epidemic of addiction and opioid misuse that provided many indications of the strains on the fabric of our society that have now become so evident with COVID-19. Often referred to as "diseases of despair," the opioid epidemic, suicide, alcohol addiction, and domestic violence continue to rage across our society, and have worsened as a result of the stress and hardship of COVID-19. Some efforts to address behavioral health have been hampered by the challenges of continuing effective interventions and therapy during a pandemic. Recent reports of suicides among medical providers treating COVID-19 patients and soaring rates of calls to mental health crisis lines highlight the alarming national suicide trends we continue to experience, and addressing stigma and providing mental health first aid programs are important now more than ever. Protect the Most Vulnerable As we think about a new normal in public health, the core work of promoting and protecting the health of those at risk is particularly acute given the devastating toll of COVID-19 among the elderly and people of color. Social distancing rules have exacerbated social isolation among those who are physically debilitated or suffer cognitive impairment, a situation that will not improve as our plans to reopen America place significant emphasis on the need for continued mitigation strategies for groups at greatest risk. Mitigation strategies must shift from "social" isolation to physical isolation, and public health should help pursue policy and environmental interventions that provide resources and stimulation for those who have been "shut in" by the pandemic. In this new normal, public health needs to continue to look for ways to partner with clinical providers to encourage different forms of preventive services that address a wide range of both medical and social problems. Create a New Normal Public health plays an important role as a convener in addressing many population, medical and social issues. That role is critically important moving forward. The recently updated Healthy People 2030 objectives, which will launch in August are a way to reset our efforts and lead the new normal. They provide a shared vision for public health across sectors and regions, and the developmental and research objectives which are designed to address areas of substantial disparity between populations are particularly important to our experience with COVID-19. It is a challenging time in public health. COVID-19 has made it difficult to meet needs and still attend to longstanding issues. After decades of neglect, public health has little surge capacity. While public health practitioners are good at finding ways to do two things at once, this is not a sustainable model for health improvement. New funding streams are emerging for public health through testing and contact tracing that may provide resources for agency expansion. We must insist that this expansion of the public health workforce is long overdue and must be sustained. Once the pandemic is controlled, these contact tracers should stay in the workforce and expand public health capacity to control core infectious diseases like HIV and other STIs. Their focus should be expanded to engage creatively in other issues like violence prevention and better control of chronic disease risk factors like diabetes, hypertension, and tobacco use—all highly relevant to COVID-19 outcomes. Good leadership requires the ability to look ahead and get creative. That future will be with us before we know it, and if we are not attentive to it, the implications of the COVID-19 pandemic could ultimately be overshadowed by a resurgence of the public health issues that have plagued us in the past. The new normal means adjusting to the threat of COVID-19 while also sustaining the core work of public health. We can do two things at once, and always have, but sustained resources that will expand public health agency capacity have to be part of the high expectations of governmental public health to protect and promote the nation’s health. The new normal does not mean doing more with less. It means doing more with more. The success of our nation’s reopening depends on it. website yes

The movement to address racism through policy change in the U.S. is receiving significant political support at every level of government. Government institutions are acknowledging the systemic oppression of people of color that persists in the United States and elevating racism as an urgent public health emergency comparable to other public health crises.

In anticipation of the upcoming presidential election in November, the Republican and Democratic National Committees released their platforms. These platforms provide an overview of values, policies, positions, and principles on various domestic and foreign issues deemed most important to the two political parties. For the upcoming 2020 elections, delegates of the Republican National Committee approved a resolution that renewed support for the platform adopted in 2016 and the Democratic National Committee approved a 2020 platform. Although both platforms touch on a diverse list of issues, there are several that are of interest to health and public health.

Deciding what book to read is a task in itself. To make things easier, ASTHO’s staff curated a list of page-turning and thought-provoking books guaranteed to be worth your time. There’s something for everyone on our list, whether you're looking for an escape or working on personal and professional growth.

With many of the state and territorial legislatures reconvening over the next few weeks, we can look forward to new (and not-so-new) legislation start to crop up that will impact public health. To help navigate the new legislative sessions, ASTHO’s "2021 Legislative Prospectus" series highlights eight priority policy areas jurisdictions will address during this year. Each prospectus in the series provides a brief overview of the issue, the issue’s impact on health, and recent legislative trends aimed at addressing the issue. This year, ASTHO developed prospectuses on COVID-19, e-cigarettes, HIV, influenza, maternal mortality and morbidity, neonatal abstinence syndrome (NAS), polyfluoroalkyl substances (PFAS), and rural health.

A mid-session legislative update on five of ASTHO's top 10 public health state policy issues to watch in 2023: tobacco, HIV, mental health, PFAS, and opioids.

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.

COVID-19 has elevated our nation’s stress level. When not managed properly (or without any buffers like social support) stress is associated with increased depression and anxiety. Because COVID-19 impacts risk factors for suicide, such as depression, anxiety, substance misuse, and unemployment, the implications for suicide prevention are many. And with September being Suicide Prevention month, it’s a good time to take stock of how public health leaders can reduce suicide risk during this pandemic.

ASTHO CEO Michael Fraser, PhD, and Tracey Wareing Evans, President and CEO of APHSA, sit down to discuss building a foundational family well-being roadmap amidst the COVID-19 pandemic.

State and local jurisdictions are developing Ending the HOV Epidemic plans. The EHE initiative has largely focused on four key strategies: Diagnose, Treat, Prevent, and Respond to potential outbreaks. The EHE initiative set a goal to increase the estimated percentage of individuals with indications for PrEP who have been prescribed PrEP to 50 percent by 2025, as the national average as of 2018 is 18.2 percent. Several states have proposed and/or passed legislation to ensure insurance coverage of PrEP and/or to allow pharmacists to prescribe and dispense it. In addition to efforts addressing cost-related challenges, states can also employ innovative approaches—such as telehealth—to expand access to PrEP services to those in need.