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The findings detailed in this report were gathered during a series of School Behavioral Health Advisory Committee convenings in spring 2021. The goal was identify policy gaps and strategies for delivering behavioral health services in schools. Final recommendations include: develop shared communication and vision; enhance state-cross sector partnerships; use data driven action; and implement innovative policies to improve access to services

This report discusses school restorative justice practices as a potential protective factor and an alternative to exclusionary discipline policies in K-12 school settings.

Health Equity in Overdose Data to Action Overdose prevention and health equity are two vital aspects of addressing the urgent public health crisis of substance use and overdose. Overdose data is crucial in identifying inequities and shaping effective interventions. By using data to drive action, health agencies can create more equitable and impactful strategies to prevent overdoses. To support this work, ASTHO has created health equity resources for recipients of CDC’s Overdose Data to Action (OD2A) cooperative agreement. Resources OD2A Health Equity Needs Assessment Overview ASTHO, in consultation with CDC, created the OD2A Health Equity Needs Assessment to assess the support, technical assistance, and training that state, local, and territorial health agencies need to move health equity forward within their OD2A programs. Based on the results of the needs assessment, ASTHO, in partnership with Strickland Health Consulting, identified nine prevalent technical assistance needs and developed a resource, Advancing Health Equity in the Overdose Crisis Response, a compilation of existing resources, to address these components of integrating health equity into overdose surveillance and prevention efforts. Health Equity Sharing Forum: Health Equity and Culturally Responsive Evaluation ASTHO, in partnership with CDC, hosted a virtual OD2A Health Equity Sharing Forum on January 11, 2023. The forum focused on how health equity and culturally responsive evaluation are informing OD2A prevention efforts, as well as understanding how CDC and ASTHO can support these efforts through technical assistance and resource development. Panelists discussed incorporating health equity and culturally responsive evaluation into their OD2A activities and opportunities for collaboration with health equity subject matter experts. The forum featured three speakers from CDC’s Program Evaluation Team and Applied Prevention Science Team: Minda Reed, Marissa Roberts, and Jenelle Mellerson. Three OD2A jurisdictions—Sarah Ruiz of Massachusetts, Jan Fields of Michigan, and Stacy Christopher and Ashly Jordan of New York City—and two health equity evaluation experts—Pat Campbell of Campbell Kibler Associates and Veronica Thomas of Howard University—also joined the discussion. Sharing Forum Resources  OD2A Health Equity Sharing Forum Resources: A curated set of resources referenced by panelists. Health Equity Focused Evaluation Profiles (Parts 1 – 4): A collection of four posts written by Jan Fields for the OD2A Evaluation Community of Practice blog between December 2021 through June 2022. Part 1: Root Cause Analysis and Equity Review Part 2: Plan for Adaptions Part 3: Context Analysis Part 4: Health Equit Indicator Development Health Equity Focused Evaluation Profiles (Part 5): This is the fifth of a series of blog posts on implementing core components of a health equity work plan that was created by NACCHO and Health Equity and Action Research Tools & Training for Transformation, a Colorado-based consulting firm. Part 5: Community Engagement Assessment Lessons Learned from ASTHO's Mentorship Program: Health Equity Track The Overdose Data to Action Mentorship Program: Health Equity Track convenes both newer and experienced OD2A cooperative agreement staff to celebrate successes, identify challenges, and share ideas through peer exchange, health equity trainings, technical assistance, and a structured mentor/mentee relationship. website False

This blog describes how Palau's health ministry collaborated with its community to design indicators to better measure health equity in its jurisdiction.

This post explores the importance of including maternal and child health considerations in infectious disease emergency preparedness and response in states, territories, and freely associated states.

Community members and policymakers that want to prevent suicides, overdoses, and adverse childhood experiences can choose to intervene at different levels.

As new diseases or emergencies arise, working alongside trusted committees can help health officials quickly respond and prevent undue burden on at-risk groups such as people with disabilities, pregnant people, and children.

This post examines the youth mental health and loneliness crises and shares guidance for how public health agencies can work alongside schools to address these crises through social connection.

Rural hospital closures exacerbate poor socioeconomic conditions, job loss, cost of health services, transportation times and barriers, and inequitable access to quality care, all of which contribute to unfavorable maternal and infant health outcomes.

What We Learned at the Public Health TechXpo and Futures Forum ASTHO | Our staff's top takeaways from the TechXpo. astho, association of state and territorial health officials, public health techxpo and futures forum, public health leaders, u.s. public health system, public health policy, data sharing and modernization, population health, governmental health agencies, public health infastructure, workforce resilience, public health workforce, techxpo and futures forum, public health infrastructure, build workforce resilience, future of public health, health techxpo and futures, health leaders and experts, experts across the technology, health workforce, health outcomes, futures forum, health leaders, health departments, public health professionals, today and the future, public health services, public health techxpo Dylan Reynolds Marcus Plescia and Garfield Clunie present "The Future of Measuring Health Equity - A World of Evolving Data." Last month, ASTHO kicked off the Public Health TechXpo and Futures Forum in Chicago, an opportunity for some of the world’s top leaders in technology and to engage public health leaders on challenges and solutions for successfully modernizing the U.S. public health system. Over 600 participants were in attendance, with 200 more attending virtually from around the world. It was a packed three days. Our speakers demystified the world of public health policy, opened doors to new funding streams, and gave us a glimpse into the glittering future of data sharing and modernization. Heavy hitters from Amazon and Google weighed in as well, showing us how they’re working hand-in-hand with health agencies to change the way they approach population health and well-being. So as we look back on a busy week—and look ahead to our virtual follow-up event on June 15—here are some of the messages that stuck with us the most: "Standards are like toothbrushes. Everyone has one, and no one wants to use some else’s." The line from Gabriel Seidman, director of policy at the Ellison Institute for Transformative Medicine, was met with a belly laugh from a crowded room during one of the week’s most well-attended sessions, a panel conversation on the future of measuring health equity. However, Seidman’s comparison was an apt one. There is certainly much to be said for a public health data system that is engineered to meet the specific needs of its target community. However, for public health experts to do their best work, they must be able to speak a common language—at a local, state, territorial, and national level. When each level of public health is operating with different standards in place and with a different definition of success, data gets lost and people get left behind. One of the loudest calls to action from the week was for governmental health agencies to break down these data siloes and establish common standards between agencies. The "Next Pandemic" is a Priority—But It's Not the Only One There is—understandably—mounting national attention on preparing for what many public health experts believe will be the inevitable "next pandemic." The COVID-19 pandemic showed us what a lack of preparedness could mean for population health, and there is so much unknown about what the future of pandemics has in store. However, experts at the TechXpo reminded us that public health is about more than responding to a singular crisis. "I think many of the conversations we're having are so focused on COVID-like pandemics," said John Auerbach (alumni-MA) "But if we look at the things that are still killing people, for the most part it's not infectious disease." Instead, Auerbach cited challenges that have long been a part of the public health story, such as diabetes, the fentanyl overdose crisis, and climate change. Before COVID-19 entered the national spotlight, public health’s day-to-day work was largely centered on chronic disease and behavioral health. Auerbach reminded us that amid all of the unknowns of our future, there is plenty we do know—and plenty we can be doing to address it. "Modernizing data systems is more than buying a big computer." While there were many versions of this message over the course of the forum, Auerbach perhaps said it most concisely of all. In other words, it doesn’t matter if a public health agency has a chrome-plated exterior and a cloud-based data system, so long as the underlying infrastructure isn’t sustainably and thoughtfully built. Whether it’s a matter of restricted funding, antiquated processes, or siloed thinking, health agencies and their leaders must have a plan to address these challenges before assuming that “buying a big computer” will catch their data dashboards up to speed. This was one of the ironies of this future-forward event: Amid so many exciting innovations and inventions, many of the challenges boiled down to basic, equity-centered questions about the best way to get this new technology in the right people’s hands. If public health is going to take a technological leap at a national level, then it must also be able to make a leap at a community level—in communities of color, in territorial health agencies, and in our policies. Jumping lightyears ahead doesn’t count if entire populations are still being left lightyears behind. Workforce Resilience Cannot Be Taken for Granted We cannot separate the future of public health from the future of its workforce. The COVID-19 emergency response has left many public health workers feeling burned out and harboring traumatic levels of toxic stress, pushing many of them to seek out jobs outside the field. In fact, according to a recent analysis of data from the Public Health Workforce Interests and Needs Survey, 46% of state and local public health employees left their jobs between 2017 and 2021. For public health to reach its full potential in the future, we must begin investing in that workforce today. Over the course of the week, we heard often from mental health experts and senior health officials to learn about their priorities, challenges, and paths to improve workforce well-being in their health agencies. This included the unveiling of the PH-HERO Workforce Resource Center, which arms health agencies with the resources and knowledge they need to support their workforce. Whatever the future of public health holds, it begins with a workforce who is motivated to make that future a reality. More than anything, the TechXpo was a reminder that public health’s future is as multiple as it is uncertain. We are working toward a future that is more adaptable than ever before—with thought innovators and health experts who are constantly reflecting, pivoting, and adjusting to the moment. There are so many conversations yet to be had. For those who have not done so already, we invite you to register for our fully virtual TechXpo follow-up forum on June 15, and add your voice to the growing chorus. website yes

ASTHO has been helping jurisdictions prepare for and respond to the needs of people with disabilities during public health emergencies by embedding disability preparedness specialists in 16 state and 2 territorial health agencies.

States and territories are adopting a wide array of policies to improve mental and behavioral health, including significant investments in suicide prevention, support for youth mental health, and improving access through telehealth.

The Key Role of Cross-Sector Partnerships in Navigating Barriers Keon Lewis Community partnerships are critical to public health's mission to promote optimal health for all — learn more. Public health departments’ mission and vision statements often share certain values and goals aimed at improving the public’s well-being. Rather than just reactively responding to immediate health threats as they come, public health departments aim to take a more proactive approach through strategies that prevent the future spread of diseases, injury, or other incidences of harm. These actions support their visions of creating communities where all residents can thrive and achieve their full health potential. Strong community partnerships are critical to public health departments’ ability to fulfill their goals. Recognizing this, the Robert Wood Johnson Foundation introduced the Culture of Health Framework in 2015. As a leading national philanthropic organization focused on dismantling barriers to optimal health for all, the framework’s foundation is built upon the following action areas: Making Health a Shared Value. Creating Health. More Equitable Communities. Strengthening Integration of Health Systems and Services. Fostering Cross-Sector Collaboration. The COVID-19 pandemic and its aftermath underscored the factors that created challenges to health outcomes for underserved communities; it also demonstrated the importance of sustaining strong cross-sector partnerships. Public health’s ability to align its goals with the community it serves is vital to efforts to save lives. This alignment allows public health departments to leverage the diverse resources and lived experiences that community partners bring. Recognizing the unique concomitant relationship that it has with government funding, public health departments are now going to have to pivot their strategies to achieve their missions. As public health departments experience budget and personnel cuts, its ability to promote optimal health for all and mitigate the social determinants of health is now even more reliant upon the strength of collaborative partnerships. The Public Health Paradox Public health has always been a component of our nation’s health care system, which primarily reflects specific health issues that have impacted our communities. Rather than focusing on the foundational issues that exacerbate these long-term gaps in underserved communities, government systems often allocate funding based on specific diseases or chronic health issues impacting community health. Although diseases and chronic health issues are significant public health elements that need to be addressed, there are significant nonmedical factors that play just as vital a role in influencing community health outcomes. Identified by the World Health Organization (WHO) and adopted by CDC as the social determinants of health, these variables — which include elements such as social and community construct, economic stability, and education access — have become the central driving force of public health. “The Public Health Funding Paradox,” an article from Sage Journals, offers a great perspective on how an intriguing paradox has been created due to this relationship between public health and government systems. The article underscores the complexity of governmental funding that helps to advance public health strategies while there still exist harmful policies that create barriers for certain communities. The Flint water crisis in Michigan demonstrated this paradox. Flint citizens experienced lead poisoning and death from Legionnaires’ Disease, underscoring how a community’s ability to thrive can be quickly impacted by economic difficulty and leadership decisions made by the accompanying government. The Power of Partnership Public health has long had to combat a barrage of stigmas and policy hurdles. Even at the height of the COVID-19 pandemic, public health departments were not only in contention against the virus but also against the influence of viral misinformation that questioned their practices, strategies, and purposes. Despite these barriers, the nation witnessed the power of true cross-sector partnerships. Health care and grassroot organizations quickly found common ground to help address the needs of underserved populations. From addressing food insecurity to mental health and transportation barriers, communities successfully pivoted toward hope and found ways to save lives. Nonprofit organizations also created innovative and impactful peer-to-peer funding models that enabled them to fulfill their missions in spite of budget cuts. During this time, community health workers became a vital public health resource. As conduits between departments and local communities, community health workers became a necessary element to re-reestablishing trust in systems and care. Although the work of frontline workers and support staff served a critical role in mitigating the future spread of COVID-19, advocates and allies at the grassroots level also played an invaluable role in promoting health for all. As “The Public Health Funding Paradox” demonstrated, public health departments are only as effective as their accompanying government systems. If the leadership within these respective systems fails to align and empathize with their public health counterparts, then as a community we inevitably repeat a vicious cycle that results in poor health outcomes. Identifying Alternative Routes Cross-sector partnerships serve a vital role in enabling public health systems to better serve their communities. Budget cuts and stricter policies have created barriers for local and statewide agencies, academic institutions, and nonprofit organizations. The ability to develop essential personnel, continue pertinent research, and utilize mitigating practices have been inhibited by these barriers. It has become increasingly evident that, rather than focusing on reactive strategies, public health must go upstream and address the social needs of our communities. With cuts to funding, public health systems have to do more with less, making it more difficult to address diseases and chronic health problems. Working upstream to address root causes of health outcomes is one way to better leverage thinner resources. As our public health systems continue to work diligently to monitor, support, and mitigate community health barriers, there is still more research needed to explore the most effective cross-sector partnership frameworks. Public health’s efforts must remain intentional in developing comprehensive health advisory coalitions, leadership development cohorts, civic and community engagement projects, and paradigm shifts in academic curricula. The leaders and changemakers of tomorrow require growth in their competencies today. Cross-sector partnerships must continue to build their foundations upon systems of trust and transparency. Public and private health systems, the social sector, and other community stakeholders can partner to improve the population’s overall well-being while simultaneously achieving a mutually beneficial “social return on investment.” Public health’s ability to align with the achievement of optimal health for all requires more than just serving on the front line when a crisis occurs — it is critical that these departments must continuing enhancing their collaborative partnerships and community engagement. article yes

This blog shares key takeaways from the first Island Areas COVID-19 Health Equity Action Institutes.

The Embedded specialist in South Carolina used an ASTHO tool to assist the South Carolina Department of Health and Environmental Control improve inclusivity of people living with disabilities in their public health programs.

Community design strategies that increase the availability of safe and accessible outdoor spaces create more physical activity opportunities for people of all abilities.

March 24 is World TB Day, we have made significant progress in TB prevention, detection, and treatment. However, there is still a long way to go towards achieving TB elimination.

USDA has proposed a final rule for long-term school nutrition standards and is seeking public input on the proposed changes through April 10, 2023.

Breastfeeding is a key protective factor against infant and toddler nutrition insecurity and is the ideal source of nutrition for most infants, since it adapts to each child’s unique nutritional needs.

This blog describes the island areas COVID-19 successes and their cultural and historical context.