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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.

The need for food and nutritional assistance is growing. Based on Feeding America’s food insecurity projections released in March, it is anticipated that 42 million people may experience food insecurity this year—up from 35 million pre-pandemic. The job loss in communities as businesses had to shut down or reduce capacity has left many families across the country relying on food banks. In fact, food banks in the Feeding America network distributed 6.1 billion meals to individuals and families during this pandemic, an increase of 43% from 2019. Many of the people who have fallen into food insecurity are experiencing it for the first time in their lives, as our food pantry partners across the country report that 35% or more of the people they’re serving today had never received charitable food prior to the pandemic.

As the number of COVID-19 vaccinations grows, some states are looking at their vaccination rates to determine when to loosen measures that mitigate the spread of COVID-19, such as venue capacity limits, business closure times, and masking requirements. As vaccinations allow businesses to reopen and customers to return, questions have arisen about whether venues or services—especially those that bring people in close contact for long periods of times—such as retail stores, concert venues, entertainment venues, air travel, cruise ships, etc., can require patrons or customers to verify that they received a COVID-19 vaccine. So far, state policy makers have had mixed views on the issue.

As the U.S. continues to undertake the largest vaccination campaign in almost a century, it has required government at all levels to surge workforce capacity. The federal government, states, territories, and local jurisdictions are acting to meet the immediate demand for vaccination as well as expand the long-term vaccination workforce. Looking ahead, expansion of the vaccination workforce long-term will help support potential COVID-19 booster shots and expand vaccine access broadly.

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.

“Building Bridges to Better Health,” the theme for the 2021 National Public Health Week. ASTHO is committed to building and maintaining the partnerships and connections needed to achieve our shared vision of state and territorial health agencies advancing health equity and optimal health for all. These relationships are bridges that connect us to others and to work that amplifies and complements our own.

A once obscure public health issue that’s gotten more attention in recent years, polyfluoroalkyl substances (PFAS) are a group of synthetic chemicals used in products such as nonstick cookware, water-repellent clothing, stain resistant fabrics, cosmetics, and firefighting products. During production and use, PFAS can migrate into soil, water, air, where they persist. Because they remain in the environment, PFAS can accumulate in humans and animals and can be found at low levels in many food products. Exposure to PFAS can lead to harmful health effects, including an increased risk of kidney and testicular cancer and a decreased vaccine response in children.

As the nation grapples with the ongoing COVID-19 pandemic, community health workers are being recognized for the role they play in improving health outcomes of our most vulnerable communities. In fact, the recently enacted American Rescue Plan Act of 2021 allocates funding for the recruitment, hiring, and training community health workers by public health departments.

While COVID-19 has shown some of the best attributes of the U.S. public health system, it has exposed the weaknesses of our data systems—wrought by chronic underfunding and further exacerbated by siloed, categorical funding and planning. Yet, even with our pandemic weariness and persistent, systemic inequities, this historic event has revealed resiliency across the country. It has also yielded new innovations, along with promising practices and partnerships in how we leverage technology and data to better respond and mitigate public health threats. To build further momentum and support the ongoing modernization efforts of our partners, ASTHO is hosting its first-ever TechXpo.

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 the Association of State and Territorial Health Officials, ASTHO is committed to the T in our name. The health officials from the territories and freely-associated states are valued members and we are committed to advocating for the unique policy needs and priorities of the Pacific and Atlantic jurisdictions. The insular areas face unique challenges locally but also require a specific strategy here in Washington, D.C. Funding approaches and requirements set for states do not always translate to the unique context of the insular areas.

One of President Biden’s first actions just before being sworn into office was to draft up the American Rescue Plan, a sweeping proposal that ASTHO has committed to working with the Biden Administration on. The proposal offers a national vaccination plan, a promise to address COVID-19 health disparities, and efforts to prioritize the expansion the public health workforce. This post details some of the high-level takeaways, as they relate to public health.

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.

A pressing public health issue before the COVID-19 pandemic hit, the need for public health interventions to reduce tobacco use is heightened with a strong association between tobacco use, in all forms, with severe COVID-19 outcomes. Additionally, tobacco use remains the leading cause of preventable death in the U.S., claiming approximately 480,000 deaths each year. Evidence-based policies to reduce tobacco use like raising the age of sale to 21, increasing tobacco pricing, and prohibiting the sale of flavored tobacco products are common public health strategies enacted through state legislation. As anticipated in ASTHO’s 2021 Legislative Prospectus on E-Cigarettes, states are considering many of these evidenced-based tobacco reduction strategies during the 2021 legislative sessions.

One of tools presidents have to implement and drive their strategy are executive actions. Executive orders and presidential memoranda carry the force of law and allow presidents to move quickly, deliver a clear message, organize the functioning of the executive branch, and spotlight critical issues with declarations of commemorative observances.

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.

Neonatal Abstinence Syndrome (NAS) has become more prevalent in the United States, with the hospitalization rate increasing from 2.9 to 7.3 hospitalizations per 1,000 newborn births between 2009 and 2017. NAS occurs in newborns who experience withdrawal from substances they were exposed to during pregnancy. While NAS is most often associated with exposure to opioids (e.g., Neonatal Opioid Withdrawal Syndrome), it can also be caused by exposure to other drugs such as cocaine, amphetamines, or barbiturates. Infants with NAS experience withdrawal symptoms including tremors, irritability, poor feeding, vomiting, dehydration, and increased sweating. These symptoms usually appear within 72 hours of birth.

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.

Community engagement is essential in the fight to end the HIV epidemic. By prioritizing a health equity lens, those battling HIV can be better heard and involved in improving their health.