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Georgia Technology Authority guidance for state employees on responsible generative AI: pre-authorization, data privacy, and human oversight.

Connecticut state responsible AI framework: guiding principles, 4 implementation phases, AI Advisory Board oversight, and LLM guidelines.

2026 Briefs and Infographics article

States are pioneering strategies to improve access to sexual and reproductive education and healthcare for adolescents.

The high rates and cost of maternal mental health disorders coupled with near-universal Medicaid coverage during pregnancy creates enormous potential for innovations in payment and coverage structures to improve maternal mental health, including Value Based Payment and public-private partnership arrangements.

Evidence-Based Approaches to Promoting Health Equity in Retail Food Safety ASTHO, Association of State and Territorial Health Officials, health equity, food safety, health in all policies, foodborne illness, public health, food code, food service employees, food safety resources, safety standards, barriers to food safety, retail food safety, communication barriers, diversity of language, understand and implement, educational resources, culturally respectful, food science, impacted populations, equitable enforcement, best practices, food safety training, community health, conduct inspections, control measures, jurisdiction demographics Heather Tomlinson ASTHO | Public health agencies can incorporate health equity into their food safety work by tailoring their messages and strategies to their communities. Foodborne illness is costly, preventable, and all too common. Public health agencies are responsible for food safety and reducing foodborne illness by educating and inspecting retail food establishments. Several studies have found that independent ethnic restaurants—those that serve food originating from a culture or heritage of certain ethnic groups—had more violations and, as a result, were inspected more frequently than the average. Some of these violations may be related to a misunderstanding of the food code and/or language barriers. Currently, more than one in four food service employees speaks a language other than English at home and 22% of employees have less than a high school diploma. It is crucial that food safety resources and messaging provided by public health agencies be made available to reflect varying languages and literacy proficiencies to ensure accessibility and comprehensibility for all. Achieving health equity, in which everyone has a fair and just opportunity to attain their highest level of health, requires health agencies to evaluate their approaches to food safety so all food establishments can meet retail food safety standards. Addressing Communication Barriers Health agencies should be familiar with the diversity of languages and cultures in their jurisdiction so materials can be tailored to each community’s differing needs. Providing food safety training courses, regulations, and other materials in languages spoken by local restaurant staff can reduce barriers so restaurant operators and workers who don’t speak or read English fluently have access. Having interpreters or multilingual inspectors can drastically improve communication between inspectors and restaurant staff. For health agencies without these resources, inspectors can utilize photos or translation services, such as Google Translate or language lines, to communicate effectively with restaurant operators. Demonstrating proper practices in person or through videos can also help communicate through observation. With more than half of U.S. adults aged 16 to 74 years old reading below the equivalent of a sixth-grade level, food safety educational resources should be developed so that all populations have access to documents written at educational levels tailored for their community. Educational materials should meet plain language accessibility requirements, including limited text in the appropriate language and simple cultural appropriate imagery. Food safety inspectors can carry materials in multiple languages or have online resources they can share with the retail food facility, such as Washington’s Food Worker Manual or FDA’s Educational Posters that provide flyers on common food safety topics. Finally, newly developed resources should include the target audience in development and pilot testing to ensure they are achieving the desired impact. Designing Materials to Support Your Audience Being familiar with cultural norms and communicating in a culturally sensitive way can enhance the delivery of food safety messaging. One study found that produce safety education materials developed for produce growers in the U.S. Virgin Islands were not seen as culturally appropriate. After redesigning the materials based on community feedback, the managers saw improvements in food safety knowledge and hygiene practices among produce growers. These results and similar studies suggest that educators should partner with impacted populations to evaluate the utility of potential interventions before implementation and ensure they are interpreted as intended. In addition to culturally appropriate food safety education materials, agencies can ensure that they meet the practical needs of the retail environment. For example, materials targeted for mobile facilities (i.e., food trucks) may need to be durable and waterproof to withstand operation and transportation. Ensuring Equitable Enforcement at Your Health Agency Health agencies can incorporate concepts such as equitable enforcement and health equity into their staff’s annual training curriculum. Equitable enforcement promotes compliance with law and policy that considers and minimizes harm to people affected by health inequities. ChangeLab Solutions’ guide on Equitable Enforcement to Achieve Health Equity educates policymakers, advocates, and enforcement officials on best practices in the design and development of enforcement provisions to avoid inequitable impacts and promote community health. A study from Michigan State University found that food safety professionals throughout the United States, especially at the local level, encountered a variety of ethnic food establishments and ethnic foods for which they lacked relevant food safety training. The smartphone application, Cultural Food Safety App, offers searchable information on food safety issues and control measures associated with specific culturally based foods. This app can help regulators better understand cultural foods and their production to ensure foods are being safely prepared and be more familiar with what to look for when conducting inspections. Lastly, health agencies can incorporate a Health in All Policies framework into their food safety practices through ASTHO’s Food Safety Guides. ASTHO strongly supports health agencies in promoting a diverse and culturally competent food safety workforce. By assessing jurisdiction demographics, addressing communication barriers, tailoring resources to fit the audience, and building a culturally competent workforce, health agencies can improve equity in their jurisdiction’s food safety programs. 5U18FD007739-02 website yes

Wisconsin is leaning into teamwork to address homelessness and safe housing in the state.

Enhancing Consumer Awareness Improves Access to Risk-Appropriate Care Lexa Giragosian Enhancing consumer awareness can improve health outcomes for pregnant and birthing populations. Risk-appropriate care (RAC) is a strategy to ensure that pregnant women and infants with high risk of complications receive care at facilities with personnel and services that can provide the required level of specialized care. States can utilize the process of perinatal regionalization to create coordinated care systems based on levels of maternal care (LoMC) to support RAC access. Implementing and strengthening maternal RAC systems as well as enhancing consumer awareness can improve health outcomes for pregnant and birthing populations and reduce the incidence of severe maternal morbidity and mortality. Maternal Mortality in the United States The U.S. maternal mortality rate nearly doubled between 2018 and 2021, with the starkest increases occurring among American Indian/Alaska Native and Black populations. Among other high-income nations, the United States has one of the highest maternal mortality rates and is continually increasing. According to the Maternal Mortality Review Committee's most recent data, over 80% of pregnancy-related deaths are preventable, and barriers such as low consumer awareness can inhibit the prevention of pregnancy-related deaths. The Importance of Consumer Awareness Consumer awareness refers to patient’s knowledge, attitudes, and awareness about their health. There is a gap in understanding among pregnant and non-pregnant women of the major health risks associated with pregnancy or what can pose a risk during pregnancy. There are also challenges surrounding consumer awareness of what levels of maternal care are, and which level is right for everyone. More specifically, there is a common misconception that higher levels are always the safest level to receive care. A lack of consumer awareness is associated with poor health outcomes and can create gaps in access to RAC. Providers have an important role in improving consumer awareness by educating their patients about their pregnancy risk factors and levels of maternal care, while also having adequate awareness about levels of maternal care themselves. Provider awareness about levels of maternal care can promote RAC accessibility since providers are often the main point of contact for pregnant women and are responsible for ensuring the patient receives care at the appropriate level. State Success Strategies Support and work with communities to build capacity for addressing consumer awareness. Promote community organizations’ ability to improve pregnant women’s understanding and usage of health information (literacy, language instruction, social support, etc.) to enhance consumer awareness and corresponding health outcomes. Specifically, supporting women of color-led community organizations will foster equitable consumer awareness. Implement and support policies that make doulas and community health workers more accessible within communities. Develop and disburse public health campaigns about maternal health. Utilize effective health communication techniques rooted in health equity. CDC’s Hear Her Campaign is an effective public health campaign that increases awareness of pregnancy complications and warning signs, empowers pregnant people to raise their concerns to their provider, encourages support systems to listen to pregnant people’s concerns, and provides the tools needed to foster communication between providers and patients. Ensure that health education materials are accessible and consider the social factors affecting the priority population. Inclusive and preferred language in educational materials should be applied and understandable, actionable, and culturally sensitive. Form partnerships with providers, hospitals, foundations, and professional associations to take a collaborative approach toward improving consumer awareness. Create resources with these relevant partners to inform patients about how to choose a provider and a hospital based on the level of care their pregnancy risks indicate. The National Accreta Foundation has a myriad of resources to help patients navigate the care process and ensure their access to RAC. Utilize partnerships with key stakeholders to disseminate materials in prenatal care settings such as provider offices or hospitals that outline RAC and the care coordination system in place at that location. Ensure that transferred/referred patients are receiving materials about the reason for their transfer/referral and about the new level of care they are entering. website yes

Infographic depicting findings on a survey around opioid use among pregnant people.

What Surrounds Us Shapes Our Health caregiver stress, traumatic childhood experiences, secondary prevention, tertiary prevention, child abuse, physical health, supporting services, healthier neighborhoods, mental health, primary prevention, affordable childcare, neglect in families, family members, physical abuse, emotional abuse, soil formation, provisioning services, mental illnesses, traumatic experiences, nutrient cycling, traumatic events, cultural services, health problems, domestic violence, experienced trauma, respite care, child abuse and neglect, substance abuse, ecosystem services, astho, association of state and territorial health officials ASTHO | Health and well-being are impacted by every aspect of how we live, work, and play. Learn how primary prevention can improve well-being by addressing the root causes of health in this infographic. Health and well-being are impacted by every aspect of how we live, work, and play. This infographic demonstrates how primary prevention can improve well-being by addressing the root causes of health and preventing risk factors the negatively impact health, like adverse childhood experiences. Get the Infographic (PDF) website yes

U.S. Virgin Island’s Federal Grant Planning and Set Up Process Improvement ASTHO, Association of State and Territorial Health Officials, u.s. virgin islands, grant management, federal grant planning, grant planning, workflow visibility, cross agency leadership, federal grant management, community of practice, cross agency, oversight responsibilities, standard process, facilitate workflow, community of practice cop Kristin Sullivan, Colton Anderson ASTHO | Recommendations to improve speed and quality of the U.S. Virgin Island’s Federal Grant Management processes. This infographic details strategies for improving the speed and quality of the U.S. Virgin Islands’s Federal Grant Management “Plan and Set Up” process. Get the Infographic (PDF) website yes

Strengthening Grant Management Functions in Puerto Rico ASTHO | Toolkit helps to optimize grant activities and funds in Puerto Rico The Grants Management Office Structure Optimization Toolkit helps to assess a health department's federal grant workload, staffing requirements in its grant management office, and potential to optimize grant management activities. The Puerto Rico Department of Health (PRDOH) is using it as a guide for improving internal grants management capacity and oversight to maximize federal funding outcomes. PRDOH anticipates increased information flow, a more inclusive culture, and additional benefits. Get the Infographic in English (PDF) Obtén la infografía en español (PDF) website yes

About the Peer Networks About ASTHO's Peer Networks Learn about the different peer networks that support the development of state and territorial agencies through services such as events, skill-building workshops, online discussion boards, peer-to-peer mentoring, and technical assistance. ASTHO regularly convenes peer networks that support the development of state and territorial agencies (S/THAs) through services that include in-person and virtual events, skill-building workshops, online discussion boards, peer-to-peer mentoring and coaching, and technical assistance. Chief Financial Officers and Financial Leaders Chief Financial Officers and Financial Leaders Peer Network provides a forum to share expertise, information, peer experiences, and emerging issues on public health financing and grant management. It promotes best practices in health economics, financial and grant management, and budgeting; builds leadership and operational management skills; and strengthens relationships and coordination with other senior health officials. Titles may include but are not limited to: Chief Financial Officer, Director of Finance, Chief of Administration, Chief Operational Officer and those who are leaders in their health agency finance department. Other titles are included on a case-by-case basis. Clinical Service Leaders Clinical Service Leaders Peer Network is a space for state and territorial health agency leaders with broad oversight of public health-based clinical services. Peers connect on emerging issues and share strategies related to public health and health care partnership, access to care, and healthcare service delivery. ASTHO provides this peer network with timely updates on federal funding and policy initiatives related to public health’s role in safety net service provision and access to care. Titles may include but are not limited to: chief medical officers, state medical directors, or chief nurses. Directors of Public Health Preparedness and its Executive Committee Directors of Public Health Preparedness and its Executive Committee (DPHP EC) provide jurisdictional-based expertise and leadership for all-hazards public health preparedness and response. The network provides a forum to develop and share strategies, tactics and sound practices and maintain communications regarding common operational issues in state/territorial public health preparedness and response. The group convenes regularly with federal and organizational partners to provide feedback on emerging and existing programmatic and policy issues. Informatics and Data Modernization Network Informatics and Data Modernization Network (IDMN) provides a forum for S/THA informatics and data modernization leaders, such as informatics directors and data modernization directors, as well as staff who support the informatics and data modernization efforts in their health department. ASTHO’s goal is to include leaders across public health informatics and data modernization for each jurisdiction. Through quarterly meetings and the my.ASTHO online community, the IDMN provides a venue for members to learn, share, and discuss timely and emerging informatics and data modernization efforts, innovations, opportunities, resources, and best practices. Additionally, ASTHO relies on this group to provide and validate information and data related to data modernization and informatics efforts at their agency and nationally (e.g. public health data standards). Titles may include but are not limited to: Informatics Director, DMI Director, DMI Lead, DMI Champion, State Epidemiologist, Chief Data Officer, Chief Information Officer, Chief Informatics Officer, Chief Public Health Informatics Officer, Chief Data Officer, Information System Manager, Chief of Innovation, Data Management Director, Data Governance Program Manager, Health Statistics and Informatics Division Director, Health Data and Informatics Director, Technology and Resources Director, DMI Coordinator, Health Informatics Program Manager, DMI Project Manager, Deputy Director, Surveillance and Informatics Supervisor, ELC Information Specialist. Medical Countermeasures Coordination Network Medical Countermeasures Coordination Network, along with its online platform on my.ASTHO, serves S/THA staff working in medical countermeasures and representing the 62 PHEP awardee jurisdictions. It enables them to engage in programmatic practices and areas of policy, share materials and resources, foster peer-to-peer discussion, and request and receive technical assistance from ASTHO. Primary Care Office Directors State and Territorial Primary Care Office Directors meet as a peer network to form one collective voice when engaging with HRSA and to share information and promising practices relating to the HRSA PCO cooperative agreement. ASTHO supports a PCO National Committee, comprised of ten PCOs representing each HRSA region, as well as hosts regular peer-sharing calls and a highly interactive my.ASTHO discussion board. These activities provide resources that can orient new PCO directors and staff into their role, mentoring relationships, and form a coordinated PCO voice. Public Health Communicators Peer Network Public Health Communicators Peer Network will help develop public health communication professionals to build strong and effective relationships with their leadership teams including the state and territorial public health officials, so they are able to collectively communicate strategically, build trust in public health, and create a culture of partnership and collaboration in support of their state public health agencies and state and territorial public health official. Through this network, you can: Access valuable resources and training sessions on crisis communication, media relations, and more. Join quarterly peer-to-peer conference calls, participate in leadership development programs, and attend annual meetings with fellow communicators. Get help with the development of communication plans and other products. connect with peers through an online community designed for sharing best practices and capacity-building opportunities. Titles may include but are not limited to: public information officers, directors of communications, communications managers, and deputy communications directors; however, other related titles may be considered on a case-by-case basis. Public Health Lawyers Public Health Lawyers provides a forum for attorneys representing state and territorial health departments to share legal expertise and best practices as well as offer peer-to-peer support on emerging legal topics impacting these departments. Public health lawyers may be employees of the health department or may sit within a jurisdiction’s attorney general’s office or department of justice. Titles may include but are not limited to: assistant/associate/general counsel, attorney, assistant/associate/chief counsel, assistant/senior assistant attorney general, or legal/policy specialist. Senior Deputies Senior Deputies provides a forum for support, education, and networking opportunities to advance the ASTHO mission and support senior staff’s needs in S/THAs. The senior deputy is identified by and usually reports to the state/territorial health official and can hold responsibility for public health programs, finance, operations, or some combination thereof. Titles may include but are not limited to: Deputy Director, Deputy Secretary/Commissioner, Chief of Staff, Chief Public Health Officer. State Environmental Health Directors State Environmental Health Directors is comprised of environmental health leadership from U.S. state, territorial, and freely associated state health agencies, including Washington, D.C. The group weighs in on and drives environmental public health policy issues forward, such as food safety issues, risk communication challenges for both regulated and unregulated drinking water contaminants, childhood lead poisoning prevention, and health risks posed by excessive heat, and participates in internal and external environmental health-related committees or workgroups. In addition to these topics, the group meets regularly to discuss environmental public health topics like natural disasters (e.g., hurricanes, wildfires, and tornadoes), climate and health, and emerging chemical contaminants (e.g., Ethylene Oxide). Titles may include but are not limited to: Environmental Health Program/Section Manager, State Toxicologist, State Epidemiologist. State and Territorial Legislative Liaisons State and Territorial Legislative Liaisons connect health agency staff who serve as the liaison between their agency and their legislature. ASTHO engages with the community to provide technical assistance, share policy updates, emerging trends, and facilitate peer-to-peer sharing of information and best practices. State Tribal Liaisons State Tribal Liaisons (STL) peer group is committed to the sharing of approaches that recognize the sovereignty of and enhance the optimal health of American Indians and Alaska Natives (AI/AN). Peer group convenings serve as a forum for Liaisons to network and share information related to key public health issues impacting Tribal communities within their jurisdiction. Titles may include, but are not limited to: Tribal Liaison, Director, First Nations Health and Wellness Program, Tribal and Indigenous Health Equity Strategist, Manager Constituent & Tribal Services. Telehealth Policy Telehealth Policy Peer Network is a learning collaborative that provides opportunities for state and territorial public health department staff to gain subject matter expertise on emerging telehealth topics, policies, and priorities. The network facilitates peer networking opportunities, connections to telehealth subject matter experts, and resource sharing. Titles may include, but are not limited to: Deputy Director, Director [Office of Telehealth], Telehealth Clinical Specialist, Program Coordinator, Policy Analyst.

Peer Networks ASTHO Peer Networks   <!-- 2024 Workforce and Human Resource Directors 2024 Informatics and Data Modernization Network In addition to supporting chief health officials, ASTHO fosters the development of other state and territorial agency staff. We do this through in-person and virtual events, skill-building workshops, online discussion boards, peer-to-peer mentoring, technical assistance, and much more. We encourage all state and territorial health agency staff to explore whether our peer networks could be of value to them and connect with agency leadership to confirm participation. Explore Our Peer Networks Discover detailed descriptions of our peer networks and the typical titles of agency staff who participate by visiting About the Peer Networks. These communities — primarily hosted online — help public health professionals share their expertise, learn about best practices, and develop sound policy in their area of specialization. ASTHO currently offers the following peer networks: Chief Financial Officers Clinical Services Leaders Informatics and Data Modernization Network Legislative Liaisons Medical Countermeasure Coordinators Primary Care Office Directors Public Health Communicators Public Health Lawyers Public Health Preparedness Directors State Environmental Health Directors State Tribal Liaisons Senior Deputies Telehealth Leads Workforce and Human Resources Directors Each network is led by an ASTHO subject-matter expert who guides the network’s mission and focus. If you are a state or territorial health agency staff and are interested in participating, please ensure approval from your health official and email our Membership team at membership@astho.org. --> website

Explore ASTHO-led resources helping state and territorial health agencies navigate AI in public health in a rapidly evolving landscape.

Senior Leader Reserve Corps for Health Agencies Could you and your agency benefit from having experienced former state/territorial health agency leaders support you in addressing your toughest challenges? Request support through ASTHO’s Senior Leader Reserve Corps (SLRC). In collaboration with CDC, the SLRC is a flexible and innovative program through which former health agency leaders use their specific expertise to provide technical assistance (TA) to current state/territorial health agency leaders. If you have a specific challenge in your jurisdiction as an executive, ASTHO can match your agency with former public health leaders to provide on-demand targeted technical assistance and thought partnership at no cost to your health agency. Example areas include: Support for senior leadership in identifying opportunities to modernize data architecture and communicating the needed changes to staff and stakeholders. Support in business process improvement for developing spenddown plans. Support for senior leadership in considering health equity and department structure. Each project is custom built around the health agency’s needs. ASTHO works closely with the agency to develop a project proposal, and then match with an SLRC member with relevant expertise to support them in addressing the challenge. The role of the SLRC member can include strategic thought partner, tactical implementer, objective third party, outside voice, advisor, subject matter expert, and more. website no False

Becoming a Senior Leader Reserve Corps Member Are you a former state, territorial, or federal health agency leader retired from government service who desires to use your expertise to support health agency leaders in addressing their toughest challenges? In collaboration with CDC, the Senior Leader Reserve Corps (SLRC) is a flexible and innovative program through which former health agency leaders use their specific expertise to provide technical assistance (TA) to current state/territorial health agency leaders. Upon receiving a request for TA, ASTHO turns to this pool of former leaders to serve as paid expert consultants to health agencies. The role of the SLRC member can include strategic thought partner, tactical implementer, objective third party, outside voice, advisor, subject matter expert, and more. Each project is custom built around the health agency’s needs. ASTHO works closely with the agency to develop a project proposal, and then matches with an SLRC member with relevant expertise to support them in addressing the challenge. website no False

ASTHO is at the forefront of helping state and territorial health agencies navigate the rapidly evolving landscape of artificial intelligence (AI) in public health. This curated list of resources provides users with interdisciplinary information on AI use cases, policy development, research, risk mitigation, and more. We will regularly add to and edit this library as new insights surface across this highly dynamic field. If you would like to share resources you’ve found useful, contact us at innovation@astho.org.  AI in Public Health: Resource Library AI in Public Health: Resource Library Browse this library of resources focused on AI in public health, for interdisciplinary insights on use cases, policy development, research, risk mitigation, and more. article

ASTHO supports, equips, and advocates for state and territorial health officials in their work of advancing the public’s health and well-being by providing capacity building and technical assistance in a variety of topic areas.

Critical look at why evaluating AI health interventions is often inadequate and what better evaluation frameworks should require.