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Continuing ASTHO’s Legislative Prospectus series—which highlights the top 10 public health policy issues for 2022—we are focusing this week on mental and behavioral health as well as supporting the public health workforce.

Amid so much uncertainty, it might feel naïve to make any claims about what the future holds. But it is in these moments that it becomes more important than ever to have beacons to guide us and give us hope. As we look ahead to 2022, here are four priorities that must steer the public health course in the year to come.

Vaccines are one of the greatest public health achievements of the last century, as well as some of the most powerful and cost-effective tools to prevent disease, disparities, disability, and death among children and adults. The COVID-19 pandemic and the unprecedented development and distribution of the vaccines against the novel coronavirus have generated much focus on state laws related to vaccinations. As state and territorial legislatures prepare to convene in the coming weeks, we can already identify several topics within vaccine law that policymakers across the country will consider.

While governments have faced challenges in adopting a Health in All Policies (HiAP) approach to respond to COVID-19, the impact of the public health emergency across sectors such as housing, transportation, and employment has created a unique opportunity for stakeholders to build and strengthen collaborative systems to address the inequities exacerbated by COVID-19.

In the late fall of 2021, ASTHO leadership visited select jurisdictions in the Pacific and the Atlantic for the first time since COVID-19 curtailed travel to these regions. It was a fantastic to reconnect with our leadership and dedicated staff. Unsurprisingly, we heard about the jurisdictions’ challenges, including chronic ones related to funding and infrastructure, as well as new challenges resulting from the global pandemic.

The 2020-2021 influenza season in the United States was historically quiet since so many people took steps to mitigate COVID-19 exposure (e.g., masking, hand washing, travel restrictions, and school closures). As a result, reduced population immunity could make this flu season more severe. Nationwide, both laboratory-confirmed influenza detection and outpatient visits for influenza-like illness have increased in the last weeks of 2021.

As communities around the country continue to navigate the complexities of COVID-19 management and prevention this fall, reliable resources are needed for connecting public health leaders with the latest information on treatment. HHS's Combat COVID website provides information and tools for both the public and public health officials to learn about available COVID-19 treatments and clinical trial research underway to identify new treatments.

Housing and overall neighborhood conditions significantly influence a community’s health. Housing quality, stability, and affordability also directly impact an individual’s opportunity and ability to be healthy. There are several policies and initiatives at the federal and state levels focused on improving four pathways connecting housing and health as discussed in this post.

On Dec. 3, International Day of Persons with Disabilities, ASTHO is commemorating nearly 12 months of supporting disability and preparedness specialists in state and territorial health agencies. Throughout 2021, ASTHO embedded 20 full-time disability and preparedness specialists within state and territorial public health agencies to ensure an inclusive approach to emergency preparedness. This is the first of a multi-part series spotlighting these embedded experts.

The disparities experienced during the COVID pandemic have brought a national focus to health equity in our nation. The attention and resources currently being provided to help address health inequities provide an opportunity that I have never experienced in my public health career. There are still challenges, but we have an opportunity to build momentum for the first time in decades if we can focus on implementing evidence-based strategies, demonstrating change and documenting our progress.

Every year on Nov. 22, ASTHO—and countless other agencies and organizations worldwide—take a moment to acknowledge the public health workforce on Public Health Thank You Day. Like so many other days of recognition, it has become a blip on our yearly calendar. And, simply put, that’s just not enough. This year, ASTHO leadership took pen to paper to share some of our feelings, fears, and—yes, our thanks—for everything the public health workforce has always done to protect us.

A groundbreaking “all-of-government” approach is getting underway in the U.S. Virgin Islands to more efficiently manage and expend federal grant funding for social determinants of health and overall population health improvement. The initiative follows findings that public health agencies encounter redundant, multi-layered review and approval processes that hamper their ability to efficiently procure needed goods and services that address long standing and emerging public health needs. Moreover, such processes hinder the ability to quickly stand up critical programs and respond to public health emergencies.

As we anticipate the likely approval of COVID-19 vaccination for children, our nation faces the final step to bring the COVID-19 pandemic under control. If approved for children ages 5-11, the COVID-19 vaccine will dramatically improve our efforts to resume in-person learning in our nation’s schools and will help break the cycle of transmission from children to adults.

In addition to the countless hours worked during the COVID-19 pandemic, many public health workers are also grappling with how to repay outstanding federal loans. In response, the U.S. Department of Education (DOE) recently announced temporary relief to current and future Public Service Loan Forgiveness (PSLF) program participants as a result of the COVID-19 pandemic.

Nov. 3, 2021, marks the sixth annual One Health Day, a global campaign to recognize and embrace how public health is connected to the health of animals and our shared environment. In this post, ASTHO talks about One Health with Wayne E. Cascio, MD, who serves as the Acting Principal Deputy Assistant Administrator for Research and Development at EPA.

Flavored tobacco policy has changed rapidly over the past few months. In April, FDA announced their intention to implement rules prohibiting the sale of menthol e-cigarettes and flavored cigars, though it may take years until they implement a final rule. And in 2021, 15 states and Washington, D.C. considered legislation prohibiting the sale of some or all flavored tobacco products. However the tobacco industry has seen success recently in obstructing the legislative efforts of states in this area.

Researchers estimate more than 140,000 children in the United States experienced the death of a parent or grandparent caregiver between April 1, 2020 and June 30, 2021. The study highlights disturbing disparities in caregiver deaths by race and ethnicity. Hispanic, Black, and American Indian/Alaska Native children were at 1.1 to 4.5 times higher risk of losing a caregiver than non-Hispanic White children. These inequities result from structural and social conditions such as discrimination, living in under-resourced neighborhoods, barriers to accessing healthcare, experiencing food insecurity, and economic instability.

The Special Supplemental Nutrition Program for Women, Infants, and Children is a targeted public health nutrition program designed to support nutrition and health behaviors that reach low-income families. The program is funded through discretionary funds to the United States Department of Agriculture and administered by each state’s health or public health department. The department then contracts with county health departments, local health centers, hospitals, federally qualified health centers, and private nonprofits to deliver community-based clinic services.

In 2020, the COVID-19 pandemic exacerbated barriers to care and treatment for individuals experiencing opioid use disorder. Experts estimate a record-setting 90,000 people died of a drug overdose in 2020. Additionally, as the pandemic continues, it has understandably diverted attention, funds, and personnel usually focused on the opioid crisis. State and local public health departments are experiencing an all-time low in staffing, especially among Maternal and Child Health programs.

Six questions with Scott Becker, CEO of the Association of Public Health Laboratories. Becker is active in national and international public health initiatives. He chairs the Governance Working Group for the Global Laboratory Leadership Program, a collaboration with the World Health Organization, CDC, and others to develop a competency-based curriculum for laboratory leaders. Additionally, Becker is a member of the Affiliate Council of ASTHO, which he formerly chaired.