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This session focuses on increasing awareness on how PRAMS weights are constructed, how to properly subset data for weighted analyses, and when health department staff should be worried about over/under estimation. The presenters provide thoughts and methods for checking assumptions of subgroup estimations, potential bias risks, and how re-weighting is sometimes used for smaller subpopulation assessments. Featured Speakers: - Jared Parrish, PhD, ASTHO Contractor - Phil Hastings, PhD, Founder and Principal, Far Harbor. - Joe Pirozzolo, PhD, Research Statistician, Far Harbor.

In this webinar, participants obtain an overview of the impact data equity has on improving maternal and infant health outcomes as well as the role providers play in advancing maternal health through data equity practices. Featured Speakers: - Jennifer Tang, MD, MSCR, Associate Professor, UNC Department of OB-GYN, UNC Project-Malawi - Ndidiamaka Amutah-Onukagha, PhD, MPH, CHES, Associate Professor, Public Health and Community Medicine, Assistant Dean of Diversity, Equity, and Inclusion, Director and Founder, Center for Black Maternal Health and Reproductive Justice, Director and Founder, MOTHER Lab

ASTHO informatics and innovation leaders gathered for an introduction to AI and its potential applications in state and territorial public health.

In Georgia, funding from CDC's Preventing Adverse Childhood Experiences: Data to Action (PACE:D2A) program helps address and prevent adverse childhood experiences (ACEs), build resilient communities, improve community environments, and reduce and destigmatize trauma.

Leveraging Healthy People 2030 to Build Non-Traditional Multisector Partnerships multisector partnerships, healthy people 2030, health equity, health outcomes, social services, health disparities, preventable disease, premature death, health literacy, economic stability, social determinants of health, department of health, improving the health, united states, long term, life expectancies, population health, chronic diseases, prevention and health promotion, health care system, disease prevention and health, health systems, healthy people 2030 objective, subject matter experts, office of disease prevention, personal health literacy, achieving health equity, health problem, population groups, astho, association of state and territorial health officials Corinne Gillenwater, Megan DeNubila-Griffin ASTHO | This toolkit helps public health build and maintain relationships with non-traditional partners across a multitude of sectors. The goal of this toolkit is to help state and territorial health agencies (S/THAs) build non-traditional, non-public health sector partnerships to improve health outcomes and advance health equity. The Healthy People 2030 objectives, aligned closely with the Social Determinants of Health (SDOH) framework and Health in All Policies (HiAP) lens, can serve as the cornerstone of these collaborations. This toolkit is implementation-focused, providing partnership-building and -sustaining skills that are rooted in Healthy People 2030 tools and success stories and can be operationalized for community needs. Overall, this toolkit encourages S/THAs to implement these described strategies in their own public health practice to: Establish and maintain partnerships within and across sectors at the state and territorial level to create a shared vision of health. Respond to public health priorities collaboratively and strategically. On This Page Using Healthy People 2030 in Non-Traditional Partnerships to Improve Public Health Types of Non-Public Health Sector and Non-Traditional Partnerships for Consideration Foundations of Strong Partnerships Sustainability of Partnerships 10 Steps for Strong Public Health Multisector Partnerships Conclusion Additional Resources website yes

In May 2021, President Biden released full details of the fiscal year 2022 budget. Overall, the budget request combines President Biden's American Jobs Plan, his American Families Plan, and funding priorities for the Pentagon and domestic agencies, for a projected total of $6 trillion. Read more about what the president is proposing in this post.

Information and resources regarding PRAMS, an ongoing, site-specific, population-based surveillance project.

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.

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.

State issued documents, such as birth certificates, are often required to navigate daily life. Vital records policy is a complex and evolving issue with many of the processes and procedures left to jurisdictional policy-makers.

Upgrading how public health and healthcare systems share data.

Public Health’s Silent Defender: Cybersecurity ASTHO, Association of State and Territorial Health Officials, Public health, health sector coordinating council, strategic preparedness, preparedness and response, ASPR, HHS, cybersecurity, cyber attack, health data, public health data, hack, cyber threat, patient care, healthcare system, hospital data, disabled systems, information technology, department of health and human services, patient data, medical devices, public health trends, health information, patient safety, ransomware attack, federal government, sector risk management, critical infrastructure, medtech pharma, infrastructure security, mandatory reporting, mitigating attacks, cybersecurity video, cybersecurity resource, HICP, health industry cybersecurity practices Jennifer Jean-Pierre ASTHO | Learn the importance of cybersecurity to public health and hear strategies for public-private cyber partnerships. In August of 2022, a cyberattack took the Fremont County Department of Health offline for 30 days—and health systems continue to be a top target of similar attacks. In this conversation, Brian Mazanec and Greg Garcia share how health systems can prepare for and prevent cyber attacks. Hear strategies for public-private cyber partnerships, easy wins every health agency can take, and how cyber attacks have evolved—and dramatically increased—in recent years. Show Notes Interviewer Jennifer Jean-Pierre, Director, Content Development and Communications, ASTHO Guests Greg Garcia, Executive Director, Healthcare Sector Coordinating Council Brian Mazanec, PhD, Deputy Assistant Secretary and Director, Office of Security, Intelligence, and Information Management, U.S. Department of Health and Human Services Interview Transcript-Blog - Public Health’s Silent Defender: Cybersecurity website yes

On May 16, 2023, ASTHO announced that the annual Public Health TechXpo and Futures Forum in-person registration is sold out. However, virtual participation is still open and encouraged.

To learn more about Iowa’s recent efforts to fight against HIV, ASTHO spoke with Sarah Reisetter, chief of compliance and a deputy director at Iowa HHS, and Randy Mayer, chief of the Iowa HHS Bureau of HIV, STI, and Hepatitis.

Surveillance data allow public health practitioners and researchers to track changes in the burden of ACEs by collecting data on previous exposure, health conditions that may impact or be impacted by exposure, and other related topics.

ASTHO’s 2023 Public Health TechXpo and Futures Forum is a platform to tackle the toughest public health challenges facing the nation, both today and in the future.

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

Explore INSPIRE: Readiness by ASTHO—an innovative hub for public health preparedness. Share strategies, tools, and solutions to boost readiness.

Illinois Strengthens Public Health Infrastructure with New Data Modernization Director Alicia Camuy Learn how Illinois is using Public Health Infrastructure Grant funding to promote data modernization. As COVID-19 demonstrated, robust data infrastructure is critical to an effective public health emergency response. The pandemic highlighted the urgent need for health departments and other public health entities to improve how health data is collected, stored, and shared. The CDC-led Data Modernization Initiative (DMI) is working across all levels of public health to meet this urgent need. Part of this initiative is the Public Health Infrastructure Grant (PHIG), a groundbreaking investment supporting 107 recipients working to bolster the public health workforce, enhance foundational capabilities, and advance data modernization and informatics. PHIG national partners and specialized Implementation Centers support these efforts through technical assistance and capacity building. Some PHIG recipients have utilized this funding to staff dedicated DMI positions and convene advisory committees. The Illinois Department of Public Health (IDPH) recently hired Gayatri Raol as its Data Modernization Director to oversee the state’s efforts in this area. What are your highlights from your data modernization work around PHIG so far? Gathering Data Modernization Stakeholders To build some structure around DMI implementation, IDPH recently kicked off a data governance board, data modernization advisory committee, and DMI strategic planning workgroup, which all bring in key stakeholders to have focused conversations on data initiatives. The board defined data governance for IDPH and is working on approving and adopting a department-wide data suppression policy, which will be a major success for the department. Adopting a Data Sharing Agreement IDPH has finalized a Master Data User Agreement to streamline data sharing practices, which will allow local health departments to access data for birth and death records, hospital discharge, cancer registries, syndromic surveillance, prescription monitoring programs, and more. Bolstering the Data Modernization Workforce We are working with the CDC Foundation Workforce Acceleration Initiative, a program that places data and technology experts in public health agencies to accelerate data systems improvement. Through that collaboration, we have been awarded two technical and two project management support positions. Training a Data Literate Health Department IDPH has also started exploring a data literacy program to support IDPH staff and local health departments in understanding the data we have, what it means, and how to manage it. This program will be the initial step towards change management to build a data-driven organization and a data literate workforce. Building a Streamlined Data Request Management System IDPH is streamlining and centralizing data request processes across the department. The department is collaborating with IT to develop a data request tracking and management system. If we can reduce the time of the process by even 25%, then it will be a success. This project will increase the transparency around data requests processing and keep our data governance board, internal review board, and data owners informed about data sharing practices. What challenges do you expect to encounter and how do you plan to meet them? Our challenges are not unique compared to those faced by other public health departments, but they are significant in the context of other data modernization initiatives. Some of our main challenges are: Slow, cumbersome, and complicated hiring and procurement processes. Stringent policies. Understanding diverse workforce and population needs. Acquiring sustainable funding and buy-in. For those challenges beyond our control, our team focuses on communication and collaboration to move toward improvement. However, for those challenges we can directly impact, we follow several key strategies: Reviewing and updating existing policies to make them more flexible and adaptable, allowing us to respond more quickly and effectively to new opportunities and challenges. Investing in data literacy programs to enhance our workforce’s skills, enabling them to better interpret and use data in decision-making processes. Incorporating a health equity and justice lens into data-related projects and processes to better meet the needs of the communities we serve. Investing in foundational data management practices and processes. How is IDPH’s data modernization work impacting IDPH itself and, ultimately, Illinois residents? It is difficult to measure the direct impact of state-level data modernization efforts on the lives of Illinois citizens. However, enhanced data management practices will equip our public health leaders to make more informed decisions. Better quality and more integrated data will help keep decision-makers informed on how to allocate resources, identify public health trends and outbreaks, and respond efficiently to public health crisis. OE22-2203 PHIG article yes

Advanced Grant Payments: Creating a More Equitable Public Health System Advanced Grant Payments Promote Equity in Public Health Jignasa Jani, Ryan Rivera Learn how advanced grant payments can ensure smaller community-based organizations have necessary resources, creating greater equity in public health. Community-based organizations are critical partners to state health agencies in implementing public health programming, often reaching underserved populations and those at greater risk of experiencing health disparities. However, smaller or less-established organizations frequently face significant barriers when receiving grant funding (e.g., not having the necessary upfront capital to cover initial project costs). The Colorado Department of Public Health and Environment (CDPHE) recognizes these challenges and is taking bold steps to improve administrative processes for grant funded programs. These steps will go a long way towards ensuring that smaller community-based organizations have the resources they need to succeed, creating greater equity in the public health system. Redesigning Payment Structures for Greater Access To improve its administrative process, CDPHE is redesigning its payment structure for grant-funded programs. Historically, many grants have operated on a cost-reimbursement basis, where organizations must first cover the costs of services or goods before being reimbursed by the state department. This approach can exclude or unfairly burden smaller or less-established organizations that lack the upfront capital to participate fully in grant-funded initiatives, many of which serve disadvantaged and under-resourced populations. As such, CDPHE identified advanced payments as a priority, reflecting the department’s commitment to inclusion, diversity, equity, and accessibility. Following the enactment of Colorado House Bill 21-1247, CDPHE worked with policymakers to allow the department to provide advance payments to certain grantees and were granted the authority to provide certain grant recipients up to 25% of the total award value immediately on execution or renewal of the contract. By doing this, CDPHE may provide funding opportunities for eligible organizations to have the financial support they need from the start to support their communities. Jignasa Jani 1 - Advanced Grant Payments Promote Equity in Public Health The Prevention Services Division (PSD) within CDPHE led implementation of House Bill 21-1247 and administers a wide range of programs, including those focused on chronic disease prevention, tobacco cessation, injury prevention, suicide prevention, sexual health, and women’s health. By offering advanced payments, PSD empowers smaller organizations to carry out these important public health programs, which are essential to improving the health and well-being of Colorado’s most vulnerable populations. Ryan Rivera - Advanced Grant Payments Promote Equity in Public Health Overcoming Challenges in Implementation While the benefits of advanced payments are clear, implementing this new process has come with its fair share of challenges. The complexity of state and federal rules often places smaller organizations at a disadvantage, making it difficult for them to navigate the administrative requirements of grant funding. PSD staff dedicated significant time and effort to developing the necessary guidelines, policies, and procedures to support the advance payment process. These safeguards were crucial in gaining the support of department fiscal staff, ensuring that taxpayer funds are used appropriately and effectively. PSD staff had to go above and beyond their regular duties to create a robust process that would mitigate risks while providing necessary support to grantees. Their dedication to this initiative reflects a deep commitment to equity and inclusion, and to ensuring that all organizations, regardless of size, have equitable access to grant funds for public health work. Jignasa Jani 2 - Advanced Grant Payments Promote Equity in Public Health Supporting Grantees Through Ongoing Assistance To ensure the success of the advance payment process, PSD staff work closely with grantees to help them understand and comply with the new requirements. This includes providing technical assistance on financial management, invoicing, and compliance with state and federal regulations. By offering this support, CDPHE helps organizations build the capacity they need to manage grant funds effectively and reduce the likelihood of being classified as high-risk in the future. PSD’s efforts extend beyond the initial implementation of the advance payment process. The division is committed to continuous improvement, regularly gathering feedback from grantees and internal staff to refine and enhance the process. This approach ensures that the system remains responsive to the needs of community-based organizations and continues to support their success. Looking Ahead This initiative has the potential to increase the number of applications and funding awards to community-based organizations serving under-resourced populations, further enhancing the diversity and reach of public health programs in Colorado. As more organizations successfully navigate the grant funding process, the overall capacity of Colorado’s public health system will grow stronger, leading to better outcomes for all communities. article yes