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Rhode Island Health Director Nicole Alexander-Scott, MD, MPH, Named ASTHO President ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) announced the appointment today of Nicole Alexander-Scott, MD, MPH, director of the Rhode Island Department of Health, as ASTHO’s new president, effective Sept. 27. “I am incredibly excited to serve as president of this amazing organization and to have an opportunity to collaborate with so many talented and dedicated public health leaders,” says Dr. Alexander-Scott. “I look forward to working with states and territories to help address the many public health challenges we face today, so we can ensure that everyone has an equal opportunity to be as healthy as possible, and to live in as healthy a community as possible, no matter what you look like, what you sound like, or where you live.”  Dr. Alexander-Scott has served as director of the Rhode Island Department of Health since April 2015. She is the first African-American individual to serve as Rhode Island’s top health official. She was elected ASTHO president-elect in September 2017. During her career, Dr. Alexander-Scott worked as a specialist in infectious diseases for children and adults, previously an associate professor of pediatrics, medicine, and public health (with a focus on health services, policy, and practice) at Brown University. She is board certified in pediatrics, internal medicine, pediatric infectious diseases, and adult infectious diseases.  In Rhode Island, Dr. Alexander-Scott has made it a priority to address health equity, with the conviction that every person and every community should have an equal opportunity to be as healthy as possible. She has emerged as a leading voice committed to addressing community-level determinants of health, such as education, housing, transportation, and employment, so that a person's health does not depend on their ZIP code. Originally from Brooklyn, New York, Dr. Alexander-Scott attended Cornell University, majoring in human development and family studies. She subsequently graduated from SUNY Upstate Medical University at Syracuse in 2011. After completing a combined internal medicine-pediatrics residency at SUNY Stony Brook University Hospital in 2005, Dr. Alexander-Scott finished a four-year combined fellowship in adult and pediatric infectious diseases at Brown in 2009. She holds a master’s degree in public health from Brown University. “We are thrilled to have Dr. Alexander-Scott serve as our new president. Her experience addressing the social determinants of health in Rhode Island has been a true inspiration for all of us who work in public health,” says Michael Fraser, chief executive officer of ASTHO. “We look forward to her continued work in this area with this year’s ASTHO President’s Challenge, ‘Building Healthy and Resilient Communities.’ In public health, we often talk about moving upstream and addressing health disparities. Nicole’s tremendous leadership at the Rhode Island Department of Health really exemplifies what is meant by this. I look forward to working with and learning from Nicole in the year ahead.” Nate Smith, director of the Arkansas Department of Health, will serve as ASTHO president-elect.  ASTHO Press Release Boilerplate website yes

Health Officials Respond to Alarming Increases in Congenital Syphilis ARLINGTON, VA—Newborn syphilis cases have more than doubled in the last 4 years, and last year, the United States saw the most cases of congenital syphilis since 1997, according to a new CDC report. Babies born with untreated syphilis can face serious consequences, including an array of neurological and developmental health problems. The Association of State and Territorial Health Officials (ASTHO) and its members are committed to protecting the health of mothers and infants by raising awareness and urging action to address this alarming disease. Several states are also seeing a rise in congenital syphilis cases. Many women are not receiving timely prenatal care for early detection and treatment, so the increase may be partly because more women of reproductive age are infected with the disease. “In California, and nationwide, we are seeing a significant and concerning increase in the number of congenital syphilis cases,” says Karen Smith, state public health officer and director of the California Department of Public Health. “It is critical that pregnant women be tested for syphilis at their first prenatal visit, and women at risk for syphilis should receive repeat screening during the third trimester and again at delivery.” John Hellerstedt, commissioner of the Texas Department of State Health Services, also recognizes the importance of prenatal care for every pregnancy: “We’re partnering with healthcare providers and community organizations to increase awareness about congenital syphilis. Texas, along with other high burden areas, has also convened case review teams to help us better understand what’s leading to an increase in cases, including possible barriers to prenatal care.” In late 2017, California, Texas, and seven other jurisdictions received grants from the Centers for Disease Control and Prevention (CDC) to strengthen local capacity to address and respond to congenital syphilis. “The data in CDC’s 2017 STD Surveillance Report reiterates the need for continued work on STD prevention,” says Hellerstedt. “It presents a significant challenge, but with support from our partners in healthcare, public health efforts can stem the tide of congenital syphilis.” “With cuts to public health budgets, it’s no surprise we’re seeing a rise in rates,” says Michael Fraser, CEO of ASTHO. “What we’re hearing from states is that the unfortunate increases in congenital syphilis cases has a lot to do with decreases in funding for the core work for STD prevention. These statistics remind us that we need to sustain funding for public health – we know what we need to do, we just need to have the resources to do it.” ASTHO Press Release Boilerplate website yes

Michigan Court Decision on Health Official's Case is Bad for Public Health ARLINGTON, VA—Michael Fraser, CEO of the Association of State and Territorial Health Officials (ASTHO), issued the following statement today in response to a Michigan court's decision to proceed with the prosecution of a sitting health official for decisions made in notifying the public about an outbreak of Legionnaires' disease in Genesee County in 2014 and 2015: "We are very disappointed that the court decided to allow the prosecution against Nick Lyon to proceed to trial. ASTHO firmly believes criminally charging a public health official for deaths related to an outbreak sets a dangerous precedent for leadership and decisionmaking during a public health crisis. The ultimate goal among our nation's state and territorial health officials is to protect the health and well-being of their constituents. State health officials and their leadership teams are trained to make thoughtful, scientific, and data-driven decisions, while limiting undue public panic. As this case moves forward to trial, ASTHO will continue to articulate the serious ramifications and lasting impact the court's decision will have on our profession as a whole." ASTHO Press Release Boilerplate website yes

Illnesses on the Rise from Mosquito, Tick, and Flea Bites Remain Top Issue for Health Officials ARLINGTON, VA—Today, CDC released a Vital Signs report on the nation’s increasing risk of vector-borne disease and what can be done to reduce those risks. The Association of State and Territorial Health Officials (ASTHO) applauds CDC’s rigorous review of data to shine an evidence-based spotlight on how vector-borne diseases affect humans but is concerned about how states will address these growing disease threats with limited funding. Key points stressed in the report include: A total of 642,602 cases of vector-borne disease spread by mosquitoes, ticks, and fleas were reported from 2004-2016. The number of reported cases of vector-borne disease tripled during this time period. Risks of vector-borne disease appear to be increasing, with nine new vector-borne diseases discovered in the US since 2004. Unfortunately, 84% of vector control programs report needing improvement in one or more of five core vector control competencies. Every state is vulnerable. States and local public health agencies can help mitigate the growing threat of vector-borne disease by building and sustaining public health programs, training vector control staff, and educating the public about how to prevent bites and control vector-borne disease in their communities. "Today’s report vividly demonstrates that diseases like West Nile Virus, Zika, Lyme, dengue, plague, and Rocky Mountain Spotted Fever, and other emerging pathogens carried by mosquitos, ticks, or fleas, increasingly remain a clear and present danger to the public’s health," says John Wiesman, ASTHO president and secretary of health at the Washington State Department of Health. "Community-based vector control services are all-to-often neglected and under resourced." State, territorial, and local public health departments have a critical role in the nation’s main defense against the increasing threat of these diseases. Demands on public health agencies across the country for services such as vector and disease tracking, laboratory testing, epidemiologic investigation, vector abatement and control, pesticide resistance testing, and public education are also increasing, but funding levels are not keeping pace with these demands. "Everyone has a role in protecting themselves against mosquito and tick bites and controlling mosquito and ticks in and around their home and property,” says Michael Fraser, executive director of ASTHO. “Government policy and decision makers also have a role in taking the necessary steps to increase our investments in preparedness and response in order for states and territories to have comprehensive and effective vector prevention and control programs." For more information on vector control, check out these ASTHO resources: Before the Swarm: Guidelines for Managing Vector-Borne Disease Outbreaks Communicating about Effective Mosquito Control Public Health Confronts the Mosquito ASTHO Press Release Boilerplate website yes

ASTHO Urges Congress to Increase Funding for Public Health Programs ARLINGTON, VA—Today, John Wiesman, ASTHO president and secretary of health at the Washington State Department of Health, submitted written testimony to the House Labor, Health and Human Services and Education Appropriations Subcommittee urging Congress to provide increased funding to support public health programs in FY19. This funding would allow federal agencies that support state, local, and territorial public health departments to improve the health of the population by addressing the opioid epidemic, enhancing preparedness programs, and continuing services through the Preventive Health and Health Services Block Grant. “Our federal partners, including CDC and HRSA, provide a level of financial support to health departments that state budgets simply cannot fulfill on their own. We are pleased Congress recently provided the most significant increase for public health in over a decade, however, we must build upon this momentum and provide states and territories with sustained, predictable, and hopefully increased funding in FY19 and beyond. State and territorial health officials are saving lives every day and health departments rely heavily on these federal funds to achieve broad impact and sustain high levels of success. The health of our nation is a matter of national security. ASTHO and our members stand ready to assist Congress and the Administration in our shared work of protecting and promoting the public’s health.” ASTHO Press Release Boilerplate website yes

ASTHO Statement on the Appointment of CDC Director, Robert Redfield ARLINGTON, VA—John Wiesman, ASTHO president and secretary of health at the Washington State Department of Health, issued the following statement on the appointment of Dr. Redfield as the director of CDC. “ASTHO looks forward to meeting and building a positive working relationship with Robert Redfield, MD, the new director of the Centers for Disease Control and Prevention (CDC). As the nation’s premiere resource for public health practitioners and their partners, CDC provides critical resources, scientific expertise, and technical assistance to state, local, and national programs to strengthen public health capacity, share timely and critical information, and improve health and save lives daily.” “ASTHO believes a strong CDC is essential to the strength, economic well-being, and productivity of the American public. We are eager to share the priorities and perspectives of state health leaders and continue to ensure the use of sound scientific evidence when making policy decisions to protect, improve, and promote our nation’s public health. We are confident that Dr. Redfield will value and draw upon the expertise of state and local public health leaders as he begins his tenure as director of the agency.” ASTHO Press Release Boilerplate website yes

ASTHO Applauds Bipartisan Budget Deal ASTHO Applauds 2018 Bipartisan Budget Deal ARLINGTON, VA—Today, President Trump signed the Bipartisan Budget Act of 2018 into law ending the very brief government shutdown. John Wiesman, ASTHO’s president and secretary of health at the Washington State Department of Health, issued the following statement in response: “We applaud Congress and the Administration for their approval of the Bipartisan Budget Act of 2018. This bi-partisan law will greatly assist state and territorial public health in promoting and protecting the health of all Americans. Specifically, this law provides the necessary resources for states and territories recovering from the recent natural disasters, and ensures stable funding for the Maternal, Infant, and Early Childhood Home Visiting Program. During negotiations of the bill, Congress also promised to provide $6 billion to help address the ongoing opioid crisis. Given the current public health emergency declaration, ASTHO strongly urges Congress to allocate a portion of this funding to the Centers for Disease Control and Prevention and states and territories so they can scale up evidence-based public health prevention programs. The deal does restore funding to the prevention and public health fund for FY19-FY21, which we greatly appreciate. These funds support core work detecting and responding to outbreaks, preventing tobacco use, and immunizing our children. However, ASTHO remains very concerned about cuts to the fund after 2022 and the core public health programs that these funds support. It urges Congress and the Administration to reconsider that decision in the out years. Health promotion and disease prevention activities require robust and sustained federal funding. The Bipartisan Budget Act is an important step in the right direction and we look forward to working with Congress to develop the FY18 omnibus appropriations bill to ensure additional resources are allocated to public health so we can continue our mission to improve the health and wellbeing for all.” ASTHO Press Release Boilerplate website yes

Opioid Epidemic Remains a Public Health Emergency ARLINGTON, VA—ASTHO President John Wiesman issued the following statement in response to Acting HHS Secretary Eric Hargan’s announcement about the renewal of the public health emergency declaration to address the opioid crisis.  “Renewing the public health emergency declaration is an important step in the right direction. However, this renewal must be coupled with resources so states and territories can scale up their public health interventions. We also hope the public health emergency can spur efforts to reduce the stigma that can be associated with substance use disorder and treatment, and fund prevention efforts with our youth and families to help end this crisis.”  “Ninety days have passed since the President first declared the opioid epidemic a public health emergency. Neither the Administration nor Congress has requested or provided additional resources to address this epidemic that is plaguing our nation. Since the initial declaration in October, nearly 4,140 people have died from opioid overdoses and 90,000 have been treated in hospital emergency departments. Congress needs to take action and increase federal support for treatment, recovery, and prevention programs.”  ASTHO Press Release Boilerplate website yes

Mixed Progress on Preventing Preterm Births Concerns State and Territorial Health Officials ARLINGTON, VA—Today, the March of Dimes released its 2017 Premature Birth Report Card, which found that few states have lowered prematurity rates, and in some states, prematurity rates have increased among all racial/ethnic groups. Preterm birth remains disproportionally higher among African-American women and minority groups. "Preventing preterm births is vital for healthier babies and mothers. Such births have both short-term and long-term negative impacts, and disproportionately impact women of color. We must do more to address this problem and think beyond simply the doctor's office or a prenatal visit. We must work to reach women in their communities and look at the social determinants of health—the conditions in which we live, work, and play,” says Karyl Rattay, MD, director of the Delaware Division of Public Health and chair of ASTHO’s Healthy Babies Subcommittee. “These determinants can have a significant impact not only on women's access to care, but also increase their risk for preterm birth." The Association of State and Territorial Health Officials (ASTHO) remains committed to helping states and territories reduce prematurity rates. Preterm birth, a complex, multifaceted issue without a single solution, is the largest contributor to infant death in the United States. “As a country, we have made many strides toward improving access to care for pregnant women and children and reducing non-medically necessary early elective deliveries. But the slight increase in some states’ preterm birth rate is a call for all of us to collectively redouble our efforts,” says Michael Fraser, ASTHO’s executive director. “This report card provides data that should spur continued efforts to reduce preterm birth and further address racial, ethnic, and socioeconomic disparities. As Congress debates funding for our nation’s public health and prevention programs, I hope they do not forget to prioritize the neediest among us—our children—as well as support state and territorial health programs.” Infants born before 37 weeks gestation are more likely to die or experience long-term negative health outcomes and lifelong morbidity. Most preterm infants have a low birth weight, which places the infant at greater risk for developing chronic health conditions as an adult, such as diabetes, which in turn becomes a future risk factor for preterm birth. Other potential health impacts of premature births include breathing problems, jaundice, vision loss, and intellectual delays. There are many reasons why preterm births occur, including access to healthcare, even in a time of expanded coverage, as well as unplanned or closely spaced pregnancies, and environmental concerns in communities. State and territorial health departments work daily to improve the health of mothers and babies and create conditions to achieve optimal health for all. To learn more about how states are working to improve birth outcomes, view ASTHO’s Healthy Babies map. ASTHO Press Release Boilerplate website yes

ASTHO Awards Public Health Leaders for Outstanding Service ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) honored public health leaders with several awards this week at its 2017 Annual Meeting in recognition of their outstanding service and dedication to improving state and territorial public health.  “On behalf of ASTHO, I am truly honored to present this year’s awards to a group of individuals who bring transformative leadership to the field of public health and embody a genuine desire to improve our nation’s health. Their accomplishments have made a difference in the lives of others, and we are inspired by their commitment to lead with compassion, integrity, and perseverance,” says ASTHO Executive Director Michael Fraser. The 2017 ASTHO awardees include:  Georges Benjamin, MD, executive director of the American Public Health Association Ed Thompson 2017 Lifetime Achievement Medal With over 35 years of experience in public health as a physician, state health official, and executive director of the American Public Health Association, Benjamin has inspired countless public health leaders and has been named among the 100 most influential people in healthcare. Michael Botticelli, executive director of the Grayken Center for Addiction Medicine at Boston Medical Center ASTHO 2017 Presidential Meritorious Service Award Botticelli, former director of the White House Office of National Drug Control Policy, was the first person to hold this position while also in long-term recovery from a substance use disorder. Vivek Murthy, MD, 19th Surgeon General of the United States ASTHO 2017 Presidential Meritorious Service Award As surgeon general, Murthy created initiatives to tackle our country’s most urgent public health issues, including the first-ever Surgeon General’s report issuing a call to action on addiction as a chronic illness. Tom Frieden, MD, former director of CDC National Excellence Award On the national level, Frieden, who served as director of CDC from 2009-2017, led work to end the Ebola epidemic and control the largest outbreak of drug-resistant tuberculosis in the United States, among other initiatives. J. Patrick O’Neal, MD, commissioner of the Georgia Department of Public Health State Excellence Award On the state level, O’Neal brings a great deal of medical and military experience to the public health community, greatly enriching ASTHO’s mission and the health of all Georgians. Paul Jarris, MD, chief medical officer for the March of Dimes ASTHO Alumni 2017 Award As a nationally recognized expert in healthcare policy, clinical quality initiatives, public health, and disease prevention and wellness, Jarris used his expertise to serve as commissioner of health at the Vermont Department of Health from 2003-2006 and ASTHO executive director from 2006-2016. Rep. Tom Cole, chair, House Labor, HHS and Education Appropriations Subcommittee 2017 ASTHO Legislative Champion Award Cole was elected to Congress in 2002 and is currently serving in his eighth term in the U.S. House of Representatives. Cole has been supportive of important public health initiatives, such as the CDC’s Public Health Emergency Preparedness program. Rep. Rosa DeLauro, ranking member, House Labor, HHS, and Education Appropriations Subcommittee 2017 ASTHO Legislative Champion Award DeLauro is the Congresswoman from Connecticut’s Third Congressional District. DeLauro spearheaded bipartisan legislation to raise awareness of gynecologic cancers and the WISEWOMAN program, and has supported food safety measures, youth tobacco use prevention, and mental health and substance abuse prevention. Edward Ehlinger, MD, commissioner of health for the Minnesota Department of Health Arthur T. McCormack 2017 Award In addition to directing the work of the Minnesota Department of Health, Ehlinger formerly served as ASTHO president, where he exemplified his dedication to advancing the important work of public health and improving health for all. Keith Yamamoto, MPA, deputy director of the Hawaii Department of Healt Noble J. Swearingen 2017 Award Yamamoto, a key member of ASTHO’s Senior Deputies Committee, has provided critical guidance and expertise in state and territorial public health leadership. In addition, ASTHO presented its 2017 Vision Awards and the de Beaumont Foundation PH WINS: Research to Action Model Policies and Practices Challenge Awards. ASTHO congratulates the 2017 award winners for demonstrating excellence in public health leadership and working tirelessly to protect and promote our nation’s health. ASTHO Press Release Boilerplate website yes

State Health Officials Strongly Encourage Influenza Vaccinations Among Pregnant Women ARLINGTON, VA—Jay Butler, MD, ASTHO president and chief medical officer for the Alaska Department of Health and Social Services, released the following statement today regarding the importance of influenza vaccinations for pregnant women: “As we enter flu season, state and territorial health officials strongly encourage all individuals six months or older to receive an annual influenza vaccination, including pregnant women and older adults. Each year, millions of Americans are affected by the flu and influenza vaccines are vital to reduce the chances of getting sick. Illness from influenza infection can be particularly dangerous for pregnant women and their developing babies. A recent report from the ongoing Vaccine Safety Datalink project found that there may be a possible link between miscarriage early in pregnancy and the flu vaccine in women who received a certain version of the vaccine two years in a row. ASTHO and its members are concerned about this potential risk when weighed against other risks, including the risks posed by influenza during pregnancy, and continue to work with national healthcare organizations, including the American College of Obstetricians and Gynecologists and CDC, to determine whether these new findings should lead to any changes in national recommendations. Given the large volume of data indicating the safety of influenza vaccination during pregnancy, ASTHO and its members support current recommendations for use of vaccines during pregnancy. This study raises an important question about risk, and an ongoing investigation to study this issue further is recommended. It is also important to note that this study does not prove that flu vaccine was the cause of the miscarriage. Earlier studies have not found a link between flu vaccination and miscarriage. CDC continues to recommend that pregnant women get an influenza vaccine during any trimester of their pregnancy because flu poses a danger to pregnant women, and a flu vaccine can prevent influenza in pregnant women which also protects their baby after birth. State and territorial health departments continue to encourage pregnant women to get vaccinated to be protected from influenza during pregnancy. Immunizations are a vital public health tool and one of the most cost-effective means of public health promotion and disease prevention. Vaccines prevent disease, disability, and death in children and adults.” ASTHO Press Release Boilerplate website yes

ASTHO Recognizes Georgia’s Public Health Champions ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) is honoring 15 Georgians who are world-renowned public health leaders during an event today hosted by Emory University’s Rollins School of Public Health, and supported in part by the Healthcare Georgia Foundation and the CDC Foundation. Each of these outstanding “Georgia Giants in Public Health” honorees is being recognized for their leadership and dedication to improving the lives and well-being of not just communities in Georgia, but across the nation and around the world. “I am not sure every Georgian knows the rich history of public health that Atlanta has served to nurture, but they should be proud of Georgia today,” says Michael Fraser, ASTHO’s executive director. “This state is home to leaders that helped end smallpox, eradicated Guinea worm, developed the national strategy to control HIV/AIDS, cut tobacco use to record lows, reduced health disparities, and established global immunization programs. In short, the work of these committed Georgia Giants has improved the lives of millions—even billions—worldwide. For that, our nation is truly grateful and our leaders are here today in Atlanta to share our thanks and recognize Georgia’s many contributions to public health.” As ASTHO celebrates its 75th anniversary this year, we reflect on how Atlanta-based institutions like the CDC have shaped generations of public health leaders, contributing to ASTHO’s legacy and commitment to advancing the important work of public health. The Georgia’s Giants in Public Health awards honor transformational state and territorial government leaders and alumni, along with those working at the federal level and with non-governmental organizations to protect and promote our nation’s health. The Georgia Giants in Public Health honorees include: Former U.S. President Jimmy Carter and Former First Lady Rosalynn Carter. James W. Curran, MD, MPH, for his many contributions to disease prevention and epidemiology, as well as his leadership in the field of HIV/AIDS research and outreach. Michael P. Eriksen, ScD, for his contributions to tobacco control, social and behavioral science, and urban and global health. Brenda Fitzgerald, MD, for her leadership as commissioner of the Georgia Department of Public Health, directing the state’s 18 public health districts and 159 county health departments. William H. Foege, MD, MPH, for his many achievements as a champion of child survival and development, as well as contributions to domestic and international health policies, disease eradication and control, and reducing the impact of smallpox. Tom Frieden, MD, MPH, for his numerous achievements in a career dedicated to public health, including leadership as CDC director. Jeffrey P. Koplan, MD, MPH, for his many achievements in epidemic intelligence and infectious disease. Judith Monroe, MD, for her many contributions and continued focus on strengthening public-private partnerships, as well as her leadership as chief executive officer of the CDC Foundation, director of CDC’s Office for State, Tribal, Local and Territorial Support, and her service as a state health official in Indiana and president of ASTHO. Gary Nelson, PhD, for his many contributions to health improvement and healthy aging, as well as his leadership in cancer prevention and control. David A. Ross, ScD, for his pioneering career in public health informatics, as well as his leadership as chief executive officer for the Task Force for Global Health and director of the Public Health Informatics Institute. David Satcher, MD, PhD, for a career dedicated to public health, including numerous contributions in disease prevention and multicultural health disparities, and leadership as the 16th Surgeon General of the United States, assistant secretary for health at HHS, and CDC director. C. Wade Sellers, MD, MPH, for his distinguished public health career, as well as the career of his grandfather, Thomas Fort Sellers, who served as director of the Georgia Department of Public Health from 1948 to 1960, where he developed the tool for rapid diagnosis of rabies. Louis W. Sullivan, MD, for his efforts to enhance health literacy and advance healthy behaviors, as well as his leadership as the 17th HHS secretary and founding dean of the Morehouse School of Medicine. Phillip L. Williams, PhD, for his many achievements in research and toxicology, as well as his leadership as founding dean of the College of Public Health at the University of Georgia. “It is truly wonderful to have an opportunity to celebrate the achievements of Georgia’s public health champions,” says Brenda Fitzgerald, MD, commissioner of the Georgia Department of Public Health and ASTHO’s president-elect. “The men and women honored here inspire us all as they continue to transform public health. I am privileged to serve as the public health commissioner in a state with such incredible resources and leadership.” ASTHO Press Release Boilerplate website yes

State and Territorial Health Officials Gather in Washington, D.C. to Make the Case for Prevention and Public Health Programs WASHINGTON, DC—State and territorial health officials from across the country gathered in Washington, D.C. this week to ask Congress to sustain investments in public health and prevention programs regardless of actions to repeal and replace the Affordable Care Act (ACA). During a Capitol Hill briefing today and meetings with key White House and congressional leaders this week, members of the Association of State and Territorial Health Officials (ASTHO) said that the nation’s health is at risk if proposals to eliminate the Prevention and Public Health Fund do not specify a viable replacement. “Federal funding for core state prevention and public health programs and services has existed for decades. Since its creation in 2010, the Prevention and Public Health Fund has invested $6 billion in preventive health services and core public health programs at the local, state, and federal levels,” says ASTHO Executive Director Michael Fraser. “Eliminating public health programs for community health needs, maternal and child health, cancer screenings, chronic disease prevention, and immunizations without a clear plan for replacement will seriously undermine our ability to effectively protect and promote health programs and guard against emerging public health threats.” “We commonly associate roads and bridges, railways and airports with infrastructure, but public health is also part of our nation’s critical infrastructure,” adds Jay Butler, MD, ASTHO President and Chief Medical Officer at the Alaska Department of Health and Social Services. “Just as the federal interstate highway system promotes commerce between the states, a strong public health infrastructure assures a healthy and productive workforce across the nation. As Congress looks to reinforce our nation’s aging transportation infrastructure, we urge similar efforts to improve and upgrade our nation’s public health system.” ASTHO’s health care infrastructure concerns stem from the fact that many local water systems are rapidly deteriorating and environmental contamination threatens the availability of safe drinking water for millions of Americans. State and territorial public health agencies monitor the air and water safety and work across government to remediate environmental hazards. Critical public health laboratory, public health information systems, and epidemiology capacity are also part of our nation’s public health infrastructure.  In addition to making the case for prevention, state and territorial health officials discussed last year’s public health response to the Zika outbreak and plans for this year’s response, the need for continued support to address the opioid epidemic, and the nation’s need to include public health in proposals to improve the nation’s aging infrastructure. In fiscal year 2016, Congress allocated $932 million from the Prevention and Public Health Fund to programs across multiple federal health agencies, providing the bulk of funding for health programs affecting millions of Americans. ASTHO Press Release Boilerplate website yes

State and Territorial Health Officials Applaud Surgeon General’s First Ever Report on Alcohol, Drugs, and Health ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) commends U.S. Surgeon General Vivek H. Murthy for issuing a landmark report on alcohol, drugs, and health, and remains committed to helping state and territorial health departments enhance prevention efforts, expand access to treatment, and ensure that recovery is possible for everyone struggling with substance use disorders and addiction. “Substance misuse and addictions must be recognized as public health issues, and not just a concern of the criminal justice system,” says Dr. Jay Butler, ASTHO president and chief medical officer for the Alaska Department of Health and Social Services. “We now know that addictions are chronic conditions involving brain function, and substance misuse is often deeply rooted in early life events and social factors. To truly make an impact, we must make these connections to create and implement effective, science-based responses.” Launched in September 2016, ASTHO’s President’s Challenge, led by Dr. Butler, centers around public health approaches to preventing substance misuse and addictions. Through the challenge, ASTHO hopes to further unite and rally state health officials, affiliates, and partners to take action over the next year on this critical and urgent public health issue within states and communities. Since 2012, ASTHO has convened state agencies, healthcare and mental health professionals, third-party payers, researchers, and community-based partners to identify actionable steps to better understand and address prescription drug abuse. “This report marks an important turning point in our nation’s response to substance use disorders and addiction, and further exemplifies the need to support health departments in taking steps to address substance misuse through a comprehensive approach,” says Dr. Michael Fraser, ASTHO Executive Director. “We look forward to continued partnership with our members, federal agencies, local health departments, and other organizations working to address the many issues we face related to misuse and abuse of drugs and alcohol.” Substance misuse and addictions to alcohol, prescription drugs, and illicit substances are long-standing but growing problems in the United States. Over 20 million people have substance use disorders, and 12.5 million Americans reported misusing prescription pain relievers in the past year, according to HHS. Addressing drug and alcohol misuse has been a top priority for health officials across the nation. The Surgeon General’s report includes many ways that all Americans can get involved in preventing drug and alcohol misuse. Specific actions that state health leaders can take include: Providing leadership, guidance, and vision in supporting a science-based approach to addressing substance use-related health issues. Improving coordination between social service systems and the health care system to address the social and environmental factors that contribute to the risk for substance use disorders. Implementing criminal justice reforms to transition to a less punitive and more health-focused approach. “We aren’t going to treat our way out of this problem of misuse and addiction, nor are we going to arrest our way out of it,” says Fraser. “Instead, we have to focus on preventing misuse in the first place. The Surgeon General’s report is a great way for all Americans to get engaged on this issue and promote healthy behaviors at home, at work, in our communities, and in our states.” For more information about ASTHO’s 2017 President’s Challenge, visit www.astho.org/addictions. ASTHO Press Release Boilerplate website yes

Health Officials and Attorneys General Convene to Discuss Legal and Public Health Solutions to Opioid Epidemic ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) and the National Attorneys General Training and Research Institute, a branch of the National Association of Attorneys General, held an inaugural three-day summit with health officials and attorneys general on Nov. 14-16 to promote coordination across public health, law enforcement, and medical professionals to address opioid abuse and misuse, an epidemic that claims the lives of 78 people each day and has now become one of the nation’s most urgent public health threats. At the meeting, health officials and attorneys general discussed the importance of working together to change the conversation about people with substance use disorders, and the need to move from punitive approaches toward compassionate, evidence-based treatment. Health and law enforcement officials are intensifying efforts to improve prescribing practices, apply effective regulatory and enforcement measures, and eliminate stigma and misconceptions about individuals who seek addiction treatment. “We need to reframe the conversation about addiction, from one about bad choices and moral failings to one about chronic health conditions that affect the brain,” says Jay Butler, ASTHO president and chief medical officer for the Alaska Department of Health and Social Services. “Together, public health and law enforcement officials have a critical role to play in ending this epidemic that continues to devastate our families and communities.” ASTHO’s 2017 President’s Challenge, led by Butler, centers around public health approaches to preventing substance misuse and addictions. Through the challenge, ASTHO will unite and rally state health officials, affiliates, and other cross-sector partners to take action on this critical and urgent public health issue within states and communities. State health officials will work to expand primary prevention efforts in their states to educate consumers, prescribers, families, policymakers, and other partners about opioid use, and address risk factors in communities to reduce demand for drugs and other addictive substances. U.S. Surgeon General Vivek Murthy and Office of National Drug Control Policy Director Michael Botticelli also delivered remarks on Monday, calling for greater integration of substance use disorder services into the healthcare system so that addiction can be treated with the same precision and urgency as other health conditions like diabetes, heart disease, or cancer. Nationally recognized experts and thought leaders from the National Institute on Drug Abuse, CDC’s National Center for Injury Prevention and Control, the Substance Abuse and Mental Health Services Administration, the American Medical Association, and the Johns Hopkins Bloomberg School of Public Health also described federal and state policy options, strategies for engaging medical professionals, and promising community-based prevention initiatives. ASTHO Press Release Boilerplate website yes

State Health Officials to Congress: Act on Zika Funding Now ARLINGTON, VA—While Congress debates the future of federal funding for Zika preparedness and response, the Zika virus continues to spread. Rising case numbers and new information about long-term consequences of the infection highlight the urgency of mounting a major response. For the sake of our nation’s health, our representatives in Washington must come together and approve a bill to fund needed Zika preparedness response efforts and keep our nation’s public health infrastructure strong and secure. This national and state public health emergency requires a coordinated and properly resourced effort at the federal, state, and local levels. The nation’s state and territorial health officials stand ready to be part of that effort.   Zika virus is likely to continue to spread and is here to stay. While there is still much to learn about the virus and its health impacts, what we know already justifies an aggressive response. The virus has a potentially devastating impact on fetal development, and we are learning more about the risk of long-term health impacts for adults who become infected. We also know that federal agencies and state and territorial health departments are inadequately funded to respond to this crisis. There is an urgent need for additional resources to shore up mosquito control efforts, educate the public, increase public laboratory capacity, provide help to families with infants exposed to Zika, and follow up with pregnant women who may have been exposed to Zika at home or abroad. Due to the urgency of this threat, state and federal health agencies have been forced to divert resources from other critical public health programs to pay for Zika response. We agree that this robbing-Peter-to-pay-Paul approach, described by Centers for Disease Control and Prevention Director Dr. Tom Frieden and National Institute of Allergy and Infectious Diseases Director Dr. Anthony S. Fauci in their August 31 Washington Post editorial, is the wrong way to fight the Zika epidemic. We need a focused, coordinated, and adequately funded response to Zika while continuing to support the other essential work health agencies do to protect the public. For this to happen, Congress must act now. “We urge Congress to recognize that this is a serious, nonpartisan threat and to come together to pass emergency funding so that the public health system can effectively respond to Zika while simultaneously preparing for myriad other health threats like Ebola, natural disasters, and the upcoming influenza season,” said ASTHO President and Minnesota Commissioner of Health Edward P. Ehlinger, MD, MSPH. In the absence of dedicated funding for Zika response, public health officials must fund Zika efforts by redirecting funds away from other important functions such as the all-hazards preparedness efforts of state and territorial health agencies that enable them to rapidly respond to public health emergencies of all kinds. This approach leaves us in a precarious position as Zika will not be the only public health emergency that state and territorial health agencies face. States are tasked with minimizing and mitigating the health effects of hurricanes, tornadoes, terrorist attacks, chemical spills, and all kinds of other manmade and natural emergencies. Preparation and response to Zika is a massive undertaking, and Congressional inaction is handcuffing states, limiting their ability to prepare and respond to emergency situations. It has been months since public health officials first began calling for Zika funding, and Congressional delay lays bare the inadequacy of America’s piecemeal approach to funding public health emergency responses. In addition to properly funding a Zika response, we also need to create a permanent, FEMA-style Public Health Emergency Fund to facilitate an immediate response to public health emergencies. Public health crises arise independent of the Congressional calendar, and such a fund would allow for a rapid response rather than redirecting public health funding from other critical priorities. Federal and state health agencies are obligated to protect health and wellness nationwide. We believe Congress is similarly obligated to support the critical health protection efforts in partnership with the states. As Drs. Frieden and Fauci stated, we should be working tirelessly to respond to and slow the spread of Zika infections and support those families whose newborns have been affected by this virus. We are ready to do that, but we need support from Congress now to make it happen. ASTHO Press Release Boilerplate website yes

The Association of State and Territorial Health Officials Challenges Members to Promote Health Equity and Health in All Policies ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) and ASTHO President and Minnesota Department of Health Commissioner Edward Ehlinger have issued the 2016 ASTHO President’s Challenge: Advancing Health Equity and Optimal Health for All. The challenge is based on the Triple Aim of Health Equity, a framework weaving together three core elements of public health practice and policy which recognize that health status is influenced by a host of factors—most of them outside the healthcare system. The 2016 challenge calls upon states and territories to: (1) expand their understanding of what creates health, (2) implement a Health in All Policies (HiAP) approach with health equity as the goal, and (3) strengthen community capacity to create their own healthy future. The challenge encourages states and territories to broaden their approaches to advancing health equity and improving the health of all their residents by adopting the foundational public health practices embodied in the Triple Aim of Health Equity. The challenge will be to use these practices to address a policy, program, or activity issue within their jurisdictions in the next year. “The dominant narrative in America is that health is the responsibility of individuals until they get sick, and then health becomes the responsibility of the healthcare system,” Ehlinger says. “This outdated narrative allows little room for community or social influences, and its deficiency is clear when you look at the health disparities in this country and our overall health outcomes relative to other developed nations.” The challenge specifically targets health inequities that plague a number of groups that have been disadvantaged in America. As the nation becomes more diverse, the impact of unaddressed inequities will become more evident and alarming. According to the U.S. Census Bureau, 50.4 percent of children 1 year of age and younger belong to a minority group as of July 2011. By 2044, a majority of the entire U.S. population will belong to a minority group. Yet research shows that minority populations are disproportionately affected by higher rates of poverty, decreased graduation rates, and food and housing insecurity—factors that decrease their opportunities to be healthy. The new challenge will use three core elements of public health practice that make up the Triple Aim of Health Equity approach to elevate the profile of advancing health equity and creating optimal health for all. ASTHO will support state and territorial health officials and partners who accept the challenge by providing technical assistance and support, sharing best practices and success stories, and facilitating information exchange and opportunities for collaboration around health equity and HiAP approaches. Ehlinger has recently presented on the challenge to CDC, the Institute of Medicine Committee on Community Based Solutions to Promote Health Equity in the United States, and multiple professional groups around the country. “The 2016 ASTHO President’s Challenge recognizes that good health does not begin with treating illness. Our health status arises from our everyday environments, activities, and the people around us,” says Sharon Moffatt, ASTHO interim executive director. “We are proud to work with Dr. Ehlinger to promote health equity and optimal health for all. When we build healthier communities, we all benefit.” In November, U.S. Surgeon General Vivek Murthy joined Ehlinger during the Health Equity in All Policies panel at the American Public Health Association’s 2015 Annual Meeting, where Murthy voiced his support for the new President’s Challenge. “Reducing disparities in health will give everyone a chance to live a healthy life and improve the quality of life for all Americans,” says Murthy. To learn more about the 2016 ASTHO President’s Challenge, visit: www.astho.org/Health-Equity/2016-Challenge. ASTHO Press Release Boilerplate website yes

Association of State and Territorial Health Officials Announces New Leadership Appointments SALT LAKE CITY—Edward Ehlinger, commissioner of the Minnesota Department of Health, was elected president of the Association of State and Territorial Health Officials (ASTHO) during the association’s annual meeting. Brenda Fitzgerald, commissioner for the Georgia Department of Public Health, was elected as secretary-treasurer at the same meeting. Jay Butler, chief medical officer and director of the Division of Public Health at Alaska Department of Health and Social Services, became president-elect. All appointments take effect immediately. Ehlinger has served as Minnesota’s health commissioner since January 2011. Previously, he was the director and chief health officer for Boynton Health Service at the University of Minnesota, as well as director of personal health services for the Minneapolis Health Department. He has been honored with the Albert Justus Chesley Award from the Minnesota Public Health Association, the Advancement of Justice Award from the Hennepin County Bar Association, the first Ed Ehlinger Award from CityMatCH, and the Physician Communicator Award from the Minnesota Medical Association. In Minnesota, he is famous for his “Pitch the Commissioner” tours, where he travels to different counties and invites their citizens to join him in a game of horseshoes as they share ideas about what their communities need to be healthy. Fitzgerald is a board-certified obstetrician-gynecologist and a fellow in anti-aging medicine. Prior to her current role as George’s health commissioner, Fitzgerald served on the Georgia OB-GYN Society’s board and as its president. She also worked as a healthcare policy adviser with House Speaker Newt Gingrich and Sen. Paul Coverdell. As a major in the U.S. Air Force, Fitzgerald served at the Wurtsmith Air Force Base in Michigan and the Andrews Air Force Base in Washington, D.C. In 2012, Fitzgerald led the launch of Georgia SHAPE, a childhood fitness and obesity reduction program that received formal commendation from the President’s Council on Fitness, Sports & Nutrition in 2014. Butler was appointed chief medical officer and director of the Division of Public Health at Alaska Department of Health and Social Services in 2014. Previously, he was senior director for community health services at the Alaska Native Tribal Health Consortium in Anchorage, where he was also a clinical infectious diseases consultant and medical director for infection control and employee health. Butler served as a U.S. Public Health Service medical officer for more than 23 years, and participated in a number of emergency deployments, such as heading the H1N1 Vaccine Task Force at CDC and being a team co-leader during the CDC responses to the SARS outbreak of 2003, avian influenza in 2004, and Hurricanes Katrina and Rita in 2005. In 2010, he received ASTHO’s National Excellence in Public Health Award.    Jewel Mullen, commissioner of the Connecticut Department of Public Health, became immediate past president; and Terry Cline, commissioner of the Oklahoma State Department of Health, became past president. All ASTHO offices are one-year positions. ASTHO Press Release Boilerplate website yes

ASTHO Honors 2015 Public Health Heroes SALT LAKE CITY—The Association of State and Territorial Health Officials (ASTHO) is pleased to announce the winners of the 2015 ASTHO public health heroes awards. Anne Schuchat, director of CDC's National Center for Immunization and Respiratory Diseases and assistant surgeon general, was awarded the National Excellence in Public Health Award. Schuchat has made vital contributions to preventing infectious diseases in children. She led the development of CDC′s guidelines on perinatal group B streptococcal disease, which resulted in an 80 percent reduction in newborn infections and a 75 percent narrowing of racial disparities among sufferers. She previously worked in West Africa on meningitis vaccine studies, South Africa on surveillance and prevention projects, and China on SARS emergency response. Sylvia Pirani, director of the Office of Public Health Practice within the New York State Department of Health, received the State Excellence in Public Health Award. Pirani has been a driving force behind the New York State Prevention Agenda 2013-2017, the five-year state health improvement plan to make New York the healthiest state in the nation, and was instrumental to assembling a large network of partners across the state to improve understanding of the social determinants of health and promote the Health in All Policies approach. José T. Montero, vice president of population health and health systems integration at Cheshire Medical Center/Dartmouth-Hitchcock Keene, is the 2015 McCormack Award winner. Established in 1950 to honor Arthur T. McCormack, a Kentucky state health official, the McCormack Award is presented each year to a current or former public health official who has served for at least 10 years, been a chief state health official for at least five years, demonstrated excellence, and made a significant contribution to the knowledge and practice of the field. From 2008 to 2015, Montero was the public health director at the New Hampshire Department of Health and Human Services, Division of Public Health Services, and served as ASTHO president from 2012-2013. He is a leader in developing population health at the national level and integrating public health and healthcare to improve population health outcomes. The Noble J. Swearingen Award was awarded to Guthrie S. Birkhead, deputy director of New York State Department of Health. Since 1979, the Swearingen Award, named for a former ASTHO executive director, has been bestowed on one individual in public health administration who has five or more years of experience in a state health agency, and five or more years in service to the ASTHO Senior Deputies Committee or in some other capacity. Birkhead is a communicable disease epidemiology specialist whose work in New York includes directing the Center for Community Health, AIDS Institute, Center for Environmental Health, Wadsworth Center Laboratory, Office of Public Health Practice, Office of Health Emergency Preparedness, and Office of Public Health Informatics and Project Management. The Presidential Meritorious Service Award is given by the ASTHO president to honor a health leader who has made outstanding contributions to ASTHO and state public health. This year, ASTHO President Jewel Mullen recognized Joycelyn Elders, the sixteenth Surgeon General of the United States. Elders was the first African American and second woman to head the U.S. Public Health Service. Elders grew up in a rural, segregated, poverty-stricken pocket of Arkansas before becoming the first person in Arkansas to be board-certified in pediatric endocrinology. She is a professor emeritus at the University of Arkansas for Medical Sciences, and remains active in public health education. ASTHO’s Alumni Award is presented to a former chief state health official who has demonstrated his or her continued commitment to public health. This year’s Alumni Award winner is Bob Harmon, a physician executive at Cerner Corporation and director of the Missouri Department of Health from 1986 to 1990. Harmon has authored more than 70 publications dealing with health information technology, quality improvement, managed care, primary care, public health administration, and health policy. ASTHO in honored to recognize these public health leaders for their dedication and service to improving health and wellness. ASTHO Press Release Boilerplate website yes

New platform will provide forum for data exchange, analysis, and visualization to support public health work