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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

Public Health Organizations Unite in Call to Restore State and Local Emergency Funding and Approve Emergency Supplemental for Zika ARLINGTON, VA—As the weather warms and the threat of Zika virus intensifies, state and local health agencies are faced with the dilemma of a significant funding cut, as documented in two new reports released by the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), the Association of Public Health Laboratories (APHL), and the Council of State and Territorial Epidemiologists (CSTE). Absent dedicated funding from Congress to prepare and respond to the threat of Zika virus, the Centers for Disease Control and Prevention (CDC) last month announced it will need to reprogram $44.25 million from the Public Health Emergency Preparedness (PHEP) fund to help combat Zika. State and local health agencies depend on PHEP funding to prepare and respond to health emergencies, everything from natural disasters to terrorist or mass casualty events. Preparing for and responding to emerging infectious disease is also a primary use of PHEP funding, meaning state and local health agencies will have less capability to find, control, and mitigate localized outbreaks of Zika as a result of the reallocation. ASTHO, in cooperation with CSTE, APHL, and NACCHO, asked their members what the consequences of the PHEP reprogramming would be, should the cuts take effect on July 1. The results raise significant concern showing that state and local emergency response will be compromised. Major findings from the surveys include the following. Community Preparedness Will Suffer the Most Both state (77%) and local (75%) respondents listed “Community Preparedness” as the area that will be most negatively affected. Scenario planning and training exercises will be curtailed or eliminated. Volunteer recruitment and training will slow or cease. Community partnerships and contracts with specialized vendors will be compromised. Laboratory Testing and Surveillance Capacity Will Diminish More than 70 percent (72%) of state respondents said they expect that functional preparedness programs, including disease surveillance, epidemiology, lab services, and mosquito control, would be negatively affected. Labs would be forced to delay or eliminate new equipment purchases or scheduled equipment maintenance. Public Health Staff Cuts State and local agencies suffered significant job losses—up to 20 percent—during and after the Great Recession that started in late 2007, and they have not come close to adding that number back since. Both state and local survey respondents report likely staffing cuts as a result of the PHEP reprogramming. Almost two-thirds (64%) of local health agencies responding to the survey said they expect to lose at least one health preparedness staff person. There is significant fear that this could worsen significantly if the reprogramming continues in future years as the threat of Zika is not expected to abate in the short term. Zika Response at State and Local Level Will Be Compromised as a Result of the Reallocation State and local health agency leaders are unified in saying the reduction of PHEP funding will harm their ability to respond to and control Zika once it establishes itself in the U.S. Our capacity to identify localized outbreaks and our capability to control and eliminate virus transmission will be slower. Local agency responders cited the following concerns: A decrease in staffing, Medical Reserve Corps (MRC) unit, or volunteer sustainability. A reduction in opportunities to provide staff trainings as well as plan and conduct exercises. An inability to conduct surveillance or epidemiologic investigations. At the state level, 61 percent of respondents say decreased PHEP funding in their state will significantly harm their ability to prepare for and respond to Zika. One respondent wrote: “The PHEP funding in [our state] is the resource we have for providing a response to Zika, and any other novel communicable disease. By reducing this funding you are reducing our ability to respond to a Zika event in [our state].” All public health sectors—federal, state, and local—have worked hard to build and sustain an all-hazards preparedness infrastructure that can deliver on their mission to protect and enhance the health and well-being of their constituents. However, large-scale emergencies, such as the 2009 influenza pandemic, Ebola, and Zika, require sufficient and reliable core funding to maintain a solid and ready public health infrastructure and additional emergency funds to provide the enhanced protections and services those living in the United States deserve and expect. Robbing the fund that sustains the all-hazards infrastructure to pay for large, widespread emergencies, no matter how necessary, ensures that infrastructure will deteriorate. Dedicated emergency funding that will enable all public health sectors to prepare for and respond to Zika is essential. ASTHO Press Release Boilerplate NACCHO Boilerplate APHL Boilerplate CSTE Boilerplate website yes

Multistate Measles Outbreak Drives Up State Health Agency Costs and Points to Importance of Quality Immunization Communication ARLINGTON, VA—With the Disneyland measles outbreak up to 87 cases in seven states as of Jan. 26, state health departments are responding to the disease by educating primary care providers and the public about measles and conducting contact tracing. Measles is airborne and one of the most contagious diseases in existence-it can linger in a room for up to two hours after the infected person has left. It also remains pervasive around the world and can easily be imported into other countries. WHO reports that although measles deaths decreased by 73 percent worldwide between 2000 and 2013, measles still caused 145,700 deaths globally in 2013. "Measles was declared eliminated in the United States in 2000. Sadly, this status is endangered," says Paul Jarris, MD, MBA, Association of State and Territorial Health Officials (ASTHO) executive director. "Many parents and physicians have never seen a case of measles before. This outbreak demonstrates why we can never let our guard down against vaccine-preventable diseases." Due to its highly infectious nature, health departments have to respond rapidly and thoroughly to contain outbreaks and save lives. If a measles patient has traveled to school, the grocery store, or any other public space, a large group of people may have been exposed to the disease. State health departments are responsible for ensuring that patients are isolated to prevent further spread. They then identify potential contacts, educate them about measles symptoms, advise them on when to go to the doctor, and encourage them to become immunized if they aren't already. "At ASTHO, I'm proud of the work that the California Department of Public Health and other states are doing to protect our children by containing this outbreak, preventing future ones, and bringing us closer to maintaining full elimination status," Jarris says. In addition to the time spent containing a measles outbreak, responding to them is expensive for state and local governments. A March 2014 study found that there were 16 measles outbreaks in 2011 that resulted in 107 cases, which cost local and state public health departments an estimated $2.7 million to $5.3 million. However, these outbreaks and their time and economic burdens are preventable. Every dollar spent on the child measles, mumps, and rubella vaccine saves $23.30, according to CDC. "This is an important opportunity for public health to continue to articulate the benefits of immunization," says Kathy Talkington, ASTHO's senior director of immunization and infectious disease. "This measles outbreak illustrates that we live in a global world, and as long as these diseases exist in other countries, we must continue to protect ourselves in all communities through high immunization rates." See ASTHO's blog StatePublicHealth.org for the full article on the measles outbreak, as well as tips on how public health professionals can communicate with the public and primary care providers about how vaccines can prevent outbreaks and save lives. ASTHO Press Release Boilerplate website yes

Public Health Leaders’ Joint Statement in Response to the Attack on CDC In response to the horrific shooting that occurred on Friday, August 8, targeting the Centers for Disease Control and Prevention (CDC), the public health community stands in solidarity with our CDC colleagues. We denounce acts of harassment, terror, and violence against the public health workforce. Our hearts break for the family of police officer David Rose who lost his life protecting his community. Two hundred bullets struck and caused damage to six federal buildings and over 500 rounds were fired at the CDC campus. We are saddened, alarmed, and deeply concerned about the health and safety of our colleagues. The shooting was an attack on an American workplace and on the people and infrastructure that keep us all healthy and safe. We are committed to working together to support our nation’s dedicated public servants who comprise the public health workforce and call on others to do the same. It is critical to the health of all communities that CDC and all people working in public health across the country are able to continue to make their invaluable contributions to advancing health and well-being without the fear of harassment or violence. People choosing public health as a profession are committed to advancing our nation’s health and recognize that good health in every community benefits everyone. It is our hope that all Americans will stand with us to support the vital role that CDC and the entire public health workforce play in supporting safety and well-being in every community. Their expertise and commitment to advancing health deserves all Americans’ unwavering support. American Public Health Association Association of Maternal and Child Health Programs Association of Public Health Nurses Association of State and Territorial Dental Directors Association of State and Territorial Health Officials Association of State and Territorial Public Health Social Workers Association of Public Health Laboratories  Association of Schools and Programs of Public Health Big Cities Health Coalition CDC Foundation Council of State and Territorial Epidemiologists de Beaumont Foundation National Association of Chronic Disease Directors National Association of County and City Health Officials National Network of Public Health Institutes Prevention Institute Public Health Accreditation Board Safe States Alliance The Kresge Foundation Trust for America’s Health website yes

ASTHO Partners with Veritas Data Research and HealthVerity to Launch the First-of-its-Kind Public Health Data Consortium ARLINGTON, VA — The Association of State and Territorial Health Officials (ASTHO) announced today a partnership with Veritas Data Research and HealthVerity that establishes a first-of-its-kind public health data consortium. This novel consortium brings together ASTHO, jurisdictional health departments and private partners united in a shared mission to improve public health outcomes through enhanced data access and quality, and to address long-standing challenges that hinder our nation’s public health data infrastructure. “There is tremendous opportunity when we connect the strengths of private industry with the mission of public health,” said Joseph Kanter, MD, MPH, ASTHO CEO. “By working together in a structured way, we can close long-standing data gaps and build a stronger, more responsive system for the future.” The consortium’s central mission is to improve the quality of and access to real-world data and public health data relied upon by a broad range of stakeholders to drive public and population health decisions and understand longitudinal outcomes. State health agencies, providers, payers, researchers, and others rely on this data, which is often difficult to obtain. Through this public-private partnership, members aim to expand access in ways that strengthen communities and support health care and public health systems. “Our nation and communities need a robust, sustainable model that leverages the capabilities and expertise across both private industry and public health. For too long, there have been challenges in bringing private and public entities together to address the gaps that plague our nation’s public health data and technology infrastructure,” said Jen Layden, MD, PhD, ASTHO senior vice president of population and innovation, and former CDC and state public health leader. “This consortium, by uniting on a common mission and placing governance in the hands of public health, is primed to be a game changer.” Jurisdictional health departments will gain access to real-world data and technical capabilities and will play a key role in strengthening the quality and availability of critical data. The consortium will initially focus on mortality data, a foundational asset for a variety of use cases. "This consortium represents an excellent example of public-private partnerships in healthcare," said Jason LaBonte, CEO at Veritas Data Research. "Under the governance of ASTHO, all state and territorial health agencies can securely pool their data to improve clinical practice and innovation. In return, the agencies can combine their data with national real-world data to power better public health. Veritas is pleased to facilitate these data exchanges using our robust ingestion and delivery platform, and to make appropriate data available to a wider group of stakeholders with use cases pre-approved by the state and territorial health agencies.” “We are proud to serve as a founding operating partner, applying our expertise in identity resolution and data privacy to solve the 'linkage' problem that has long plagued public health,” said Andrew Kress, CEO of HealthVerity. “Through this consortium, we are enabling a standard of data exchange that respects patient privacy while providing a level of clinical truth that will accelerate research and improve the speed of public health interventions.” To support the consortium, ASTHO is creating an advisory network to provide organizations with opportunities to stay informed and offer guidance as the initiative evolves. To learn more about the consortium or advisory network, please contact phdc@astho.org. ASTHO Press Release Boilerplate   Veritas Boilerplate   HealthVerity Boilerplate website yes

Leandro Mena and Thomas Dobbs discuss the importance of whole person care and status-neutral approaches to STI treatment.

Three public health experts share how they prioritized vaccine equity for American Indian and Alaskan Native communities on the local, state, and national levels during the COVID-19 pandemic.

This episode dissects concerns at the southwest United States border, where health and governmental officials find themselves managing an extraordinarily complex situation: handling an increase in migration activity during a global pandemic.

Designing for Connection Webinar Series article no

While COVID-19 remains a top public health priority, the pandemic has also intensified the need for strong tobacco control policies and marketing campaigns. CDC recognizes current or former tobacco users as one of several groups at higher risk of severe illness, including hospitalization and death, after contracting COVID-19. It is distressing to see signs that our success in encouraging tobacco users to quit has been slowed over the course of the pandemic. Fortunately, amid these challenges, many tobacco control groups have stayed focused.

Throughout the COVID-19 pandemic, the de Beaumont Foundation has worked closely with organizations like ASTHO to support and strengthen public health. The foundation has produced several publications and guides to support public health leaders in their efforts to inform the public about COVID-19 and help build confidence in vaccines. Mark Miller, vice president of communications with the de Beaumont Foundation, shares insights into the foundation’s response efforts to COVID-19, and its partnership with key stakeholders.

While the Biden Administration and Congress have no shortage of immediate health issues to focus on, improving maternal health outcomes—particularly Black maternal morbidity and mortality—have become a priority for federal lawmakers. To make sense of what’s going on, ASTHO staff partnered with the Association of Maternal and Child Health Programs (AMCHP) to outline the seven things to know happening on the federal level right now.

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

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

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.

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

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

This week has been both exhilarating and poignant. Almost surreal. We started the week by pausing to celebrate and reflect on the life and legacy of one of America’s greatest sons, Dr. Martin Luther King, Jr. On Tuesday, ASTHO participated in the National Day of Healing, which provided opportunities for our staff to engage in conversations with one another, seeing one another’s humanity, as well for individual mediation, reflection and learning. On Wednesday, we were honored to witness the inauguration of President Joe Biden and Vice President Kamala Harris—the first woman, first Black and first Asian American person to serve in this role. This week also marked one year since we learned of the first known case of COVID-19. Despite these challenges, I am more optimistic now than ever that our collective impact and commonsense recovery response will help guide our successful return to safety and normalcy.

A discussion with Meredith Allen, ASTHO’s Vice President for Health Security, about how the first shipments of the COVID-19 vaccinations have been a major turning point for the pandemic and a milestone moment for U.S. public health history.

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