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Jurisdictions Seek to Modernize Vital Records Systems

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Iowa,

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.

Leveraging Data Linkage to Address Adverse Childhood Experiences

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ACEs,

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.

What We Learned at the Public Health TechXpo and Futures Forum

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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

Public Health Highlights of President’s FY22 Budget Proposal

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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.

The Need for Modernizing Public Health Data in Responding to COVID-19

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Public health data collection and surveillance systems by health departments are in dire need of modernization. Though the public health community began developing a path to modernization over the last decade, attention to this issue from policy makers has sharply increased with the current response to the COVID-19 pandemic. Not only are current systems siloed, they rely on labor intensive processes to detect and facilitate a response to various public health threats.

How Can Public Health Data Take a Lead Role? Find Out at the COVID-19 TechXpo

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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: State Considerations for 2021

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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.

The New Frontier of Digital Proximity Tracing

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The New Frontier of Digital Proximity Tracing Association of state and territorial health officials, astho, public health, covid-19, contact tracing, case investigation, public health surveillance, infectious disease, proximity tracing, exposure notification, public health agencies, data privacy, public health official, state legislature, geolocation, health data, test positive for covid-19, personal data, data collected, health departments Jeffrey Ekoma Digital proximity tracing is the cutting-edge for tracking outbreaks of COVID-19, but many have concerns about data privacy. States have proposed legislation to balance the two. As state, local, territorial, and tribal (SLTT) health departments continue to cautiously reopen parts of their economy, they also continue to take necessary measures to prevent the spread of COVID-19. A major component of this work is traditional contact tracing, a staple of public health surveillance where public health workers track down and notify anyone who might have contact with someone who tested positive for an infectious disease. However, new strategies that would supplement traditional tracing have been gaining momentum. Google and Apple collaborated to create an application programming interface (API) platform for public health agencies interested in a new type of “proximity tracing” or “exposure notification.” The platforms are expected to assist in the creation of apps between software developers and public health jurisdictions. It specifically utilizes Bluetooth technology —readily available in cellular devices—to randomly generate temporary keys on a user’s device when a user downloads an exposure notification application. This then enables the application to alert an individual if they have been or potentially exposed to someone who also uses the application and who tested positive for COVID-19. It’s worth noting the platform created by Google and Apple does not collect location information or information of users who do not voluntarily mark themselves as being positive for COVID-19. There are other notable exposure notification apps being used by SLTTs including Care19, an app developed by ProudCrowd that’s currently being used in North Dakota and South Dakota. Also, CommCare, which is currently being used in New Jersey and was developed by Dimagi. As expected, the introduction and potential influx of these types of apps have brought many different concerns, primarily centered around data privacy and how the platforms and applications would protect, store, and safely discard information that it collects. This issue became of interest to Sen. Maria Cantwell, current ranking member of the Senate Committee on Commerce, Science, and Transportation. In response she drafted S. 3861 Exposure Notification Privacy Act, which proposes assistance to public health jurisdictions exploring exposure notification applications and technologies. The act would ensure that such platforms have the necessary capacity to protect the personal data of consumers, limit the type of data collected, as well as the type of entities that would have access to such data. In addition, the legislation also: reaffirms the role of public health officials in requiring their involvement in the development and deployment of exposure notification systems; requires that participation from individuals be on a voluntary basis and with consumer consent; limits the collection and use of data; prohibits commercial use of data; and permits participants to delete their data at any time; among other things. The legislation was recently co-introduced with Sens. Bill Cassidy and Amy Klobuchar, and received support from the Washington State Department of Health, Council of State and Territorial Epidemiologists, and the National Coalition of STD Directors. This legislation is currently pending in the Senate and it is unclear if it will be considered in the upcoming months. There is also movement in state legislatures to address the use of technology. In California, legislation (AB 660) was introduced that would require any state agency contract that uses a mobile device’s geolocation data for exposure notification to a communicable disease to include provisions requiring the contractor to inform the app user of the authorized purposes of the app and collected data. Another bill (AB 1782) introduced in the state would require public health entities and businesses offering exposure notification services to allow users to revoke consent for the collection, use, maintenance, or disclosure of the user’s information. Businesses that provide exposure notification services but are not affiliated with a public health entity would be required to disclose its non-affiliation. The bill would also require the encryption of data collected by the technology, limit the use of the data as well as the amount of time the data can be maintained, and require reported exposures be verified by a healthcare provider before notifying logged contacts of their potential exposure. In New York, companion bills were introduced (A 10583A and S 8448B) that would establish requirements for the collection and use of emergency health data and the use of technology for collecting data during the COVID-19 emergency. Specifically, the bill requires the disclosure of certain information to those who install and use data collecting apps on mobile devices, including information about the right to opt-in, the right to privacy, the app’s privacy policy, time limitations for maintaining the data, and the individual’s right to access the data. Unlike the bills in California, individuals in New York would be able to sue for violations of the law. Several SLTT’s are currently either exploring, developing, or implementing proximity tracing applications within their respective jurisdictions. It remains critical that SLTT health departments evaluate the implementation of any proximity tracing option, while concurrently evaluating pertinent data and privacy related issues that may arise with the collection and sharing of information from individuals. In the coming days, ASTHO plans to release a guide to assist health officials as they think through the critical functionalities, technological options, and implementation of these emerging technologies. ASTHO will continue to track and monitor legislation that seeks to address data and privacy concerns with proximity tracing and exposure notification applications. website yes

In Case You Missed It: 10 Headlines from ASTHO’s Public Health TechXpo

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A quick rundown of sessions and speakers at the 2022 ASTHO Public Health TechXpo.

ASTHO Policy Watch 2022: Health Equity and Rural Health

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ASTHO has identified health equity and rural health as issues that policymakers across the country will consider in 2022.

Public Health Infrastructure Partners Launch National Implementation Center Program to Support Data Modernization 

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CDC-funded program will accelerate data exchange between healthcare and public health to drive timely, data-informed public health action