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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

Recording Available: State Health Leaders Outline Respiratory Virus Season Strategies During ASTHO Briefing ARLINGTON, VA — Ahead of the fall respiratory virus season, the Association of State and Territorial Health Officials (ASTHO) hosted a deskside media briefing with public health leaders to discuss the importance, efficacy and safety of vaccines and the role they play in reducing the burden of respiratory illness. "Reliable studies show that vaccines are critical tools which offer protection against serious respiratory illnesses such as seasonal influenza, COVID-19, and RSV. Vaccines and boosters strengthen protection and improve the chances that any infections will be less severe in children and adults this fall and winter,” says Scott Harris, MD, MPH, ASTHO president and state health officer, Alabama Department of Public Health. “Routine childhood vaccination has been proven safe and effective, flu shots are recommended for everyone age 6 months and older with a few exceptions, and RSV vaccine helps protect pregnant women and older adults against hospitalization and death.” “Connecticut ranked highest in the country for two-dose measles vaccination rate among kindergarteners and our other increasing immunization rates stand in contrast to the national decline," says Manisha Juthani, MD, ASTHO president-elect and Connecticut Department of Public Health commissioner. "Our high vaccination rates have helped Connecticut remain one of nine states that has not had a case of measles yet as cases continue to accumulate around the country. Staying up to date on routine vaccines, particularly as we head into back-to-school and cold and flu season, is crucial for protecting families from preventable diseases and maintaining community-level immunity. We cannot predict which respiratory viral infection will be most prevalent this season, but we can protect our families against them and potential severe complications by getting vaccinated this fall." “There are signs that disinformation and confusion have impacted how parents have vaccinated their kids both for regular school-based vaccines and for respiratory viruses. This is a trend we need to really be concerned about,” says Ayanna Bennett, MD, MSPH, director of the District of Columbia Department of Health. “Children have special vulnerabilities, and we want to be sure that if we have protection, we are delivering it to them.” View a recording of ASTHO’s deskside media briefing. ASTHO Press Release Boilerplate website yes

Recording Available: State Health Leaders Convene During ASTHO Deskside Briefing to Rally Behind Chronic Disease Prevention in U.S. ARLINGTON, VA — On June 24, the Association of State and Territorial Health Officials (ASTHO), convened state health officials for a deskside media briefing focused on the impact of nutrition on chronic disease prevention in the United States. The event highlighted how strategic public health investments can help reduce chronic disease nationwide and help Americans lead healthier lives. “We know chronic disease is a leading cause of death in the United States. It’s something that state health departments have particularly been working on for a long time," says ASTHO Chief Medical Officer Susan Kansagra, MD, MBA, who moderated the discussion. “Obesity makes every chronic disease harder, it just makes life harder. I’m thrilled that this is a national priority. I welcome it,” says James McDonald, MD, MPH, commissioner of health, New York State Department of Health. “I think if we can get our handle on obesity as a nation then this is just one of the ways you can make us all healthier again.” “I am ecstatic that we as a nation and here in the state of Indiana with our Make Indiana Healthy Again plan are talking about nutrition and physical activity,” says Lindsay Weaver, MD, state health commissioner, Indiana Department of Health. “Frankly, it’s going back to the basics. It’s educating new moms and families. It’s working closely with our schools and education.” “Our legislators see the problem in their communities and we are working with them to be a part of the solution. Here in Tennessee, the General Assembly recently passed a law to expand the amount of time children have to be physically active at school,” says Ralph Alvarado, MD, commissioner, Tennessee Department of Health. Dr. Alvarado also discussed valued partnerships with faith-based communities, volunteer Health Councils which exist in every county in Tennessee, and the growing interest in ‘Blue Zone’ concepts -including in many rural parts of the state.” View the recording of ASTHO’s deskside media briefing. ASTHO Press Release Boilerplate website yes

ASTHO Members Advocate for $1 Billion Investment in Public Health Infrastructure During Annual Spring Leadership Forum ARLINGTON, VA — The Association of State and Territorial Health Officials (ASTHO) will convene state, territorial and freely associated state health leaders in Washington, D.C., March 2-5 for its annual Spring Leadership Forum. Attendees will meet with members of Congress and federal partners to advocate for sustained funding and long-term investments in the nation’s public health infrastructure. During meetings, ASTHO members will stress the importance of a strong, resilient public health system. ASTHO urges Congress to invest $1 billion in FY27 in public health infrastructure — or about $3 per person nationwide — to ensure health agencies can maintain core capabilities such as disease surveillance, laboratory capacity, data modernization and workforce development. “This week, ASTHO members will meet with Congress to highlight the essential role federal funding plays in protecting the health of communities in every state and territory as well as the impact of grant pauses and terminations,” says Joseph Kanter, MD, MPH, ASTHO CEO. “Sustained, predictable investments allow health agencies to maintain the workforce, laboratories and data systems that keep the public healthy and safe.” As part of this convening, senior leadership from the U.S. territories and freely associated states (T/FAS) will participate in island-focused meetings. On Capitol Hill, ASTHO’s T/FAS members will discuss the impact of the recently renegotiated Compacts of Free Association, as well as emphasize the importance of territorial Medicaid funding and the challenges associated with the Section 1108b cap on territorial Medicaid funding. With federal agency partners, T/FAS members will discuss emerging and priority public health issues, including veterans' access to care. "ASTHO’s Spring Leadership Forum offers an invaluable platform for T/FAS health leaders to engage directly with decisionmakers in Washington, D.C. We welcome the opportunity to share island perspectives and collaborate with Congress and federal agencies on shared public health priorities," says Justa Encarnacion, RN, MBA, HCM, the commissioner of health in the U.S. Virgin Islands and director on the ASTHO Board. ASTHO Press Release Boilerplate website yes

A Blueprint for Establishing a Health Equity or Minority Health Office 30:37 minutes Learn how to form and manage an office of health equity or minority health, based on several firsthand experiences. Listen to the podcast episode now. <!-- Podcast Embed ep 93 --> There are many considerations when forming and managing an office of health equity or minority health. The National Association of State Offices of Minority Health shares how agencies across the United States have overcome common challenges and benefited from having a dedicated health equity office. In addition, the United States Virgin Islands Department of Health discusses initial successes and challenges experienced while establishing their office. Finally, the California Department of Public Health, with a well-established office of health equity, shares how their office utilized health equity liaisons and supported rural/tribal communities. This podcast episode complements the recently published ASTHOReport “Establishing an Office of Health Equity or Minority Health,” which examines different approaches to sustainability. Show Notes Guests Rohan Radhakrishna, MD, MPH, MS, Former Deputy Director and Chief Equity Officer, California Department of Public Health Justa Encarnacion, RN, MBA, HCM, Health Commissioner and Chief Public Health Officer, United States Virgin Islands Department of Health Veronica Halloway, Executive Director, National Association of State Offices of Minority Health Resources Establishing an Office of Health Equity or Minority Health | ASTHO Islands Health Equity Framework | ASTHO Office of Health Equity | California Department of Public Health United States Virgin Islands Department of Health National Association of State Offices of Minority Health Podcast Transcript ep 93 website yes

In this episode of Public Health Review learn how different states maximize federal and state programs for improved housing, transportation, and other social determinants of health.

In this episode, our guests tell us how they put One Health into practice in a state health department, how health departments can connect across agencies to address One Health issues, and what falls under the One Health umbrella.

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.

On this episode of Public Health Review: restaurant inspections go online in South Carolina, how they're working, and what's next as public health makes changes in response to the pandemic. 

On this episode: public health on alert as the Ebola outbreak expands in Uganda; and David Lakey, MD (alumni-TX) tells us about lessons from 2014 when the Ebola virus made its way to Dallas, Texas.

In this podcast episode, experts offer perspectives on the value of cultivating partnerships between state public health agencies and state units on aging. In addition, officials from Georgia describe their collaboration to improve the health of older adults in the state.

COVID-19 revealed the dire straits of public health; now, with renewed funding, public health leaders discuss how to use COVID funding to build and maintain sustainable infrastructure.

Anne Zink (Chief Medical Officer, Alaska Department of Health and Social Services) and Larry Lewis (licensed psychologist and executive coach) speak on the importance of celebrating “small wins”—tangible stories of progress that can sustain the public health workforce in an otherwise trying time.

Medicaid plays a critical role in providing access to health services for low-income U.S. citizens in the five U.S. territories. However, Medicaid financing in the territories has been underfunded compared to states. In this episode, guests discuss the urgent need for a permanent Medicaid solution, drawing attention to the need for equitable health financing for the U.S territories. This funding is necessary to support comprehensive public health and healthcare within these jurisdictions that include expanded prevention, testing, and treatment programs and capabilities.

People living with disabilities have borne disproportionate burden in past emergency situations due to inequities in preparedness and response. To address and prevent inequities in the COVID-19 response, ASTHO placed 14 disability and preparedness specialists into health agencies around the country to promote inclusivity of people living with disabilities. In this episode, we explore ways that two of these disability and preparedness specialists have worked to address the needs of people living with disabilities in their jurisdictions.

The experts on today’s episode make the case for how a robust public health workforce could have changed the trajectory of the pandemic response, but also explain why we can reimagine what a strong public health workforce requires as we enter into pandemic recovery.

As COVID-19 spread across the country, misinformation and conspiracy theories led to beliefs that the virus was a hoax and prevention measures were unnecessary. Efforts to limit public health authority resulted in reduced confidence from the public and an inability for public health officials to lead. Our experts on this podcast episode explore what public health officials can do to build back public confidence in our public health infrastructure, and offer lessons that work. Our experts will discuss how and why this has happened, and how we can remedy this as we enter into COVID-19 recovery and the largest vaccination campaign in decades.

On this episode, we ask public health experts to zoom out a bit and reflect on a truly remarkable year. These public health leaders discuss the politicization of public health mitigation efforts, becoming the target of hateful attacks, and being at the forefront of the biggest health crisis in a century. Our experts also reflect on what they hope people have learned about our public health infrastructure and lessons learned for future disease outbreaks.

This episode highlights ongoing efforts and provides consideration for health officials to not only limit the impact of the pandemic on the economic security and housing needs of Americans but also to rebuild systems that create a healthier, more equitable post-COVID-19 world. This podcast is the first in a series that challenges state/territorial health officials to “Bounce Forward” instead of simply bouncing back to the way things were before.