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A once obscure public health issue that’s gotten more attention in recent years, polyfluoroalkyl substances (PFAS) are a group of synthetic chemicals used in products such as nonstick cookware, water-repellent clothing, stain resistant fabrics, cosmetics, and firefighting products. During production and use, PFAS can migrate into soil, water, air, where they persist. Because they remain in the environment, PFAS can accumulate in humans and animals and can be found at low levels in many food products. Exposure to PFAS can lead to harmful health effects, including an increased risk of kidney and testicular cancer and a decreased vaccine response in children.

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.

As the nation grapples with the ongoing COVID-19 pandemic, community health workers are being recognized for the role they play in improving health outcomes of our most vulnerable communities. In fact, the recently enacted American Rescue Plan Act of 2021 allocates funding for the recruitment, hiring, and training community health workers by public health departments.

One of President Biden’s first actions just before being sworn into office was to draft up the American Rescue Plan, a sweeping proposal that ASTHO has committed to working with the Biden Administration on. The proposal offers a national vaccination plan, a promise to address COVID-19 health disparities, and efforts to prioritize the expansion the public health workforce. This post details some of the high-level takeaways, as they relate to public health.

“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.

In recognition of Rural Health Day, which falls on Nov. 18, we spoke with Ayne Amjad (SHO-WV) and Maggie Cook-Shimanek (SHO-MT) about the importance of public health in rural areas.

Access to quality and reliable transportation is an indispensable aspect of American life. But for too many, social and economic conditions stand in the way. How do residents of Elk County, Kansas—where the nearest hospital is about 70 miles away—obtain necessary care in the face of transportation issues? How do residents of any medical desert bedeviled by transportation issues obtain care? These questions, among others, are difficult to answer for both the individuals who confront them directly and the experts and policy makers who confront them only indirectly.

Public health is rapidly changing, especially during the COVID-19 pandemic. Public health professionals are having to navigate their way through these changes all while remaining steadfast in their ability to help their communities. With new information emerging every day, it's essential to have a backlog of sources you can reference that are trustworthy, up-to-date, and easy to access.

November 18 is National Rural Health Day, a commemoration started by State Offices of Rural Health to recognize the power and resilience of rural communities. Twenty percent of the U.S. population lives in rural communities. Recognizing the needs of rural areas, states are introducing and enacting legislation that leads to focused investment in rural communities and expanded access to care.

When Beatriz Vallejo, the disability and preparedness specialist in Puerto Rico, first joined the health agency, she took on planning a novel program to share knowledge and clarify each sectors’ roles and responsibilities during an emergency.

In the background of the COVID-19 pandemic, cases of viral hepatitis continue to rise at alarming rates across the United States. Data from CDC highlights a 133% rise in cases of acute hepatitis C infection from 2012-2019 and new case counts four times higher than those seen a decade ago. State and territorial health officials play a crucial role in the planning and implementation of viral hepatitis elimination activities.

The ASTHO State Health Policy team provides brief updates on 5 of the ten state health policy issues to watch in 2022: public health authority, immunization, data privacy and modernization, public health workforce, and health equity.

Over the past twenty years, the frequency and intensity of extreme weather events and natural disasters have increased and, by most accounts, this trend will continue. Certain disabilities and activity limitations make it more difficult to prepare for and evacuate from an incident, underscoring the importance of planning in advance. Read about ASTHO’s specialists Erin Dotten (Michigan), Brooke Riester (New Mexico), and Stephen Heck (South Dakota), who have extensive experience understanding and responding to the needs of people living with disabilities during natural disasters.

The executive leaders of the Association of State and Territorial Health Officials and the National Council for Mental Wellbeing take a moment to collectively acknowledge the incredible efforts that public health workers have taken to address the continuing COVID-19 pandemic.

The impact of the COVID-19 response on the public health workforce has been profoundly felt by employees and the agencies they serve. Across the country, unplanned leadership transitions, early retirements, and personnel scale-ups have all impacted who the workforce is and what they do day-to-day. Many of those who have remained are feeling depleted and battered. In order to support and build the public health system the country needs, we need data specific to governmental public health.

ASTHO, NACCHO, and NCSD warn of rising tide of STDs threatening millions of American lives

Arkansas Department of Health Secretary Nate Smith Named ASTHO President BETHESDA, MD—The Association of State and Territorial Health Officials (ASTHO) announced the appointment today of Nate Smith, MD, MPH, secretary of health at the Arkansas Department of Health, as ASTHO’s new president, effective Sept. 25. “I’m thrilled to serve as president and look forward to working hard to ensure that everyone has the access and ability to be healthy,” says Dr. Smith. “I look forward supporting my colleagues at the federal, state, and local levels to address the many public health challenges and opportunities affecting the United States.” Dr. Smith has served as Arkansas’ state health official since 2013, where he provides senior scientific and executive leadership and strives to help colleagues achieve their full potential using public health best practices supported by science-based decisions. Dr. Smith previously served the Arkansas Department of Health as branch chief for infectious diseases, state epidemiologist, and deputy director for public health programs. He is board certified in internal medicine and infectious diseases and holds voluntary faculty positions in the Division of Infectious Diseases at the University of Arkansas for Medical Sciences (UAMS) College of Medicine and in the Epidemiology department at UAMS’ Fay W. Boozman College of Public Health. He was elected president-elect of ASTHO in September 2018. Born in Massachusetts, Dr. Smith lived in multiple countries and U.S. cities before attending Rice University, Baylor College of Medicine, and the University of Texas School of Public Health. He is also an ordained minister in the Anglican Church. Dr. Smith and his wife, Kim, served two terms as medical missionaries at Kijabe Hospital in Kenya, where he was involved with the President's Emergency Plan for AIDS Relief, a program that reduced the adult HIV prevalence from over 10 percent to less than 6 percent. In Kenya, Dr. Smith’s roles included chief of internal medicine, medical intern program director, infectious diseases consultant, country medical director for the University of Maryland School of Medicine in Kenya, and senior medical technical advisor for the AIDSRelief program in East Africa. “We are thrilled to have Dr. Smith as our new president,” says ASTHO Chief Executive Officer Michael Fraser. “His impressive background in infectious disease demonstrates an expertise that will be crucial to facing the threat of antimicrobial resistance in the United States. His compassion, public health insights, and wealth of medical and scientific knowledge, sharpened during his work abroad and in his service to the state of Arkansas, will be truly valuable assets as the nation contends with public health emergencies like the ongoing opioid crisis. I know that Dr. Smith will move our organization—and public health—forward in the year to come.” Rachel Levine, MD, secretary of health at the Pennsylvania Department of Health, will serve as ASTHO president-elect. ASTHO Press Release Boilerplate website yes

ASTHO Members and Staff Named to Inaugural List of 40 Under 40 Public Health Leaders ARLINGTON, VA—Members and staff of the Association of State and Territorial Health Officials (ASTHO) received recognition today from the de Beaumont Foundation for their contributions and leadership in the public health field. The de Beaumont Foundation’s inaugural "40 Under 40 in Public Health" list honors several health officials, health department staff, and ASTHO staff and affiliates, including: Jonathan Ballard, Chief Medical Officer, New Hampshire Department of Health and Human Services Christa Cupp, Public Health Educator, Wisconsin Department of Health Services, Division of Public Health, Office of Policy and Practice Alignment Julian Drix, Asthma Program Manager, Rhode Island Department of Health Eric Harkness, Director, Office of Health Policy, Tennessee Department of Health Jeffrey Howard, Commissioner and Chief Medical Officer, Kentucky Department for Public Health Joseph Kanter, Assistant State Health Officer and Region One Medical Director, Louisiana Department of Health Joneigh Khaldun, Chief Medical Executive and Chief Deputy Director for Health, Michigan Department of Health and Human Services Carolyn Mullen, Chief of Government Affairs and Public Relations, Association of State and Territorial Health Officials Kaitlyn Neises-Mocanu, Special Assistant for Policy, Sustainability, and Development, Commonwealth Healthcare Corporation Jamila Porter, Director of Programs and Evaluation, Safe States Alliance (ASTHO Affiliate) Lauren Powell, Director, Office of Health Equity, Virginia Department of Health Alison Traynor, North Dakota Suicide Prevention Program Director, North Dakota Department of Health  Mariah Wilberg, Communications Specialist and Health Educator, Minnesota Department of Health "I am thrilled and honored to see ASTHO leaders represented on this list," says Michael Fraser, ASTHO's chief executive officer. "Their inclusion speaks to the passion, commitment, and tireless effort demonstrated every day by both ASTHO and the state and territorial public health leaders we represent in order to improve the nation's health."  A panel of judges selected these individuals based on their fresh perspectives, creative problem-solving, and innovative health solutions in communities across the country. Nominees for the "40 Under 40 in Public Health" list included a wide range of public health professionals, including health commissioners, directors of health equity, doulas, and epidemiologists. For more information about the "40 Under 40 in Public Health" honorees and their accomplishments, visit de Beaumont Foundation's 40 under 40 page. ASTHO Press Release Boilerplate website yes

U.S. Territories Face Healthcare Cuts if Congress Does Not Address Impending Medicaid Financing Cliff ARLINGTON, VA—Association of State and Territorial Health Officials (ASTHO) member Esther Muña, MHA, chief executive officer at the Northern Mariana Islands Commonwealth Health Corporation, and other territorial health leaders from Guam, Puerto Rico, America Samoa, and the U.S. Virgin Islands testified today before the United States House Committee on Natural Resources about the impact that cuts to Medicaid would have on U.S. territory populations. “On the heels of Super Typhoon Yutu, which devastated the Commonwealth of the Northern Mariana Islands’ economy and its people, we face another crisis – our Medicaid program is unable to sustain its operations with the low statutory cap on federal contributions,” says Muña. “Low federal contributions, coupled with the exhaustion of the Patient Protection and Affordable Care Act funds this year, creates a fiscal cliff for our Medicaid program. This fiscal cliff threatens to unweave our substantial improvements over the past ten years in the delivery of healthcare, further erodes our economy, and threatens the health and well-being of our people. “I strongly urge Congress to stabilize Medicaid financing for the territories by raising or eliminating the arbitrary cap on federal dollars to the program so I can continue my work to protect and promote the health our population,” Muña continues. Unless Congress acts, the U.S. territories’ Medicaid programs will become gravely underfunded. Federal funding for Medicaid in territories is capped and it is subject to a fixed federal matching rate. For more information about the hearing, visit the committee’s website. ASTHO Press Release Boilerplate website yes

Illinois Department of Public Health Director Ngozi Ezike Testifies on Lung Disease Outbreak WASHINGTON—Ngozi Ezike, MD, director of the Illinois Department of Health, testified today before the House Oversight and Reform Committee, Subcommittee on Economic and Consumer Policy on the current multistate outbreak of lung injury associated with e-cigarette product use. The hearing, “Examining the Outbreak of Lung Disease and CDC’s Urgent Warning Not to Use E-Cigarettes,” provided members of Congress the opportunity to discuss and examine the cause of the outbreak, which has affected more than 530 individuals within 38 states. The Association of State and Territorial Health Officials (ASTHO) is pleased that Congress is investigating the outbreak and supports aggressive efforts to reduce all tobacco use, including e-cigarettes and their associated liquids containing nicotine and other harmful agents. “While the negative effects of vaping and related products are yet to be fully understood, what we are certain of, is that vaping and e-cigarettes are unequivocally detrimental to the health and wellbeing of adolescents and anyone who has never smoked tobacco,” says Ezike. “Nicotine is highly addictive, and more so for the youngest of vape users. Contemporary product designs, attractive technology, and associated items, like vape wear, appeal to our youth and serve only to enable use of these products by young people. We cannot stand idly by and watch the high-tech e-cigarette erase the incredible progress of the last 10 years with enticements to vape by marketing to young people through flavors such as strawberry, watermelon, mango, and blue raspberry e-juices.” For more information and to read Ezike’s testimony, visit the committee’s website. ASTHO Press Release Boilerplate website yes