Displaying 1-20 of 50 results for

Investing in Indiana’s Public Health Infrastructure Through Community-Driven Policy Change public health infrastructure, community driven policy, indiana state health commissioner, public health system, indiana department of health, outpatient facilities, technical assistance, data and information integration, emergency preparedness, child and adolescent health, legislative action, state and local elected officials, health problems, health care, health system, health departments, federal agencies, essential public health services, centers for disease control, state and local levels, health outcomes, health organization, covid-19 pandemic, health infrastructure, promoting health, public health organizations, states public health, federal funding, astho, association of state and territorial health officials Maggie Davis, Keith Coleman Indiana enacts historic public health funding through community engagement and legislative support. In April 2023, Indiana passed bill SB 4, which was a historic investment in the state's public health funding and restructuring its public health system. This case study shares how the Governor's Public Health Commission and the Indiana Department of Health approached community listening sessions, formulated recommendations, and successfully built legislative support to reform the public health system in the state. Get the Report (PDF) website yes

The Suicide, Overdose, Adverse Childhood Experiences Prevention Capacity Assessment Tool (SPACECAT) compiled a national report and accompanying infographic, that break down the biggest findings from the data, and highlight the biggest barriers facing health agencies today.

This report analyzes the results from a survey of state and territorial health agency staff to collect information regarding health agency efforts to address climate change and extreme weather.

Discover how improving public health data infrastructure can create more robust care for people with disabilities in this blog post.

In addition to PFAS exposure assessments, state and territorial health agencies may also consider the role of social stressors during the risk assessment process.

Linking Datasets to Address Racial Equity in Maternal and Child Health Outcomes astho, association of state and territorial health officials, data sources, people of color, centers for disease control, racial inequities, advance racial equity, maternal morbidity, maternal death, maternal health, child health, participate in prams, risk assessment monitoring system, disease control and prevention, maternal and child, morbidity and mortality, pregnancy risk assessment monitoring, pregnancy related death, racial justice, linked data, achieve health equity, advancing health equity, racial equity, maternal and child health, maternal mortality and morbidity, racial disparities, health equity, data linkages, vital records, pregnancy risk assessment monitoring system Stephany Strahle ASTHO | Strategies for promoting racial equity in maternal and infant health through data linkages. Racial disparities in maternal and child health outcomes impact populations across the United States. Having robust data to understand these disparities may inform more comprehensive initiatives and policies that address the impacts and root causes of inequities. Looking at administrative datasets, such as hospital discharges and vital records, allows health professionals to monitor inequities by racial and ethnic communities. Often not captured in these data, however, is the complex interaction of social determinants—such as access to social support, racial discrimination, insurance coverage throughout pregnancy and postpartum, and access to paid family and medical leave—and their impact on health outcomes. Public health surveillance systems monitor these outcomes and aim to answer questions on a broad range of contextual experiences. These systems can be combined with administrative data through data linkage, “a process that matches records representing the same person or entity derived from different data sources in order to generate new and more comprehensive datasets.” These linkages can help identify areas for patient-centered outcomes research and inform policy recommendation and programs that address maternal and child health disparities across racial and ethnic groups. State Approaches to Data Linkages Linking Vital Records with Income Data California In a recent working paper on maternal and infant health inequities in California, researchers linked administrative vital records with parental income data. This research found that “infant and maternal health in Black families at the top of the income distribution is markedly worse than that of White families at the bottom of the income distribution.” Linking vital records, a source that typically does not capture income information, with data sources that do, provided a novel and robust dataset illuminating the exacerbated disparities experienced by racial and ethnic minorities at all income levels. Using PRAMS to Monitor Health Outcomes The Pregnancy Risk Assessment Monitoring System (PRAMS) allows jurisdictions to monitor various maternal and infant health indicators before, during, and after pregnancy. As one of the few public health surveillance systems collecting data on race-related experiences and discrimination, it also provides a better understanding of disparities among racial and ethnic groups. As part of ASTHO’s Linking PRAMS and Clinical Outcomes Data Multi-Jurisdiction Learning Community, two state teams from Massachusetts and Georgia used data linkage of PRAMS to explore racial disparities in maternal and child health outcomes. Massachusetts The Division of Maternal and Child Health Research and Analysis at the Massachusetts Department of Public Health linked PRAMS data with the Pregnancy to Early Life Longitudinal Data System (PELL), a data system linking birth files to hospital discharge records that can be later used to link hospital-based service records, data on early intervention services, and other data documenting maternal and infant health experiences beyond birth. Previously, both PRAMS and PELL data informed Massachusetts’s 2022 report from the Special Commission on Racial Inequities in Maternal Health, which provided policy-related recommendations on doula workforce development and equitable implementation of paid family and medical leave within the state. Sarah Stone, PhD, MPH, the director of the Massachusetts Office of Data Translation, notes that linking PRAMS, which provides insights into the social determinants shaping people’s experiences during pregnancy, with the more administrative data included in PELL can further inform additional evidence-based initiatives to address inequities in maternal mortality and severe maternal morbidity. Georgia At the Maternal and Child Health Section of the Division of Epidemiology in the Georgia Department of Public Health, linkages between PRAMS and Georgia Vital Record data can provide insight into the observed differences in health outcomes among the state’s diverse population. Jenna Self, MPH, Georgia’s PRAMS project director and health surveys team lead, explains that “the linkages will help explore the association between maternal postpartum behaviors and negative infant health outcomes (e.g., mortality, hospitalization, emergency department visits) with the goal of understanding the health disparities” to inform future equity-focused initiatives. The development of a linked data environment will allow the Georgia Department of Public Health to ask and answer previously time and resource prohibitive questions. Recommendations Data linkage can be a powerful tool to create enhanced datasets that better inform state initiatives to improve racial equity in maternal and infant health outcomes. To use data linkages that identify areas needing equitable public health efforts, states should: Build and strengthen cross-collaborative relationships within and between various state agencies owning the datasets to facilitate data sharing. Consider the racial equity impacts of performing data linkages by exploring research questions that lead to more evidence-based decision-making. Understanding the linked data using a racial equity lens can better inform equitable policy recommendations and programmatic planning. Examine which data sources, when linked, could fill in gaps of understanding and provide a wealth of information to identify disparities and point to specific gaps in quality health care. Brief - Linking Datasets to Address Racial Equity in Maternal and Child Health Outcomes - Special Thanks website yes

Better Defining Disability Will Make Data More Inclusive and Usable ASTHO, association of state and territorial health officials, access to health care, centers for disease control, syndromic surveillance systems, health outcomes, person with a disability, disaster medical assistance team dmat, mental health conditions, people with disabilities, health disparities, mental health, health equity, public health emergencies, syndromic surveillance, disaster medical assistance teams, disability data, people living with disabilities, disability inclusion Margaret Nilz ASTHO | Syndromic surveillance data on disability prevalence will help people with disabilities in emergencies. Over the past two decades, the frequency and intensity of natural disasters have increased — and will continue to do so. While disasters impact whole communities, past incidents highlight specific effects on people with disabilities, as it is more challenging for them to prepare for and recover from an incident. Understanding the prevalence of disability in a jurisdiction helps fully address the population’s needs.​ There is not a universally accepted way to collect data on people with disabilities. However, the need for disaggregated data by disability status is critical to helping measure health disparities and underlying factors contributing to inequities. Such data will support the development and continuous evaluation and improvement of public health programs and policies. Key Considerations for Collecting Data on People with Disabilities Disability data is essential for inclusive public health practice. Several factors are important to keep in mind when gathering data on people with disabilities. Participation is critical as exclusion from research can further marginalize already vulnerable groups and limit access to advancements. Accounting for historical trauma/negative impacts helps people with disabilities who are at increased risk of coercion, inclusion without consent, and other exploitation. Unwarranted disability assessments, particularly those implemented with limited evidence of effectiveness, have been shown to have negative mental health impacts on participants with disabilities. Different models of disability provide a reference as programs, services, laws, and regulations are developed. Primary models of disability include the Medical Model, Functional Model, Social Model, and Medical/Rehabilitative Model. Current Measures and Definitions of Disability - Brief - Better Defining Disability Disability Inclusion in National Syndromic Surveillance Program (NSSP) NSSP includes electronic health record (EHR) data from 73% of the nation’s emergency departments (EDs). However, it contains no systemic way to identify people with disabilities. Including disability data within a system as valuable as NSSP can help close gaps in monitoring the impacts of emergencies on people with disabilities. Syndromic surveillance data can guide decision-making during emergencies and policy formation at the local, state, and national levels. There are limitations of using syndromic surveillance data. First, diagnostic codes may not map directly onto functional limitations. Second, codes do not provide information about residual functioning, loss of functioning, or disability severity. Additionally, reporting in EHRs may not be accurate due to input or data errors. Codes can be related to a visit or encounter, even if it does not end up being true for a patient. Furthermore, diagnostic codes reflecting disability may not be used in every encounter and people with disabilities may be missed through using ED data as it only represents a snapshot in time. Benefits of Expanding Disability Data Access and Use Expanding the collection, access, and use of disability data for public health program development and emergency preparedness promotes health equity for people with disabilities. More specifically, this data can inform fiscal, programmatic, service policy, and public health planning decisions. When Disaster Medical Assistance Teams (DMATs) deployed to shelters in North Carolina, CDC’s NSSP team asked health officials if they wanted to integrate these data. Within 24 hours, data from DMATs were available in NSSP, providing a snapshot of health in those shelters. Data were monitored along with ED visits to give a complete picture of the storm’s health impacts. In 2017, Hurricane Harvey made landfall in Texas, resulting in 88 deaths and $125 billion in infrastructure damage. Public health officials used syndromic surveillance to understand increases in ED visits by those who evacuated to the Dallas–Fort Worth (DFW) area. Area hospitals saw roughly 4,400 more ED visits than normal; at least 600 were evacuees. Syndromic surveillance data demonstrated extensive health care services use outside the affected areas by highlighting the importance of surge capacity planning one to four hours outside the disaster area. Ongoing Efforts Through a cooperative agreement with CDC, ASTHO is working with subject matter experts to create a definition of disability for syndromic surveillance. ASTHO conducted key informant interviews with disability professionals to inform the development of this new diagnostic code-based definition, along with four scientific panels to assess the drafting and review of national and state-level pilot testing. An expansion of this kind benefits jurisdictions through increased data capacity for fiscal, programmatic, and service policy decision-making and supporting longitudinal tracking of prevalence and risk. Conclusion Efforts to expand data about people with disabilities can help build public health capacity to monitor the health and well-being of people with disabilities before, during, and after public health emergencies. However, efforts in data collection on disabilities require interoperability and standardization across all systems to be successful. Efforts to contextualize public health emergency data and gather supporting data on impacted populations allow health officials to better turn data into action in pursuit of health equity across public health emergencies. NU38OT000290 website yes

Social determinants of healthcare are the conditions in which people are born, live, work, play, worship, and age. Read how these issues affect population health.

This report shares results and key takeaways from interviews on topics including the overall structure of Legionnaires’ disease programs, diagnosis and clinical testing protocols, and risk communication.

Technical assistance for procuring software to support data dashboard development.

This report shares Puerto Rico’s strategy and recommendations for developing a social determinants of health dashboard.

This ASTHOBrief addresses the importance of developing robust, culturally competent risk-appropriate care systems for American Indian and Alaska Native communities.

Arizona Department of Health Services Pursues Policies to Advance Data Sharing with Tribal Nations Erik Skinner, Christina Severin, Reema Mistry The Arizona Department of Health Services is pursuing policies to advance data sharing with tribal nations, centered around partnerships, education, and more. With leadership support and funding to modernize its public health infrastructure, the Arizona Department of Health Services (ADHS) is pursuing policies to advance data sharing with tribal nations. This includes investing in partnerships with tribal leaders, educating the public health workforce about tribal governments and tribal health care, and working to improve data identification processes to support effective data sharing between the state and tribal nations. Data sovereignty is an important consideration for ADHS, as there are 22 federally recognized tribal nations in Arizona. ADHS recognizes the inherent right of tribal nations to access their citizens’ public health data and is developing a tribal data sovereignty policy that both acknowledges their unique data needs and aligns with state requirements around tribal engagement. Leadership Support and Effective Tribal Engagement ADHS leadership understands the importance of making strong connections with tribal nations and recognizing each nation’s public health priorities while meeting its statutory requirement to develop tribal consultation policies. To that end, ADHS developed the tribal liaison position to serve as a resource, advocate, and communication link between ADHS and Arizona’s Native American health care community partners, including tribal community leaders, health and epidemiology directors, Indian Health Service (IHS), and Tribal Epidemiology Centers (TECs). Understanding cultural norms is essential to building trust with tribal partners; the tribal liaison role has been vital to ADHS engagement with tribal nations on data sovereignty topics. People and processes are important to establishing data sharing policies, and a well-informed workforce is essential for effective collaboration with sovereign tribal nations. ADHS is working with the Native Nation Institute to provide training on tribal sovereignty and cultural humility for staff. It has also developed a tribal handbook for public health staff on sovereignty, cultural trauma, and the roles of IHS and TECs. Identifying Tribal Affiliation within Datasets and Tribal Public Health Priorities ADHS conducted a data assessment to identify instances in which data sharing was active and ongoing between ADHS and tribal nations, and instances in which it had expired. A notable technical challenge was identifying tribal members within existing datasets, as many public health datasets are incomplete (e.g., do not include tribal affiliation) or rely on IT systems that are unable to aggregate data appropriately—making it difficult to ensure tribal authorities receive relevant, comprehensive public health data for their communities. In addition, because each tribal nation’s public health priority areas and data needs could differ from the data that state health information systems collect, sharing relevant data with tribal nations can be challenging. ADHS is working with each nation to identify tribal public health priority areas, find solutions to identify tribal data within state collected datasets, and share it with the respective nations. Ken Komatsu - Brief - AZ DHS Pursues Policies to Advance Data Sharing with Tribal Nations Honoring Sovereignty in Data Sharing Relationships Data sharing agreements with public health agencies often establish that the state agency controls the disposition and use of the data, and that each party benefits. Acknowledging that tribal partners are entitled to their citizens’ data without conditions differs from how ADHS has historically approached data-sharing relationships with others. ADHS plans to formally establish a non-transactional data sharing policy with tribal public health partners, and establish data sharing agreements that align with this approach going forward. Implementation Considerations Considerations for state health agencies in fostering strong relationships and effective engagement with tribal partners around data-sharing efforts include: Center tribal sovereignty when framing data sharing agreements with tribal nations. Engage tribal liaisons in data-sharing efforts with tribal nations. They maintain close relationships with tribes and can help develop mutual cultural understanding, which is essential to engaging tribal partners. Assess datasets to determine data completeness with regards to tribal affiliation and identify opportunities to improve comprehensive data sharing with tribal authorities. Invest in state health agency staff training on tribal sovereignty and cultural humility, so staff can be well-prepared when engaging in data sharing conversations with tribal partners. Gerilene Haskon - Brief - AZ DHS Pursues Policies to Advance Data Sharing with Tribal Nations OT18-1802 website yes

Get insight into the successes and challenges of integrating race/ethnicity data in public health and future directions in this field.

Six DELPH scholars give their insights to learn more about how the data modernization initiative and DEI intersect with public health.

The adage “what gets measured, gets done” has had staying power for a reason. When we can accurately describe conditions, quantify impact, and elucidate connections, we have a better chance at taking collective (and effective) action to tackle even the most challenging problems facing our communities. The National Survey of Children’s Health is a powerful tool to provide this critical information to researchers, policymakers, and state-level decision makers.

We can prepare for the future of health equity and data by ensuring the equitable collection of data and building systems that are flexible enough to account for forward progress.

As a truly historic year comes to an end, many public health policy issues received a considerable amount of attention in 2020. Subjects such as the pandemic that will live on in infamy, racial health disparities, and the future of the Affordable Care Act, are just a few of the major health issues that took center stage on Capitol Hill this year.

A mid-session legislative update on five of ASTHO's top 10 public health state policy issues to watch in 2023: data privacy and modernization, reproductive health, health equity, strengthening public health agencies, and immunization.

This blog explains ASTHO’s Islands Health Equity Framework, which outlines a culturally resonant approach to health equity in the island areas.