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When rural hospitals close, it increases the distance people must travel for essential healthcare services. The COVID-19 pandemic has highlighted and magnified the factors leading to rural hospital closures across the country. Many healthcare facilities suspended elective procedures to conserve critically needed personal protective equipment and reduce the risk of exposure to COVID-19 by patients and hospital staff. For many rural hospitals, however, the suspension of elective procedures with the reduced the use of non-urgent services by apprehensive patients meant a loss of revenue and the furloughed healthcare staff. Since the onset of the COVID-19 pandemic, approximately half of all rural hospitals are experiencing negative operating margins due to reduced outpatient revenue. The rate increases in states that have not expanded Medicaid. Unfortunately, these kinds of challenges are not new to rural hospitals.

Though we’ve made progress on the number of HIV cases in the U.S, tens of thousands of Americans are diagnosed with HIV each year—a disproportionate number being people of color. In 2019, the federal government launched the Ending the HIV Epidemic: A Plan for America (EHE) with a goal of ending the HIV epidemic by 2030. EHE leverages four strategies to reduce the prevalence of HIV: diagnosis, treat, prevent, and respond. State efforts to reduce the incidence of HIV align with the federal plan, with many states passing legislation to enhance prevention and harm-risk reduction efforts.

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.

In order to contain and mitigate the COVID-19 pandemic, widespread, rapid testing is key. Rampant and efficient testing determines who has the virus and who may be at risk of transmitting it, and allows for effective management of isolation and quarantine activities for the infected or exposed. While testing has increased over the past months across the country—by mid-July the number of tests reached between 700,000 to 800,000 per day, double the number of daily tests performed in May. However, that number is still well below the estimated 1.2 million daily tests needed to contain the outbreak and 4.3 million tests per day that would suppress the virus.

Continuing ASTHO’s Legislative Prospectus series—which highlights the top 10 public health policy issues for 2022—this post focuses on mental and behavioral health, as well as supporting the public health workforce.