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Several states and territories, as well as many local governments, are going beyond recommendations and requiring individuals to wear face coverings when they are in public settings and spaces (i.e. grocery stores, retail stores, restaurants, public and private transportation services, parks, etc.). Ongoing research and evidence suggests the relationship between mandatory face coverings and declines in daily COVID-19 growth rates is statistically significant.

The COVID-19 pandemic has exasperated challenges around access to nutritious and affordable foods. In response, the federal government has taken action to increase funding and access to programs to strengthen food security.

On the 32nd anniversary of the ADA, this blog post explores state legislation around the country that supports people living with disabilities.

PrEP is a powerful tool to reduce new HIV infections; expanding access to PrEP is a priority within the federal Ending the HIV Epidemic in the U.S. initiative. One way to increase access to PrEP is by allowing pharmacists to prescribe and dispense it.

Health providers have widely used telehealth to mitigate the spread of COVID-19 infection and to improve access to healthcare services thanks in large part to policy changes and regulations. This brief explores how state and territorial health agencies (S/THAs) are responding to COVID-19 through telehealth policy and operational changes, as well as how telehealth has quickly emerged as a tool to improve health equity.

The ASTHO State Health Policy team provides brief updates on 5 of the ten state health policy issues to watch in 2022: mental and behavioral health, rural health, e-cigarettes and flavored tobacco products, HIV and PFAS.

Vaccines are one of the greatest public health achievements of the last century, as well as some of the most powerful and cost-effective tools to prevent disease, disparities, disability, and death among children and adults. The COVID-19 pandemic and the unprecedented development and distribution of the vaccines against the novel coronavirus have generated much focus on state laws related to vaccinations. As state and territorial legislatures prepare to convene in the coming weeks, we can already identify several topics within vaccine law that policymakers across the country will consider.

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

ASTHO Legislative Prospectus | Prevention 2025 state legislative action on infectious disease control and prevention.

Public health leaders are positioned to prevent illness from the "tripledemic” of COVID-19, Influenza, and RSV with approved vaccines and preventative antibody treatments.

Reconciling the tension between public health and civil liberties is one of the most significant challenges of public health law and ethics. The Supreme Court of the United States historically upheld state authority to enact and enforce public health laws that temporarily limit a person’s civil liberties, such as quarantine and isolation powers that restrict a person’s freedom of assembly in order to prevent the spread of contagious disease. There have been many legal challenges to the public health orders issued to slow the spread of COVID-19—many of the claims asserting violations of First Amendment rights of assembly, association, and expression—but they’ve largely been rejected by the courts. However, courts have treated claims asserting violations of the free exercise of religion more favorably, which may indicate an impending shift in how courts analyze the impact state and territorial actions may have on religious organizations.

The 2020 holiday season is coinciding with a nationwide surge of COVID-19 cases. With great concern that holiday travel to see loved ones may exacerbate community spread of the virus, many states are increasing public health measures before the winter holiday season. As of November 16, 2020, 13 states and D.C. had a quarantine requirement for out-of-state travelers. The U.S. territories also have instituted travel restrictions to limit the spread of COVID-19.

As we celebrate National Rural Health Day this year, we are reminded of how important telehealth can be for public health and healthcare. Telehealth can minimize challenges faced by rural patients and communities—such as transportation, provider shortages, etc.—manage volume, increase the quality of healthcare, and lower overall costs by reducing readmissions and avoidable emergency department visits. However, the COVID-19 pandemic has shown that access to reliable broadband is still a challenge and is a key social determinant of health for rural Americans.

On this episode, speakers will discuss the impact of COVID-19 on rural health infrastructure and workforce, and how to improve these conditions in rural communities. We hear from three leaders who work in states with high rural healthcare needs and vast provider shortages to learn how to increase access to quality healthcare in rural areas, barriers that exist, and innovative strategies for rural health workforce recruitment and retention.

October is Domestic Violence Awareness Month, a critical moment to address intimate partner violence as a major public health threat. Intimate partner violence associated with substance use disorders and mental health challenges, and numerous studies indicate that people who are abused are more likely to use or become dependent on substances. The risk for all of these outcomes has been heightened by the COVID-19 pandemic.

Toxic stress contributes to a variety of negative outcomes for children. And unfortunately, COVID-19 has increased the likelihood of children experiencing childhood trauma, adverse childhood experiences (ACEs), and toxic stress. States and territories should have programmatic, and policy mechanisms to both prevent and mitigate the lifelong effects. A CDC Vital Signs Report found that preventing or mitigating ACEs could reduce depressive disorder by 44%, smoking by 33%, and unemployment by 15%.

During the early spread of COVID-19, the National Rural Health Association senior vice president Brock Slabach stated: “Before the pandemic, rural hospitals were struggling for survival. COVID-19 has put a spotlight on the fractures that already existed within rural communities in terms of their healthcare delivery.” These fractures also exposed the desperate need for ethical transformational leadership within rural healthcare delivery systems. The time to build these capacities is now.

16 recommendations for states as they set up mobile and drive-through COVID-19 test sites.

Strategies and Innovations to Address Long COVID Strategies to Address Long COVID Alyssa Boyea Learn innovative strategies to address Long COVID, with examples from the field. Long COVID, or post-COVID condition, is a chronic condition that occurs after SARS-CoV-2 infection and afflicts approximately 20 million people in the United States. It is a multifaceted disease with symptoms or health problems lasting for at least three months as a continuous, relapsing, remitting, or progressive disease state affecting one or more organ systems. In 2024, the National Academies of Sciences, Engineering, and Medicine released a report defining Long COVID to harmonize terminology and measurement approaches. Long COVID has far-reaching implications beyond individual health, affecting health care systems and broader societal structures. Global economic impact of Long COVID is estimated to be approximately $1 trillion per year, including medical costs, productivity losses, and other compounding effects. Ongoing prevention efforts for Long COVID rely upon vaccination and primary prevention strategies for COVID-19 infection. The lasting impact of Long COVID requires unique health policy approaches, sustained research funding, and coordinated health and public health action to support affected individuals and mitigate long-term societal costs.  Key Challenges Diagnostics: There is no laboratory test for diagnosis nor standardized clinical diagnostic test. As a result, clinical clarity in diagnosis remains challenging. Reduced testing for acute COVID-19 infection has also hindered diagnosis and public health disease surveillance of Long COVID. Engagement: COVID-19 pandemic fatigue and reduction in trust can make it challenging to establish a trusted public health response to support impacted communities. Information is constantly evolving as more is learned about the condition, which can lead to confusion and misinformation. There is also little real-time data on community needs related to Long COVID to help tailor messaging or provide effective education. Funding: Many jurisdictions do not have dedicated Long COVID funding and are grappling with cuts to federal and state funding for Long COVID. Without sustained funding, it is challenging to retain dedicated staff — increasing reliance on part-time personnel — and continue initiatives. Jurisdiction Highlights: Advancing Long COVID Efforts Colorado In 2022, the Colorado General Assembly passed HB22-1401, directing the Office of Saving People Money on Health Care (OSPMHC) to examine and make policy recommendations that address the impacts of post-viral illness resulting from COVID-19, and directing the office to support efforts improving public health outcomes in the state. OSPMHC releases annual reports summarizing Long COVID impacts in Colorado, as well as key activities and accomplishments. Key statewide activities include developing surveys to assess socioeconomic impacts of Long COVID in Colorado, conducting a modeling study to examine factors and utilization patterns pre- and post-Long COVID diagnosis, and launching an initiative to better understand the association between clinical events prior to death and the designation of Long COVID on death certificates. Additionally, a Colorado Long COVID Community of Practice was established to discuss recent developments, share lessons learned, and inform strategies for surveillance and care, plus web/social media content to raise awareness. Minnesota The Minnesota Department of Health (MDH) launched the Long COVID program in 2021 to increase awareness and monitor potential long-term health issues following COVID-19 infection. In 2023, MDH secured state funding to expand the program and offer grants to organizations that support communities disproportionately impacted by COVID-19. Key initiatives include raising awareness about Long COVID and other infectious-associated chronic conditions (IACCs) through presentations, social media, and online resources; engaging individuals affected by Long COVID and conditions like myalgic encephalomyelitis/chronic fatigue syndrome; conducting epidemiological surveys and studies; forming a Long COVID Provider Guiding Council to foster collaboration, education, and system improvements among health care providers; and establishing the Long COVID Community Voices partner group, which led to a statewide network of organizations addressing Long COVID needs. Additionally, MDH has started a steering team of professionals and people with lived experience to guide the development of an actionable statewide framework for addressing IACCs and identify opportunities for cross-sector collaboration. New York City The New York City Department of Health and Mental Hygiene has focused its efforts on raising awareness and community engagement around Long COVID. Key activities include multilingual trainings for community and faith-based organizations and other partners to incorporate Long COVID information into their messaging with their respective communities, a study to assess long-term impacts of COVID-19 on New Yorkers, a three-part messaging campaign to share lived experience and stories of those living with Long COVID, and web/social media content to raise general awareness. Key Considerations Utilize public health resources such as the 10 Essential Public Health Services framework, “The Role of U.S. Public Health Agencies in Addressing Long COVID” and the health+ “Long COVID Human-Centered Design Report” to guide implementation of robust programs for Long COVID and related conditions. Share information on health agency websites, newsletters, or other forums to help raise awareness. Access to relevant information and resources is critical. Foster relationships and trust with various partners (e.g., health care, community-based organizations, and patient and caregiver communities) to learn about challenges/needs related to Long COVID and opportunities for collaboration. Collaborate with trusted messengers, such as community health workers and champions, to share community specific and linguistically appropriate information. Focus outreach efforts on under-resourced populations through culturally responsive frameworks. Partner with clinicians and health care systems to support clinical education and share relevant patient-focused resources for Long COVID and associated conditions. Promote sustained investment and support for Long COVID policies and research. Engage with key partners including health agency leadership, governor’s offices, state legislators, and advocacy groups to raise support for initiatives. Utilize local data and stories to show impact and advocate for dedicated resources. Long COVID Community of Practice article yes

ASTHO Legislative Prospectus | Prevention 2025 state legislative action on infectious disease control and prevention.