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The COVID-19 pandemic highlighted the importance of having in-house skills to respond to worldwide public health emergencies. Because of this, the American College of Preventive Medicine recommends that health departments consider bringing a board-certified preventive medicine physician on staff or to have one available to assist with preparedness and population health interventions.

On this episode of Public Health Review, we speak with representatives from public health, public safety, and community harm reduction programs to discuss their perspectives, experiences, and the importance of maintaining strong relationships while also negotiating differing strategies and approaches to overdose prevention.

Experts from the Washington State Department of Health discuss understanding and addressing climate and equity concerns.

In honor of ASTHO’s 80th anniversary, a leadership panel—including CEO Michael Fraser, President Anne Zink, Past President Nirav Shah, and Idaho Commissioner of Health Elke Shaw-Tulloch—discusses the unique role ASTHO plays in the public health landscape.

ASTHO’s Senior Leadership Reserve Corps is helping state health officials and their agencies achieve their goals, like the revitalization of Wisconsin’s Public Health Council.

With the pandemic upending social interaction, youth mental health is an increasingly important issue. This episode explores why understanding the intersection of suicide, overdose, and ACEs is critical to helping individuals live happy and healthy lives. It also focuses on the importance of connecting community needs, implementing awareness campaigns, and addressing stigma to reduce health disparities.

This episode discusses why there needs to be a comprehensive response in public health surveillance, in particular around the opioid epidemic. After all, without thorough data, it’s tough for lawmakers to drive action that will reduce the prevalence and incidence of drug overdoses.

Each year, nearly 700 women in the United States die from complications related to pregnancy or delivery. Three in five of these deaths can be prevented, but it involves a collaborative approach, including consistent care and cross-sector partnerships.

Co-authors from CDC and the Alzheimer’s Association provide details about the new 2018-2023 Healthy Brain Initiative Road Map, which offers strategies for public health agencies to promote cognitive health and support people living with dementia and their caregiver, and a forthcoming companion guide for Indian Country.

Readout of CDC/ASTHO/CSTE/APHL Call Regarding Avian Influenza Preparedness ARLINGTON, VA—On Friday, Nirav D. Shah, CDC’s Principal Deputy Director, Dr. Demetre Daskalakis, Director of CDC’s National Center for Immunization and Respiratory Diseases, and Dr. Vivien Dugan, Director of CDC’s Influenza Division, met with members of the Association of State and Territorial Health Officials (ASTHO), the Council of State and Territorial Epidemiologists (CSTE), and the Association of Public Health Laboratories (APHL) to discuss avian influenza planning. CDC officials emphasized that, although the risk to the public remains low, the agency wants state public health officials to be prepared to respond. CDC recommended that state public health officials engage with their state veterinarians and agriculture department officials to ensure that they have up-to-date operational plans to respond to avian influenza at the state level. For example, CDC emphasized the importance of having plans in place to quickly test and provide treatment to potentially impacted farm workers following positive results among cattle herds. CDC also encouraged state health officials to communicate about any challenges they are facing. ASTHO, CSTE, and APHL members support CDC’s recommendations and look forward to continuing their partnership with their state agriculture counterparts, as well as CDC and other federal agencies, as part of their preparedness efforts. ASTHO Press Release Boilerplate website yes

ASTHO and PIHOA Praise Approval of Medicaid Funding Fix for U.S. Territories ARLINGTON, VA—This week, Congress approved legislation to extend Medicaid funding for two years for the U.S. territories in their fiscal year 2020 appropriations bills and extenders package. Esther Muña, the chief executive officer of the Commonwealth Healthcare Corporation, Association of State and Territorial Health Officials (ASTHO) board member, and Emi Chutaro, executive director of the Pacific Island Health Officer’s Association (PIHOA), issued the following statements applauding the bipartisan and bicameral extenders package. The legislation avoided devastating cuts to the territories’ health care services for their most vulnerable residents, scheduled to take place at the end of the year—widely called the “Medicaid Cliff.” “The U.S. territories face unique healthcare and public health challenges and the support provided through the Medicaid program allows us to care for Americans who live on these islands in their communities,” says Chutaro. “It is vital that we prioritize public health for Americans living in the U.S. territories,” says Nate Smith, secretary of health at the Arkansas Department of Health and ASTHO president. “Ensuring access to care is essential to protect and ensure health equity among and well-being within this population. As state health officials, we know that what benefits the territories will help us in our quest to bring optimal health to all.” “We are grateful for the bipartisan and bicameral legislation which provides a two-year increase in funds and federal match for the Medicaid program in the U.S. territories," says Muña. “The increased funding will allow the health care and public health systems in the U.S. territories to further improve access and quality of care to the population. This funding continues to be vital to all of the U.S. territories, and while we are grateful for this temporary fix, we must find a long-term solution to Medicaid funding to provide stability to our system of care. In the upcoming year, we look forward to working collaboratively with Congress and the Trump Administration to further bolster health care and public health systems to build healthy and resilient communities throughout the U.S. territories.” ASTHO Press Release Boilerplate PIHOA Boilerplate website yes

The ASTHO-Mason Collaborative for Applied Public Health Practice will increase access to public health education and training through student fellowships, innovative curriculum, applied practice and policy research, and academic and continuing education programs for public health students and professionals.

State and Local Health Officials at the Capitol to Urge Congress to Prioritize Funding for Public Health ARLINGTON, VA—Over 80 state, local, and territorial health officials from across the country will meet with members of congress on Capitol Hill together on March 13, 2019. The aim of their visits is to share the critical need to sustain investments in public health agencies that protect and promote the health of all Americans and prevent sequester cuts in the FY20 budget. This is the first-time members of the Association of State and Territorial Health Officials (ASTHO) and the National Association of County & City Health Officials (NACCHO) will combine their annual Hill Days to show a collective voice for governmental public health at the Capitol. Public health leaders are concerned about the impact of the potential $55 billion cut to non-defense discretionary spending that will happen in FY2020 if Congress does not act to prevent it. ASTHO and NACCHO strongly urge Congress to work in a bipartisan manner to raise FY2020 budget caps and provide needed funding for non-defense discretionary programs, and support increasing CDC’s budget 22 percent by FY22. “Our entire governmental public health system is strained. My colleagues are on the ground dealing with several measles outbreaks, the opioid epidemic, and natural disaster recovery, all while continuing the core work of disease prevention—especially at the community level. Unfortunately, we are consistently underfunded and must do more with less. As a nation, we must do better and prioritize investing in public health,” says Nicole Alexander-Scott, MD, MPH, ASTHO president and director of the Rhode Island Department of Health. “Every person and every community should have the opportunity to be as healthy as possible. As part of ASTHO’s President’s Challenge, additional federal resources will help equip health officials to mobilize community-led, place-based collectives to improve the way we live, work, and play.” “In the decade since the Great Recession, public health departments have lost about a fifth of their workforce due to funding issues and recovery has been slow at best. We see the impact of these resource losses on the health and well-being of our communities every day. In so many areas of public health, we know what works, but we don’t have the resources to ensure that all Americans, no matter where they live, have access to the same basic public health infrastructure, services, and protections,” says Kevin Sumner, NACCHO president and health officer/director for the Middle-Brook Regional Health Commission. “So much of our public health system operates silently in the background. By joining together on Capitol Hill, we will amplify our voice and spread the message of the importance of governmental public health in all sectors.” For more information on ASTHO’s advocacy priorities, visit http://www.astho.org/Advocacy-Materials. For more information about the President’s Challenge, visit http://www.astho.org/ASTHO-Presidents-Challenge/2019. For more information on NACCHO’s advocacy priorities, visit https://www.naccho.org/uploads/downloadable-resources/flyer_legislativeagenda_2019.pdf. ASTHO Press Release Boilerplate NACCHO Boilerplate website yes

ASTHO Launches National Campaign to Support Healthy Communities, Aligning with NACCHO and the U.S. Surgeon General ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) announced this week the launch of a multi-year initiative to build healthier and more resilient communities across the country. The challenge, “Building Healthy and Resilient Communities,” will be led by ASTHO’s president and director of the Rhode Island Department of Health, Nicole Alexander-Scott, MD, MPH, in partnership with the National Association of County and City Health Officials (NACCHO) and aligned with the U.S. Surgeon General’s focus on community health and economic prosperity. The challenge calls on state, territorial, local, and tribal health officials to align strategic investments and promote community-driven, place-based solutions to empower communities to be as healthy as possible, reduce health disparities, and stimulate economic development. Examples of such initiatives include Rhode Island’s Health Equity Zones, Purpose Built Communities in Georgia, the Fort Worth Blue Zones Project, and Live Well San Diego. Activities to support the challenge will center on creating opportunities for health officials to mobilize community advocates and partners towards making lasting systems and policy changes that improve living conditions at the community level. Using this platform, ASTHO and its partners, along with NACCHO and the U.S. Surgeon General, will connect public health officials with business leaders, policymakers, and other cross-sector stakeholders to shift investments to promote sustainable, equitable community development. “Health officials have a critical role to play ensuring that everyone in every community has an equal opportunity to be as healthy as they can be, regardless of their zip code,” says Dr. Alexander-Scott. “My vision is for ASTHO, along with NACCHO and the U.S. Surgeon General, to empower all public health leaders to build stronger, more connected communities that have the assets and resources they need to create the conditions for success to be as healthy as possible. By funding and implementing sustainable strategies that are tailor-made for each community, we can amplify the community’s voice and transform public health for generations to come.” “America’s greatest assets are its communities, so we should turn to them more often,” says VADM Jerome Adams, MD, MPH. “We have the best healthcare system in the world, yet life expectancy in the United States is lower than in many other high-income countries. State and local health officials know their communities best and should be inspired to change the community environment to make sure that healthy behaviors are easy behaviors that are available to everyone.” “We’re pleased to lead this challenge with ASTHO and recognize there are great synergies between state and local health officials that will allow us to be successful in equipping and encouraging communities to think more strategically about health at the community level,” says Kevin Sumner, MPH, NACCHO president and health officer for the Middle-Brook Regional Health Commission in New Jersey. View ASTHO’s President’s Challenge for more information. ASTHO Press Release Boilerplate website yes

ASTHO and Safe States Alliance Respond to Rising Injury Deaths Among Children and Adolescents ARLINGTON, VA—Today, CDC released a report showing that injuries, suicides, and homicides are leading to more deaths among children and young adults in the United States. “After several years of progress in reducing injury deaths among 10 to 19 year-olds in the United States, this alarming upturn in deaths caused by motor vehicle crashes, suicides, and drug overdoses demonstrates that significant challenges remain,” says John Wiesman, president of the Association of State and Territorial Health Officials (ASTHO) and secretary of health at the Washington State Department of Health. “Preventing injuries and violence is a top priority for our nation’s health departments. ASTHO and the Safe States Alliance are committed to strengthening the capacity of state and territorial health departments to effectively advance these efforts.” While summer is the time of year when injuries among children dramatically increase, health departments are working year-round to create safe and healthy communities. “We urge Congress to invest in effective prevention programming. Expanding the CDC’s Core State Violence and Injury Program, for example, would provide necessary resources to health departments to ensure the safety and protection of all people, especially our youngest citizens,” says Rich Hamburg, executive director of the Safe States Alliance.  “As public health leaders, we find the 56 percent increase in suicides between 2007 and 2016 to be wholly unacceptable,” adds Wiesman. “To address this serious issue and save lives, we need to consider the role of mental and behavioral health and how to better integrate these principles within the governmental public health and healthcare systems. We must intensify our efforts to prevent these tragic deaths and direct greater investments toward childhood injury and suicide prevention programs.” In light of these findings, continued assessment, vigilance, and resources are needed to put proven prevention strategies into practice to save lives and prevent lifelong disability for America’s children. ASTHO Press Release Boilerplate Safe States Alliance Boilerplate website yes

State Health Officials Commend Public Health Emergency Declaration to Address Opioid Epidemic ARLINGTON, VA—Members of the Association of State and Territorial Health Officials (ASTHO) joined President Donald Trump and First Lady Melania Trump today at the White House for a meeting declaring the nation’s opioid crisis a public health emergency.  “While emergency declarations are normally reserved for natural disasters or infectious disease outbreaks, the President’s announcement recognizes the work that states and territories are already undertaking to address the crisis and will allow for increased collaboration and coordination of regional and federal assets across the country for an even more effective response,” says John Wiesman, ASTHO president and secretary of health at the Washington State Department of Health. “We hope the public health emergency declaration, combined with future additional federal investments in substance abuse treatment and prevention, will lead to fewer deaths and better health for all Americans.” State and territorial health officials have been at the frontlines of this crisis working to address the many facets of the epidemic. Six states have already declared emergencies in their jurisdictions: Alaska Arizona, Florida, Maryland, Massachusetts, and Virginia. “While federal leadership has been working hard in partnership with states to address this crisis, many states have taken executive and legislative action to address the epidemic including implementing new laws and regulations around prescribing and providing additional funding for treatment services and evidence-based public health interventions to prevent substance misuse in the first place,” says Michael Fraser, ASTHO’s executive director. “The federal emergency adds to the work that states and territories have been doing in many different ways across the country.” Treating and preventing substance use disorders and addiction is very complex. “Opioid addiction is challenging because many people first become addicted when receiving the medications through the healthcare system. Addiction is not a moral failing on the part of the individual; it is a health condition we must address in healthcare and across all sectors as a society at the national, state, and community levels,” says Jay Butler, ASTHO’s immediate past president and chief medical officer for the Alaska Department of Health and Social Services. “Addiction is treatable and, more importantly, preventable with appropriate evidence-based interventions. The declaration today will help us respond even more effectively to the loss of life and devastating impact of substance misuse and addiction.” ASTHO, in partnership with the National Association of State Alcohol and Drug Abuse Directors (NASADAD), recently released a framework on public health responses to the opioid crisis that was developed to assist health officials in combating the epidemic. As federal agencies and Congress look to implement their response to this public health emergency, ASTHO urges national leaders to provide additional resources focusing on both treatment and prevention of addiction. “This is a crisis we ultimately are not going to arrest—or treat—our way out of; instead, we have to prevent our way out of this,” adds Fraser. “Like any public health emergency, addressing this problem calls for important steps to prevent the disease in the first place. We hope that the President and First Lady’s attention to the opioid epidemic will help us focus on both treatment and prevention. That is the work of public health, and states and territories are committed to mustering all resources available to end this epidemic.” ASTHO Press Release Boilerplate website yes

If there is any word to describe 2020 it is “unprecedented,” with the work of health agencies front and center since COVID-19 emerged in the U.S. But as we approach Public Health Thank You Day and the Thanksgiving season, ASTHO wants to send a special appreciation to our entire state and territorial public health workforce. We have been so impressed by your tireless work to address COVID-19 in your jurisdictions and you have wowed us all with your dedication and commitment to the work of health protection and improvement. Thank you all for all you do to keep your communities healthy!

Alabama shares six ways a cross-cutting approach successfully impacted its PHIG workplan implementation.

An interview with ASTHO President Anne Zink (SHO-AK) about strengthening state and federal connections for public health.

The Louisiana Department of Health HAI/AR program highlights the current landscape of HAI/AR programs, the benefits of having leadership dedicated to the HAI/AR program mission and priorities, and the need for alignment of HAI/AR program communications and structure with state and territorial health agencies.