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Building a Resilience Framework in Colorado Creating Resilient Communities in Colorado Heather Tomlinson, Kerry Wyss Learn how Colorado public health is building community and cross-sector partnerships to build community resilience. Following the 2012 wildfire season and the 2013 Colorado Floods, Colorado recognized the opportunity to better prepare for natural disasters and coordinate efforts across state agencies to build resilience into their regular operations. In 2015, Colorado became the first state to develop a resilience framework and created the Colorado Resiliency Office (CRO) with the goal of building more resilient systems in the face of shocks and stressors. The Colorado Resiliency Working Group (CRWG) is an interagency group that meets on a quarterly basis to collaboratively implement and advance resilience actions and goals. The Colorado Resilience Framework serves as interagency guidance on strengthening resilience and emphasizes finding co-benefits across community sectors, reducing community risk and vulnerability to disruptions, and supporting the state in anticipating and preparing for current and future conditions. The framework is updated every five years to adapt priorities and to keep up with current conditions. Changes from 2015 to 2020 included a shift from focusing heavily on long-term recovery to taking a more holistic approach to resilience. The CRWG is currently working on the 2025 update with a focus on statewide vulnerability where they can have the most impact and prepare for future conditions with available resources. They are also focusing on clear metrics and being able to communicate progress effectively. The state also created a statutory definition of resilience, which has helped with coordination across long- term projects and agencies. Coordination with Partners Resiliency work in Colorado is greatly enhanced by working with a wide range of partners that bring their subject matter expertise to the table. As a state with strong local control, Colorado has prioritized working collaboratively with local partners, providing technical assistance and subject matter expertise to support their work on the ground, from planning support to targeted grant programs. This collaboration helps ensure continuity from the state to the local communities. Colorado’s approach to resilience ensures resilience is integrated within its many agencies. For example, the Colorado Department of Public Health and Environment (CDPHE) has continued to evolve and advance their agency’s resiliency work. Beginning March 2025, CDPHE developed a monthly internal working group to funnel knowledge into resilience leadership across CDPHE — including environmental health, chronic disease, environmental justice, disease and public health, and air pollution. Their goal is to build partnerships across internal programs and state agencies. The CRO was first established in the Governor's Office and moved to the Department of Local Affairs (DOLA) in 2018. This move strengthened continuity of its long-term work and, given Colorado’s strong local control governance structure, enabled the CRO to further the goals of building a more resilient Colorado by partnering with and supporting local governments with planning and technical assistance to build greater resilience. The CRO offers flexible Future-Ready Technical Assistance Opportunities for state agencies, which helps them apply adaptability and future-visioning lenses to their resiliency principles in programs and operations. To involve the wider network of resilience practitioners within communities across the state, the CRO launched a community of practice on LinkedIn to foster peer-to-peer learning and dialogue and ensure all voices are heard in a collaborative environment. The Governor’s Office of Climate Preparedness and Disaster Recovery (CPO), facilitates cross agency coordination and collaboration while driving proactive state-wide climate preparedness priorities and supports development of the state’s disaster recovery capacity and capabilities. The CPO also coordinates efforts to ensure that the state budget and legislative processes reflect statewide climate preparedness, disaster recovery, and resilience priorities and leads the development of Colorado’s Climate Preparedness Roadmap — a strategic guiding document updated every three years that uses the best available science and data to prioritize near-term climate adaptation actions across Colorado state government. In collaboration with the implementing state agencies, the first Roadmap, released in 2023, set achievable near-term action items ensuring clear steps to strengthen climate resilience and adaptation. Among the actions, the Roadmap outlined the need to tackle extreme heat through a collaborative interagency approach, while better understanding the unique ways that heat affects Colorado. Social and community capacity were also outlined in the framework as a priority. CDPHE has worked with the Governor's Office to evaluate best practices and strategies tailored for each unique region and implemented their first heat plan in 2024. Extreme heat can be deadly and is projected to continue to intensify. CPO takes the lead in coordinating extreme heat work across agencies. They are partnering with the Colorado State Forest Service to pilot solutions such as climate-smart tree planting to help keep people safe during high-heat events by reducing ambient neighborhood temperatures and shading individual homes to lower indoor temperatures and reduce cooling costs for residents. Building Disaster Recovery Capacity Colorado is investing in disaster preparedness and recovery capacity to reduce the impacts of disasters, help communities recover more effectively, and build resilience into recovery efforts. Ensuring strong recoveries allows for the integration of strategic investments in resilience and hazard mitigation, which the state did in partnership with Xcel Energy — in the wake of the Marshall Fire, the state provided financial assistance to rebuild home to high performance standards and integrated wildfire mitigation actions during the rebuild process. In recent years, Colorado has expanded their recovery investments, including the addition of key positions in targeted recovery areas including within CPO, at DOLA within the Division of Housing and within the Division of Local Government, at the Colorado Department of Agriculture, and at the Department of Public Health and Environment. Technical expertise and capacity at the agency level is leveraged to strengthen preparedness and to support recovery from state declared disasters through the Colorado Department of Public Safety's State Recovery Task Force, providing recovery expertise when activated according to their assigned Recovery Support Function (RSF). Colorado partnered with FEMA’s State Technical Assistance for Recovery Strategies Program to develop processes and strategies that can be integrated into the RSF plan updates within the State Emergency Operations Plan, and to refine RSF functions, capabilities, and partnerships. Over the last year, the state has additionally conducted numerous discussion-based exercises to strengthen RSF relationships and operational capability. The state continues to identify and enhance new opportunities in supporting local communities with pre- disaster recovery technical assistance. Examples include: Hosting Department of Public Safety-led regional recovery symposiums. Piloting additional focused recovery workshops that prioritize rural and less resourced communities. Developing and refining disaster recovery planning tools. Offering recovery and resilience toolkits and expertise to local governments led by DOLA. Strengthening integration of disaster considerations into local planning processes. Colorado implemented this work in summer 2025 when the state experienced numerous wildfires in short succession that received state disaster declarations, activation of the State Recovery Task Force, and required close state-local disaster recovery coordination. Ensuring strong recovery capacity and capabilities is critical to long-term resilience, enabling communities to recover more quickly, more completely, and in ways that integrate proactive resilience strategies. A Path Towards Long-Term Sustainability A key element in Colorado’s long-term approach to building resiliency is closely involving the local community. Building robust community planning and response capabilities at the local level allows for agencies to tailor plans to community needs and ensures everyone is engaged in the process. The CRO, in collaboration with state agency partners in the CRWG, developed the Guidance for Local Government Climate Adaptation, which provides comprehensive guidance, funding resources, case studies, and connections to state and federal programs that can provide support in over 25 implementable actions. The CRO has also focused their resiliency work on anticipating what is to come down the road by assessing current and future community needs. An example is the Rural Resiliency and Recovery Roadmap Program, which brought together 16 different regional community teams with over 150 rural jurisdictions and non-governmental partners to support diversifying and strengthening their economies while building regional resiliency following the COVID-19 pandemic. Each regional team developed a roadmap that evaluates local stressors and how conditions may change in the future. This program also looks at what may impact the community from perspectives of housing availability, workforce, and potential resiliency stressors. Another example is the Camp Resilience: A Rural Prosperity Leadership Academy program, which offers a summer camp themed workshop to build rural community capacity to long-term stressors such as droughts, population loss, climate change, and lack of affordable housing. While funding cycle ebbs and flows

People who use electricity-dependent durable medical equipment (DME) at home—such as ventilators and oxygen concentrators—can face life-threatening consequences during a power outage. HHS reports that 2.7 million Medicare beneficiaries rely on electricity-dependent DME to live independently. This ASTHOBrief details the significant challenges that individuals who rely on electricity-dependent DME face during power outages and discuss recent efforts to increase support for this population.

An issue brief by ASTHO and the Duke University Margolis Center for Health Policy that highlights considerations for state health officials as they look to maximize the benefits of COVID-19 therapeutics.

Six questions with Scott Becker, CEO of the Association of Public Health Laboratories. Becker is active in national and international public health initiatives. He chairs the Governance Working Group for the Global Laboratory Leadership Program, a collaboration with the World Health Organization, CDC, and others to develop a competency-based curriculum for laboratory leaders. Additionally, Becker is a member of the Affiliate Council of ASTHO, which he formerly chaired.

Pharmacies have long been instrumental partners in providing lifesaving vaccines nationwide. As state and territorial health officials evaluate their COVID-19 response, planners must include input from the pharmacy community when identifying areas for improvement, as well as best vaccination practices in advance of future public health emergencies.

Guest post by Jennifer Orme-Zavaleta, PhD. Last month, I had the pleasure of joining ASTHO’s Vice President for Health Security, Meredith Allen, EPA Administrator Michael Regan, and the president of the Environmental Council of States (ECOS) Patrick McDonnell at the ECOS Spring Meeting. The event marked the start of a strong state-federal relationship under the new EPA leadership, highlighted by the extension of a formal Memorandum of Agreement (MOA) reaffirming a partnership between our three organizations to advance cooperative initiatives in pursuit of environmental health.

Economic security and well-being, job stability, access to safe and affordable housing, access to healthy and nutritious foods, and access to resources to manage mental and physical health—all of these things impact individual, family, and community health. The COVID-19 pandemic has fundamentally impacted each of these social determinants of health for many Americans. Furthermore, some communities and industries have faced harder economic impacts than others, including households with low incomes, non-white households, and households with children. Human services and public health leaders can collaborate to make sure we are rebuilding systems and programs in a way that creates healthier, more resilient families and communities.

As COVID spread through the country and infection rates rose in every state, many of the the U.S. Affiliated Pacific Islands (USAPI) received media attention for remaining relatively COVID-free. The USAPI’s unified response in the face of a global pandemic is a history-making tale of collaboration, communication, and partnership. The successes of public health leaders provide important lessons for preventing, preparing for, and responding to future public health emergencies.

On Dec. 3, the International Day of People with Disabilities commemorates disability rights and brings awareness to essential issues for those with disabilities by promoting the “well-being of persons with disabilities in all spheres of society.” While the ADA laid a critical foundation for disability rights, the work to ensure equitable access to services and needs continues, including access to state and local emergency preparedness and response activities like crisis communication, access to resources, allocation of vaccine and other medical countermeasures, and transportation.

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!

In anticipation of the upcoming presidential election in November, the Republican and Democratic National Committees released their platforms. These platforms provide an overview of values, policies, positions, and principles on various domestic and foreign issues deemed most important to the two political parties. For the upcoming 2020 elections, delegates of the Republican National Committee approved a resolution that renewed support for the platform adopted in 2016 and the Democratic National Committee approved a 2020 platform. Although both platforms touch on a diverse list of issues, there are several that are of interest to health and public health.

Public health plays a vital role to ensure the safety of all attendees, prevent dangerous infectious disease outbreaks, and prepare for any potential threats. Learn about the work Guam did to prepare for the 2016 Festival of Pacific Arts.

Health agencies play a key role in preparing for and responding to hurricanes and other severe weather events.

As the United States begins to see more wildfires, it is important for health agencies to be ready to address concerns from the public and collaborate with other state agencies to mitigate the health risks of wildfire smoke.

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

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

Environmental health and public health preparedness staff work closely together to respond to natural disasters and climate change—learn how in this report.

How Mississippi Prioritizes Environmental Justice During Disaster Response Association of state and territorial health officials, astho, environmental health, environmental justice, public health, cross sector partnerships, emergency preparedness, natural disaster response, emergency response, health equity, social determinants of health, missisippi state department of health, office of environmental health, office of health equity, covid 19 pandemic, emergency planning and response Ali Aslam, Yaryna Onufrey, Beth Giambrone This case study dives into the Mississippi State Department of Health’s environmental justice initiatives, conducted using cross-sector partnerships. Environmental justice is defined as all people enjoying the same degree of access and protection from environmental and health hazards. This happens by intentionally involving all people—regardless of race, color, national origin, or income—while developing, implementing, and enforcing environmental laws and policies. The Mississippi State Department of Health incorporates environmental justice principles into their disaster response and emergency preparedness efforts. Mississippi's environmental justice work has been community-based and equity-driven. This case study dives into Mississippi’s cross-sector partnerships, community health initiatives, and health equity work as the state has worked to address environmental health concerns. Get the Report (PDF) website yes

This infographic breaks down the top 10 takeaways from the 2022 Climate and Health Capacity Survey.

During the COVID-19 pandemic, vaccine hesitancy has increased because of misinformation and disinformation spreading across social and traditional media platforms, targeting vulnerable and underserved communities, and further stalling vaccine uptake. ASTHO hosted representatives from faith- and community-based organizations, universities and colleges, healthcare systems, and other stakeholder groups to discuss the drivers of misinformation and disinformation during the COVID-19 pandemic, and how public health can move forward to address vaccine hesitancy.