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An ASTHO brief on the importance of understanding moral injury and burnout, with recommendations on areas of organizational focus.

Explore this report to learn about radiation readiness capacity in the public health workforce.

Implementing Health in All Policies in the Climate Space ASTHO, Association of State and Territorial Health Officials, HiAP lens, Health in all policies, climate change, climate space, flooding and rain, extreme weather, extreme heat, wildfire damage, seven strategies, Texas workgroup, national disaster operational workgroup, Washington state department of health, emergency preparedness and response, hiap implementation, Wisconsin department of health services, new mexico taskforce, interagency climate change taskforce, climate action teams, Climate and Health Capacity Survey, HiAP Task Force; Climate Change Commission, Resilience Initiative Kerry Wyss, Ali Aslam ASTHO | A Health in All Policies approach can help public health agencies better address the impact of climate change on population health and well-being. Each year, we face hurricanes, floods, extreme heat events, destructive wildfires, as well as other natural disasters and homeland security threats that test the resiliency of state, territorial, and freely associated state agencies and the communities they serve. To address the health threats posed by natural disasters and by climate change, more health agencies are integrating a Health in All Policies (HiAP) approach. This cross-sector approach can make these climate efforts more effective and impactful, and help promote health equity and optimal health. This report outlines strategies for health agencies to apply the HiAP lens and utilize cross-sector collaboration to optimize their climate and health responses. Get the Report (PDF) website yes

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

Initial estimates from 2020 suggest that annual drug overdose deaths in the United States reached a record high of 93,000. Fortunately EMS strategies are being put in place to combat this nation-wide issue.

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.

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!

Strengthening Leadership, Risk Communications, and Preparedness in the Islands Strengthening Public Health Preparedness in the Islands Sidnie Christian, Alyssa Boyea Key strategies in on leadership, risk communications, and preparedness, can help island jurisdictions prepare for and respond to emerging public health threats. ASTHO convened a two-day, in-person workshop in Honolulu from June 25 – 26, bringing together public health preparedness staff from American Samoa, the Commonwealth of the Northern Mariana Islands, the Federated States of Micronesia, Guam, Hawaiʻi, the Republic of the Marshall Islands (RMI), and Palau, as well as federal partners from CDC, the Department of Homeland Security, and the Administration for Strategic Preparedness and Response. The workshop focused on leadership and workforce development, risk communications, administrative preparedness, and more to support island areas as they prepare for and respond to natural disasters and other emerging public health threats, of which emerged key learnings that can benefit all island jurisdictions. Leadership and Workforce Development Leading through change requires transparency, trust, and collaboration. Planned change involves assessing readiness for change, identifying resources needed, securing buy-in, and determining a path forward. However, sometimes change can leave little to no time for preparation. Island jurisdictions have encountered challenges in the face of change, with many workshop participants sharing firsthand challenges around retaining institutional knowledge, infrastructure, and receiving assistance from the mainland United States in a timely fashion. As such, change readiness, succession planning, and effective change management practices are of utmost importance in the islands. Key recommendations and takeaways include: Utilizing a reputable framework, such as Kotter 8-Step Change Model, is pivotal for improving change readiness and change management. Change management frameworks and methods can assist with different types of change including structural change, strategic operational change, people-centric change, etc. Trust is hard to build, but easy to lose. Participants spoke about characteristics of high trust relationships including open communication, consistency, good judgement or expertise, and cultural sensitivity, while low trust relationships characteristics include lack of communication, inconsistency, and lack of teamwork. Succession planning is important to ensure institutional knowledge and capabilities remain in the wake of staff turnover or retirement. Identifying the necessary expertise, skills, and capabilities for each role is vital in the case of unplanned changes in staffing. Promising practices include annual review of critical positions, conducting talent calibration sessions, defining action plans, and obtaining buy-in from leadership and relevant partners. Risk Communications The island jurisdictions face emergencies that require creative response efforts. Both Hawaiʻi and RMI demonstrated innovative approaches in risk communications during COVID-19, finding success in forming critical partnerships, utilizing trusted voices within the community, and bridging communication gaps: Hawaiʻi utilized social media to showcase individuals such as doctors, pastors, social media influencers, and even local sports teams getting vaccinated, and utilized trusted voices to deliver messages. Additionally, they translated their materials into three languages (Marshallese, Samoan, and Hawaiʻian), modeling that no one gets forgotten, the true meaning of “ohana.” RMI created a working group with a mix of partners that curated press releases, educational materials, and sitreps, and served as a liaison between RMI Ministry of Health and Human Services and the community. It also partnered with several media outlets (e.g., radio stations, local papers, and other private sectors) and utilized mass text messaging to spread information quickly. The latter proved to resonate with most island jurisdictions who struggle with staying connected to hard-to-reach populations, namely those in more rural and disconnected communities. RMI was able to connect with these populations through WhatsApp to keep them updated throughout the COVID-19 response. Administrative Preparedness Improving administrative preparedness plans and processes ensure timely and efficient access to needed resources for a public health response. Most workshop participants are currently in the process of updating existing administrative preparedness plans, while some are working with other departments to create and implement new plans. Attendees discussed key partnerships for collaboration including other departments, Medical Reserve Corps, and other volunteer organizations. One common key challenge that emerged was around staffing (e.g., finding qualified people to fill vacancies, hiring process issues, making sure positions are competitive, etc.). To address this issue, island jurisdictions can work closely with other departments or jurisdictional agencies to streamline current processes, establish memorandums of understanding with different partners/facilities to assist with emergency procurement, and ensuring staffing vacancies are competitive and match public health classifications. Disease Forecasting A survey on state and territorial expertise and needs for infectious disease forecasts, models, and other outbreak analytic techniques—implemented by ASTHO with support from CDC’s Center for Forecasting and Outbreak Analytics—revealed that respondents from island jurisdictions experienced several barriers that led to limited use of infectious disease forecasts to inform communication and decision making. Challenges noted include limited software access, limited disease modeling capacity or skills, and lack of uniform reporting systems. Through a discussion-based exercise, workshop participants shared their challenges and considerations for ASTHO and CDC to assist with disease forecasting in the island jurisdictions moving forward. Challenges include but are not limited to: Delays with sending samples to labs and receiving results in a timely manner. Without timely results, it is challenging to take swift action. Lack of staff / staff wearing many hats with limited capacity. In most cases, there is no specific communication plan for disease forecasting within the departments. Communication can be challenging without clear processes and channels. Participants noted the desire for additional disease forecasting training and opportunities for collaboration. They suggested an integrated training session with island epidemiologists and other relevant staff to enhance disease forecasting knowledge and communication, as well as strengthen collaboration. Preparing for and Responding to Climate Events From hurricanes to typhoons to volcanic eruptions, the island jurisdictions are no strangers to the effects of changing climate. Willliam “Brandon” Aydlett, science and operations officer at the National Weather Service, and Shelbi Davis, Senior Analyst on the Environmental Health team at ASTHO, offer the following recommendations to island jurisdictions for preparing and responding to unprecedented climate events, as discussed with workshop participants: Create or update standard operating procedures for various climate related responses unique to the island. Always prepare for a category higher storm than is expected. Consider conducting regular vulnerability assessments to better understand areas where the island or its people may be most susceptible to adverse health impacts from climate events. Jurisdictions can learn from one another and find a sense of camaraderie in their preparedness efforts, much like the workshop participants. For example, one island jurisdiction noted that they currently do not have a warehouse to store equipment but are working on a plan to secure one; another jurisdiction, having recently revamped their warehouse, noted that they could assist their island neighbor in this endeavor and provide lessons learned as well as strategies to help secure a warehouse that will fit their needs. Looking Toward the Future Sharing lessons learned with one another and reflecting on how to apply those learnings in respective communities is crucial. Workshop participants shared their intent to share and utilize resources and information shared throughout the workshop with their leadership and team to begin implementing in their jurisdictions, as well as using strategies and skills learned to enhance partnerships. To all the participants and our Hawaiʻian hosts, we say mahalo. Related Resources Modernizing Infrastructure and Facilities for Readiness and Response | ASTHO PH-HERO Workforce Resource Center | ASTHO ASTHO STAR Center | ASTHO Evidence-Based Strategies to Enhance Public Health Emergency Preparedness and Response | JPHMP article yes

Read a detailed summary of the FY26 Senate Appropriations Bill, which was released on July 31.

Workforce Trends in Public Health Preparedness Workforce Trends in Public Health Preparedness Kelsey Tillema, Adrianna Evans Learn about ongoing changes to the public health preparedness workforce and how to best support these workers. Public health preparedness professionals fulfill critical functions in the event of a public health emergency, such as coordinating emergency response planning, managing incident command structures, and ensuring readiness for a multitude of threats. This essential group of workers faces significant strain, especially after the COVID-19 pandemic, which accelerated major workforce changes within public health. The prolonged emergency response intensified staff burnout and increased turnover, prompting many professionals to retire or even leave the field. New data shows the public health preparedness workforce specifically is less tenured and navigating unique challenges when it comes to shifts in funding and policy priorities. When it comes to who’s behind the scenes of preparedness and response, it’s crucial to consider how to maintain an engaged workforce capable of scaling, coordinating, and sustaining response operations under pressure. The Workforce Landscape According to the 2024 Public Health Workforce Interests and Needs Survey, the preparedness workforce makes up roughly 13% of the state and local public health workforce. Of these approximately 30,000 workers, nearly a quarter (23%) are age 35 or younger, and another quarter (28%) are 55 and older. Although this is not unique to the preparedness workforce, this reflects an aging workforce as experienced staff approach retirement and new professionals enter the field. Further, about half of preparedness health agency staff (49%) have been with their agency for less than five years. Considering this transition, health agencies may face the loss of institutional knowledge related to emergency operations, incident command structures, and preparedness and response protocols. As experienced professionals exit the workforce, this may also create gaps in mentorship, leadership, and overall response experience. However, like the rest of the public health workforce, most preparedness staff (73%) show commitment to staying with their organizations for at least the next year. Preparedness staff cited benefits, job stability, and supportive coworkers as their main reasons for staying. On the other hand, the top reasons for leaving are pay, organizational culture/climate, and lack of opportunities for advancement. To gain insight into gaps within the workforce’s expertise, preparedness leaders may want to consider partnering with their agency’s internal workforce development team to conduct a workforce assessment within their program. Regularly assessing a preparedness team’s skillset and needs can give greater clarity on how to best support team development and growth. Agency leadership can create cohesion between tenured and new professionals by offering or supporting both formal and informal mentorship, and establishing avenues to create familiarity with response systems, interagency coordination, and real-world experience. Newer professionals may bring fresh perspectives and diverse skillsets to the workforce but need support from tenured staff to become well-versed in the preparedness sector. At this juncture, succession planning and supporting career advancement pathways are essential components to building up the next generation of leaders in public health preparedness. Knowledge Transfer and New Skills Whether responding to pandemics, natural disasters, or radiological events, working in preparedness requires strategic and cross-disciplinary capabilities that go beyond traditional emergency response. During a public health emergency, staff must rapidly activate response plans, coordinate across agencies, and make high-stakes decisions. Since evidence shows that many workers are new to the field, it’s crucial to ensure that staff are continuously learning internal systems and building preparedness-specific skills. Both new and rising preparedness staff members need a variety of skills to make informed decisions and grow within their organizations. Areas such as administrative preparedness, navigation of policy and legislative processes, and leadership development are all key to creating a cohesive internal workforce system. Leadership skills are crucial for preparedness staff, who must coordinate across agencies, communicate crisis and risk information to a variety of audiences, and operate within the Incident Command System. Other important and emerging topical considerations for skill expansion include data analytics, artificial intelligence, cybersecurity, multimedia risk communication, and specialized areas of preparedness (e.g., accessibility, radiation readiness, climate and animal health), to name a few. While some of this knowledge can be passed on through mentorship or job experience, staff should also have access to structured, high-quality learning opportunities. Continuing education courses, certificate programs, and tuition reimbursement can all support staff development. Policy and Funding Considerations Internal workforce policies have significant influence on an agency’s workforce retention, morale, and skill building. Beyond salary, policies related to flexible working arrangements, paid training time, career advancement opportunities, and recognition and well-being programs all contribute to how supported staff feel in their roles. Agency leadership can also assess their broader levels of policy, such as student loan repayment and tuition assistance, to make preparedness careers more competitive and accessible. Externally, public health preparedness programs rely heavily on federal funding streams such as the Public Health Emergency Preparedness cooperative agreement and the Hospital Preparedness Program. As a result, preparedness hiring and turnover cycles can be influenced by grant timelines. As federal priorities shift, this uncertainty can make it challenging for agencies to sustain long-term workforce investments and main continuity of operations. Many agencies are exploring ways to adapt, using strategies to braid and layer funding streams to stabilize staff, while others use supplemental funds such as the Public Health Infrastructure Grant to invest in foundational capabilities and workforce development beyond just preparedness activities. Preparing for the Future Agencies have an opportunity to address the primary drivers of attrition and strengthen the preparedness workforce. Expanding workforce development opportunities internally and externally will help to maintain institutional knowledge and prepare the workforce for evolving modern day threats. While the future of public health preparedness does rely on funding and policy, it also relies on skilled, committed workers. As the workforce landscape continues to evolve, investing in the development, retention, and lifting up of a generation of new leaders will determine how effectively we respond to future crises. Learn more about strategies and resources to support the public health preparedness workforce from ASTHO’s Inspire Readiness Workforce page and the ASTHO Workforce Resource Center. ASTHO will continue to share promising practices to support preparedness staff. Reviewed by - Allen, Peterson article yes

In addition to the countless hours worked during the COVID-19 pandemic, many public health workers are also grappling with how to repay outstanding federal loans. In response, the U.S. Department of Education (DOE) recently announced temporary relief to current and future Public Service Loan Forgiveness (PSLF) program participants as a result of the COVID-19 pandemic.

Public Health Organizations Unite in Call to Restore State and Local Emergency Funding and Approve Emergency Supplemental for Zika ARLINGTON, VA—As the weather warms and the threat of Zika virus intensifies, state and local health agencies are faced with the dilemma of a significant funding cut, as documented in two new reports released by the Association of State and Territorial Health Officials (ASTHO), the National Association of County and City Health Officials (NACCHO), the Association of Public Health Laboratories (APHL), and the Council of State and Territorial Epidemiologists (CSTE). Absent dedicated funding from Congress to prepare and respond to the threat of Zika virus, the Centers for Disease Control and Prevention (CDC) last month announced it will need to reprogram $44.25 million from the Public Health Emergency Preparedness (PHEP) fund to help combat Zika. State and local health agencies depend on PHEP funding to prepare and respond to health emergencies, everything from natural disasters to terrorist or mass casualty events. Preparing for and responding to emerging infectious disease is also a primary use of PHEP funding, meaning state and local health agencies will have less capability to find, control, and mitigate localized outbreaks of Zika as a result of the reallocation. ASTHO, in cooperation with CSTE, APHL, and NACCHO, asked their members what the consequences of the PHEP reprogramming would be, should the cuts take effect on July 1. The results raise significant concern showing that state and local emergency response will be compromised. Major findings from the surveys include the following. Community Preparedness Will Suffer the Most Both state (77%) and local (75%) respondents listed “Community Preparedness” as the area that will be most negatively affected. Scenario planning and training exercises will be curtailed or eliminated. Volunteer recruitment and training will slow or cease. Community partnerships and contracts with specialized vendors will be compromised. Laboratory Testing and Surveillance Capacity Will Diminish More than 70 percent (72%) of state respondents said they expect that functional preparedness programs, including disease surveillance, epidemiology, lab services, and mosquito control, would be negatively affected. Labs would be forced to delay or eliminate new equipment purchases or scheduled equipment maintenance. Public Health Staff Cuts State and local agencies suffered significant job losses—up to 20 percent—during and after the Great Recession that started in late 2007, and they have not come close to adding that number back since. Both state and local survey respondents report likely staffing cuts as a result of the PHEP reprogramming. Almost two-thirds (64%) of local health agencies responding to the survey said they expect to lose at least one health preparedness staff person. There is significant fear that this could worsen significantly if the reprogramming continues in future years as the threat of Zika is not expected to abate in the short term. Zika Response at State and Local Level Will Be Compromised as a Result of the Reallocation State and local health agency leaders are unified in saying the reduction of PHEP funding will harm their ability to respond to and control Zika once it establishes itself in the U.S. Our capacity to identify localized outbreaks and our capability to control and eliminate virus transmission will be slower. Local agency responders cited the following concerns: A decrease in staffing, Medical Reserve Corps (MRC) unit, or volunteer sustainability. A reduction in opportunities to provide staff trainings as well as plan and conduct exercises. An inability to conduct surveillance or epidemiologic investigations. At the state level, 61 percent of respondents say decreased PHEP funding in their state will significantly harm their ability to prepare for and respond to Zika. One respondent wrote: “The PHEP funding in [our state] is the resource we have for providing a response to Zika, and any other novel communicable disease. By reducing this funding you are reducing our ability to respond to a Zika event in [our state].” All public health sectors—federal, state, and local—have worked hard to build and sustain an all-hazards preparedness infrastructure that can deliver on their mission to protect and enhance the health and well-being of their constituents. However, large-scale emergencies, such as the 2009 influenza pandemic, Ebola, and Zika, require sufficient and reliable core funding to maintain a solid and ready public health infrastructure and additional emergency funds to provide the enhanced protections and services those living in the United States deserve and expect. Robbing the fund that sustains the all-hazards infrastructure to pay for large, widespread emergencies, no matter how necessary, ensures that infrastructure will deteriorate. Dedicated emergency funding that will enable all public health sectors to prepare for and respond to Zika is essential. ASTHO Press Release Boilerplate NACCHO Boilerplate APHL Boilerplate CSTE Boilerplate website yes

The experts on today’s episode make the case for how a robust public health workforce could have changed the trajectory of the pandemic response, but also explain why we can reimagine what a strong public health workforce requires as we enter into pandemic recovery.

An ASTHO report describing the mental health impacts of COVID-19 on the workforce.

In May 2021, President Biden released full details of the fiscal year 2022 budget. Overall, the budget request combines President Biden's American Jobs Plan, his American Families Plan, and funding priorities for the Pentagon and domestic agencies, for a projected total of $6 trillion. Read more about what the president is proposing in this post.

One of tools presidents have to implement and drive their strategy are executive actions. Executive orders and presidential memoranda carry the force of law and allow presidents to move quickly, deliver a clear message, organize the functioning of the executive branch, and spotlight critical issues with declarations of commemorative observances.

Explore INSPIRE: Readiness by ASTHO—an innovative hub for public health preparedness. Share strategies, tools, and solutions to boost readiness.

How Washington State Leverages Data to Improve Emergency Preparedness Erin Laird Learn how Washington State has created a robust system for distributing public health and medical supplies during emergencies. When an emergency strikes, supplies like personal protective equipment (PPE) need to be deployed rapidly and strategically. Local, state, and federal partners must work together to identify and meet community needs—a process that requires timely access to actionable data about medical countermeasures and other vital public health supplies. State health agencies need to know how many public health supplies are on hand so they can make informed decisions and react to developing situations. In March 2024, ASTHO, with support from the Administration for Strategic Preparedness and Response (ASPR) and HHS Coordination Operations and Response Element, selected three state health agencies—Ohio, Massachusetts, and Washington—to identify and pilot scalable solutions to improve data and information sharing for public health response. ASTHO conducted a site visit to the Washington State Department of Health (WA DOH) in June 2024 to learn about their medical logistics center and observe the first in a series of regional tabletop exercises—Highly Efficient Local Logistics Operations Tabletop Exercise (HELLO TTX)—they conducted to better understand logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures and tracking last mile distribution. Medical Logistics in Washington State: Moving Faster to Save Lives Key Term - Blog - How WA Leverages Data to Improve Preparedness The Washington State Medical Logistics Center plays a pivotal role in emergency response, supporting WA DOH’s ability to quickly distribute vital supplies and medical countermeasures before and during major incidents. Through the COVID-19 response, the WA DOH medical logistics effort expanded to include vehicles, systems, and a 198,000 sq. ft., temperature-controlled warehouse. This effort ultimately supported WA DOH’s ability to distribute over 150 million gloves, 66 million surgical masks, 30 million N95 respirators, and other vital supplies throughout the COVID-19 emergency response. This increased logistical capacity has allowed WA DOH to respond to many other events. In 2023, in response to wildfire smoke, WA DOH distributed 850 air cleaners across the state in just two days to support points of dispensing (PODs) in tribal communities. The Yakima Fire Department experienced an opioid overdose outbreak in September 2023 and WA DOH coordinated statewide to identify supply of naloxone and support mutual aid. Finally, in May 2024, WA DOH distributed 96 portable air cleaners and pallets of N95 respirators to the Benton Franklin Health District to support POD operations for communities with air quality impacted by the Lineage Cold-Storage Fire. Receiving, storing, and distributing medical countermeasures and other supplies requires strong data management systems and practices. WA DOH strives for a collaborative approach to enhance data management for logistics. By facilitating bidirectional data sharing among health care, emergency management, public health, and tribal partners, WA DOH aims to enhance its ability to track assets and “last mile” logistics. To this end, WA DOH conducted a series of in-person tabletop exercises (TTXs) with each region of the state. These TTX discussions focused on the logistical considerations of requesting, receiving, and distributing PPE and medical countermeasures using a scenario of a novel influenza outbreak. Leveraging TTX Discussions to Understand Local Logistics Washington Department of Health staff gathered for a tabletop exercise with ASTHO staff. The tabletop discussions were organized into two modules: Medical Logistics Requesting, and Medical Countermeasures Planning and Last-Mile Distribution. The tabletop discussions focused on understanding how local jurisdictions source, receive, and distribute supplies. Cory Portner, director of WA DOH’s Office of Emergency Medical Logistics, praised the discussions: “The HELLO-TTX series highlighted the power of collaboration and gave us actionable insights into refining our response strategies and logistics operations. Effective communication across agencies is key. As always, at the end of the day it comes down to relationships and knowing who to call.” Many jurisdictions indicated they do not have the space or staff to manage more than a small stockpile of supplies. Once requested from the state, local jurisdictions coordinate with local partners—such as libraries, foodbanks, fire departments, and immigrant assistance centers—to get materials distributed to the community, often using either PODs or using trusted partners to distribute to the population they serve. Space came up as an issue repeatedly, with some jurisdictions utilizing creative solutions such as leveraging storage available at fairgrounds, a county-owned airport, and even an old jail (a solution that raised some unique challenges for receiving). Last mile tracking depended on the type of asset. For example, tracking for PPE typically ended at the community partner level (the agency or site that received the supplies), while tracking for vaccines could show more data on number of vaccines administered by a provider. The focus of last mile tracking for local jurisdictions centered around using last mile information to ensure that the requestors received what was needed. Looking ahead, additional last mile tracking could shed light on equity and a better sense of whether community needs were met, rather than just whether orders were filled. Portner reflected, “HELLO TTX showcased that local partnerships vary widely: larger urban areas typically focus on health care and emergency management organizations, while smaller rural areas engage a broader range of local sectors like fire departments and veterinary services. Medical logistics operations also differ, with urban areas having greater storage capacity and more advanced data tracking, while rural areas face limitations in both. Additionally, local prioritization of PPE and medical countermeasures affects how each area tracks logistics and manages storage.” Looking Ahead This 198,000 sq. ft., temperature-controlled warehouse serves as the Medical Logistics Center for WADOH, housing PPE, medical countermeasures, and other supplies. Effective public health response requires an understanding of what supplies are needed, where they are needed, and to track whether those needs were met. To achieve this, coordination and communication across multiple levels of public health is critical. "Next up, we’re focusing on asset tagging and improving supply chain visibility through enhanced data readiness. Our goal is to create a more transparent and responsive logistics system, to make sure that we’re fully prepared for any future emergencies in support of communities in Washington state and beyond,” explained Portner. The strategies explored by these data readiness pilot sites can improve critical processes and demonstrate sustainable methods to meet the demand of bidirectional information sharing for public health agencies and their partners. article yes

Leading Health Security Efforts Through Strategic Collaboration and Innovation Margaret Nilz This blog post illustrates how health agencies' strategic plans can improve health security and emergency preparedness. Strategic planning is a cornerstone of effective public health systems, guiding organizations in preparing for and responding to health threats. Three pivotal documents—the CDC Office of Readiness and Response (ORR) Strategic Plan, the ASTHO Strategic Plan, and the ASTHO Environmental Scan—are part of the foundation of ASTHO’s work. Each plays a critical role in shaping public health policies and practices. Understanding their synergies and differences is beneficial and crucial for enhancing our collective efforts in safeguarding public health. ASTHO’s Environmental Scan tracks U.S. public health concerns and trends. Through qualitative analyses of select health agency materials and health official feedback, this blog identifies state, territorial, and freely associated state health agencies’ (S/THAs) top current and emerging priorities across public health programs, infrastructure, and health equity and agency strategies to address them. Across 2023 and 2024, S/THAs consistently identified emergency preparedness and response as a critical priority. Callout 1-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation It is essential to align strategic plans and address emerging public health priorities in order to effectively respond to new health challenges. The ORR and ASTHO Strategic Plans share several common goals, such as implementing equitable, evidence-based practices, partnering for sustainable infrastructure improvements, and focusing on operational excellence while providing technical assistance. However, each plan also has unique missions. Callout 2-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation ASTHO’s Health Security team has a unit mission and vision that align with ORR goals and focus on supporting the needs of ASTHO members, as identified in the Environmental Scan. Callout 3-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation Aligning these strategic goals with current public health priorities is crucial in addressing existing and emerging health threats. Values The ORR and ASTHO plans express shared values like collaboration and innovation. These values guide strategic decisions and foster a cohesive public health community. Table-Blog - Leading Health Security Efforts through Strategic Collaboration and Innovation Competencies and Priorities Both organizations focus on developing competencies like leadership and technical expertise. ORR concentrates heavily on competencies specific to preparedness, including planning, response, and research for public health emergencies. ASTHO emphasizes competencies to support S/THAs, such as technical assistance, communication, capacity building, and advocacy. Building and aligning these competencies is essential for improving public health outcomes and ensuring workforce preparedness. With that in mind, ASTHO’s competencies are specifically aimed at aiding and supporting its members, and consequently the nation, in achieving the ORR competencies. Environmental Scan Observations The ASTHO Environmental Scan thoroughly evaluates current public health trends, challenges, and opportunities. Key highlights from the 2023 and 2024 Environmental Scans include: Focus on emerging threats such as infectious diseases and the impact of climate change. Changes in public health funding and resource availability. Technological advancements and their implications for public health practice. Common trends identified include a heightened focus on health equity, the importance of data-driven decision-making, and the need for increased interagency collaboration. Organizational competencies, including performance management and quality improvement, were listed as current priority areas for public health infrastructure and capacity-building. Focus issues include financial infrastructure, business processes, including procurement, recruitment, and grants management, policy development, and public health governance structures. Workforce development was listed as a priority for public health infrastructure and capacity building. Focus issues include recruitment and retention, local academic pipelines and training opportunities, staff compensation, and staff salary gaps. Data modernization and informatics are priority areas in states with state health improvement and strategic plans and were listed as current public health infrastructure and capacity-building priorities. Accountability, performance management, and quality improvement are priority areas in states with state health improvement and strategic plans and were listed as current public health infrastructure and capacity-building priorities. Implementation While ORR and ASTHO aim to achieve similar overarching goals of supporting health agencies, their implementation strategies vary. The ORR Strategic Plan focuses on four primary strategies that directly address the emerging threats and challenges highlighted by S/THAs, including: Modernizing and integrating data and systems across multidisciplinary public health entities to support data readiness and interoperability. Advancing readiness and response science to improve public health practice, including maturing and implementing evidence-based research in preparedness. Building and enhancing the response capability of CDC and state, tribal, local, and territorial health departments and driving collaboration among partners to enable rapid and effective response to public health emergencies through improved capabilities, partnerships, and funding mechanisms. Conducting rapid and ongoing readiness and response evaluation to inform continuous improvements across the detection of public health threats, readiness science, and emergency operations. While ASTHO’s Strategic Plan is less explicitly focused on preparedness, its guiding mission in supporting, equipping, and advocating for S/THOs and their agencies with a focus on leadership development highlights several strategic priorities critical to improving public health preparedness and addressing emerging priorities. Health and Racial Equity: A state and territorial public health system that prioritizes implementing policies and programs advancing health and racial equity to achieve optimal health for all. Workforce Development: A diverse state and territorial public health workforce that is engaged, well-resourced, well-trained, and connected to the communities it serves. Data Modernization and Interoperability: A state and territorial public health system supported by an enterprise-level data infrastructure in which public health data systems are interoperable, secure, and supported by a well-trained workforce. Collaborative Opportunities Maximizing the impact of these strategic plans involves leveraging the strengths of each organization through collaboration and innovation. There are numerous areas where ORR and ASTHO can collaborate to enhance public health outcomes: Joint programs leveraging CDC’s national scope and ASTHO’s state-level connections. Shared research initiatives pooling resources and expertise from both organizations. Coordinated emergency response efforts that create a unified front addressing public health emergencies. By continuing to communicate, these organizations can effectively address complex public health challenges and enhance overall public health resilience. Future Outlook Looking ahead, the strategic efforts of ORR and ASTHO will play a crucial role in shaping the future of public health infrastructure and preparedness. Engaging with and supporting these initiatives is essential for all stakeholders. To adapt to the changing health security threats, future iterations of all documents must be routinely updated to meet the needs of the nation and ASTHO’s members. A collective effort is required to improve public health resilience and response capabilities, ensuring we are well-prepared for future challenges. Ultimately, the synergy between ORR and ASTHO’s strategic plans presents a powerful opportunity to enhance public health outcomes. We can create a more resilient and effective public health system by fostering collaboration, building competencies, and addressing emerging trends and challenges. website yes