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This report analyzes the results from a survey of state and territorial health agency staff to collect information regarding health agency efforts to address climate change and extreme weather.

Wildfire and Wildfire Smoke Guidance and Resources ASTHO and various public health agencies list of wildfire resources and guidance. Following the 2023 wildfire smoke events that impacted several states in the Midwest, Northeast, and Mid-Atlantic, as well as the devastating wildfires that impacted Hawaii, ASTHO developed a document that included a list of federal, state, and partner organization resources on wildfire smoke information and how to message that information to the public to support public health officials, clinicians, schools, and communities. These include air quality data, health guidance, masking and ventilation tips, and communication tools to protect specific groups, pets, and outdoor workers. Get the Resource (PDF) article yes

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.

Communicating the Health Risks of Wildland Fire Smoke Communicating the Health Risks of Wildland Fire Smoke Kerry Wyss, Ali Aslam Learn how state agencies effectively communicate the dangers of wildfire smoke to local communities in this report. Wildfires continue to be a growing risk across large swathes of North America, one of the largest effects of these fires being severe smoke. Smoke from wildland fires — wildfire and prescribed burns — can pose serious health risks to communities, particularly for sensitive or vulnerable populations such as children, older adults, and those with respiratory or cardiovascular conditions. Wildfire smoke can spread rapidly over long distances, so timely and accurate risk communication is essential during wildfire events to help communities understand the dangers of smoke exposure and take protective actions. ASTHO hosted a wildland fire focus group in January 2025 to talk through lessons learned by state and territorial health and environmental agencies in managing wildland fire response. The group identified needs to improve community health in wildland fire response through health risk communication, disseminating information, and developing programs to support public health action (i.e., exposure reduction). Learn more about these takeaways and actionable strategies for wildland fire response in the full report. Get the Report (PDF) article yes

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

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

This report provides critical insight into the top environmental health and natural disaster preparedness concerns across the nation.

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

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

Learn how health agencies are prioritizing children’s health as they develop public health emergency preparedness planning in this blog.

This post features input from departments in North Carolina, South Carolina, and Texas to learn more about their experiences of post-hurricane environmental health issues, as well as advice and best practices for responding to these challenges.

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

States are preparing to keep their communities safe during severe storms and low temperatures this winter.

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

While communities transition from emergency response to long-term monitoring and recovery, the federal government and states are taking legislative action to improve emergency preparedness capabilities.

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.

Following a hurricane, the risk of exposure to infectious disease increases due, in part, to the presence of floodwater and debris. Hurricanes may contribute to population displacement and overcrowding—further heightening risk factors for respiratory diseases—as well as cause damage to healthcare facilities. In this post, see how jurisdictions respond to the biggest post-hurricane threats, from water-borne diseases to severe disruptions in the healthcare system.

While COVID-19 is still present and ever-changing, public health professionals must also grapple with new challenges such as monkeypox, increasing firearm homicide, and widespread heat waves. In the wake of such emergencies, public health preparedness is more critical than ever.

Building Up Health Agency Staff for Hurricane Response in Florida Building Up Health Agency Staff for Hurricane Response in Florida Emma Talkington, Nick Porter Discover how Florida bolstered health agency staff to respond to environmental health threats with ASTHO assistance. Hurricane preparedness, response, and recovery work continues to be a top priority for state and territorial health departments. Damaging winds, historic storm surge, and intense rainfall pose severe risks to those caught in the path of these formidable storms, and the impacts can be felt for far longer than the immediate hazards. In 2022, Hurricanes Ian, Fiona, and Nicole made landfall in the United States, causing dozens of deaths and billions of dollars in damage. Hurricane Ian alone caused 66 direct and 90 indirect deaths. In late 2023, and again in late 2024, CDC awarded funding from the FY23 Omnibus Disaster Supplemental to ASTHO to assist Florida in building capacity to recover from the environmental health impacts brought on by Hurricane Ian and to better respond to future hurricanes. ASTHO worked closely with CDC’s National Center for Environmental Health/Agency for Toxic Substances and Disease Registry (NCEH/ATSDR) Office of the Director and the Florida Department of Health (FDOH) to implement capacity building projects to bolster environmental health preparedness, response, and recovery capabilities identified as gaps following Hurricane Ian. Identifying Gaps and Needs from Hurricane Ian FDOH has a small environmental health preparedness team in their central Tallahassee office managing a large workload and a high demand for training, guidance, and resources from their county health departments. Using support provided by ASTHO and NCEH/ATSDR, FDOH focused on enhancing its environmental health preparedness, response, and recovery capacity through a combination of planning, resource development, and training efforts. These activities directly addressed needs identified by FDOH during scoping discussions with ASTHO and NCEH/ATSDR, as well as findings from after-action reports following Hurricane Ian. Utilizing Temporary Staff to Help Build Capacity The primary focus for FDOH’s first year of this project was on working with three temporary staff to focus on a gap and inventory analysis of FDOH’s Environmental Public Health Preparedness Unit’s policies, protocols, and resources. Additional work included updating existing environmental health materials and developing new materials — including standard operating procedures, emergency response checklists, and outreach education documents on environmental health risks. One major deliverable produced from these efforts was an updated internal all-hazards water preparedness document. In the second year of the project, two of the temporary staff from the first year left for other opportunities. The remaining temporary staff member stayed onboard and continued to support FDOH by assisting with the development and organization of resources and the refinement of internal emergency preparedness processes, strengthening FDOH’s readiness for future emergency response and statewide support. Developing Staff Mental Health During Response Trainings When discussing training needs, FDOH identified staff mental health and burnout during disaster response as areas ripe for capacity building support — FDOH also noted these areas in their after-action report for Hurricane Ian. FDOH wanted to better understand evidence-based strategies that supervisors and first responders could implement to address these issues during hurricane response. ASTHO identified a training contractor who provides mental health training that can be adapted to best fit the needs of the trainees. FDOH incorporated two in-person trainings — one for county environmental public health directors and one for agency staff in direct response roles — into their Florida Environmental Health Association conference in June 2025. Additionally, FDOH held two virtual trainings for Florida-based state and county health department staff, one of which focused on compassion fatigue while the other focused on crisis communication. The same contractor helped develop and provide six additional virtual trainings in spring of 2026. These trainings focused on both didactic training modules and practice-based case studies modeled on realistic response scenarios. Specific topics included preparedness leadership and strategic readiness, response leadership and operational execution, and recovery and mitigation leadership and system improvement. Developing an Advanced Strike Team Response Training When discussing needs for the final year of the project, FDOH expressed interest in developing and implementing an advanced strike team response training for health agency staff to prepare potential environmental public health strike team members who had not been part of previous hurricane responses and bolster the knowledge of those who had. FDOH reviewed existing training resources, such as FEMA's Center for Domestic Preparedness’ Environmental Health Training in Emergency Response (EHTER) Operations course, to identify specific skills, resources, and topics most relevant to Florida’s response priorities and began developing a training curriculum focused on said priorities. FDOH utilized lessons learned from the EHTER Operations course to develop a shorter advanced strike team training for Florida-based environmental public health strike team members. The inaugural in-person delivery of this training occurred in May 2026. ASTHO’s primary support in developing this training included identifying and hiring a temporary contractor with expertise in the EHTER Operations curriculum development to review the materials FDOH developed and provide constructive feedback. ASTHO also procured key supplies for the advanced strike team training, as well as additional supplies that could be used during future hurricane response efforts for both the FDOH central office in Tallahassee and county health departments across the state. Utilizing Technical Expertise to Provide Guidance on Mold Questions Finally, the temporary contractor brought on to review the strike team training resources provided additional technical assistance to FDOH’s newly hired mold subject matter expert, which included the development of several resources intended to help clarify mold-related questions from county health departments, other state agencies, and the general public. Conclusion The support provided to FDOH from ASTHO and NCEH/ATSDR, along with a great deal of assistance from the Environmental Public Health Preparedness Coordination staff, helped build operational capacity through the temporary staff hires, train staff across the state on topics such as mental health and well-being and key preparedness and response principles, and procure needed supplies for future hurricane response efforts. Acknowledgements Thank you to the staff within FDOH that worked tirelessly to implement this project, including the temporary staff. Thank you also to CDC’s NCEH/ATSDR staff who oversaw this project. Without their support, none of this work would have been possible. Hurricane Response Recovery - FL, PR article yes

Hurricane Response and Recovery Hurricane Response and Recovery This resource hub highlights ASTHO's support for states and territories recovering from the environmental health impacts of Hurricanes Ian and Fiona. article no