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The ASTHO Profile is the only comprehensive source of information on state and territorial public health agency activities, structures, and financial and workforce resources.

Two reports explore opportunities for improved public health action through immunization data sharing with health information exchanges, in addition to the broader legal landscape of public health data.

The Suicide, Overdose, Adverse Childhood Experiences Prevention Capacity Assessment Tool (SPACECAT) compiled a national report and accompanying infographic, that break down the biggest findings from the data, and highlight the biggest barriers facing health agencies today.

This brief details innovative uses of geographic information systems (GIS) in public health. It showcases original research conducted by ASTHO staff to better understand the value of GIS in mapping national public health emergencies

Preventive Health and Health Services Block Grant Stories article False

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.

The adage “what gets measured, gets done” has had staying power for a reason. When we can accurately describe conditions, quantify impact, and elucidate connections, we have a better chance at taking collective (and effective) action to tackle even the most challenging problems facing our communities. The National Survey of Children’s Health is a powerful tool to provide this critical information to researchers, policymakers, and state-level decision makers.

Research, Analytics, and Data Visualization Leveraging Public Health Data and Research Association of state and territorial health officials, astho, public health, public health data, state and territorial health, public health infrastructure, health agencies, data visualization, health outcomes, workforce development, community health Discover public health data and research on workforce development, infrastructure, and more to establish strategies for improving health outcomes. Public health data and research are at the heart of public health, giving state and territorial health agencies the foundation they need to improve community health. Data and research can be used to further develop understanding of public health challenges and provide evidence for health agencies to establish priorities and strategies to improve health outcomes. ASTHO collects, utilizes, and visualizes data on a variety of topics, such as public health infrastructure, workforce development, and current and emerging priorities, to support the work of ASTHO members and other public health professionals. article

Leveraging the NIH Bookshelf to Showcase Health Agency Research Island Areas Workgroup, Data Capacity Subgroup Learn how to submit your health agency research to the NIH Bookshelf to increase visibility and expand reach. If you’re looking to strengthen ties with the academic community and increase the visibility of your public health agency’s published population health reports, consider submitting them to the National Institute of Health’s Bookshelf platform. This free, searchable collection feeds into the PubMed database and accepts “gray literature,” or research produced outside of traditional commercial or academic publications. It is a great opportunity for public health agencies to expand their reach. Application and Review Process Submit content Initial screening Scientific review Technical review Publication Before submitting your content, make sure it meets Bookshelf requirements: Is your content: Full text (a full report, not just an abstract or data) with an executive summary or abstract? Aligned with at least one of the subjects priotitized by Bookshelf? Written in English? Accessible via a PDF/Word Document or online via a web link? While drafting the document, did you undergo some sort of peer review process? (E.g., an advisory council reviewed, offered feedback, and approved the final draft.) The peer review process must be publicly documented within the content, in a separate document, or via a description on the website. If you answered yes to the previous questions, follow these steps to apply: Download and complete the application for a single title or application spreadsheet for multiple titles. Complete publisher information sheet (if you are new to submitting to Bookshelf). Email your application to bookshelf@ncbi.nlm.nih.gov. Other information you will include in your application: Title of content. PDF/Word Document or URL where content can be accessed. Publishing information (name, management, qualifications, policies). Short author/editor biographies or CVs (1-2 pages). Resources for writing a professional CV (PH resume and examples). Copyright information. Abstract or summary. If you have questions about the application process or the suitability of your content, please contact bookshelf@ncbi.nlm.nih.gov. Note: If you have been publishing related content for at least two years, Bookshelf may review your content as a collection. This means any future materials may be added to the collection without an additional application. Once you have submitted your content: Initial Screening: Bookshelf staff checks that your application is complete and meets the minimum submission requirements. If Bookshelf staff have questions, they will contact you. Be ensure the project point of contact is responsive to inquiries, as timely responses are critical to moving your application forward without delays. If all submission requirements have been met, your content will move into the Scientific Quality Review. Scientific Quality Review: Bookshelf staff will assess whether your content meets the platform’s scientific standards (e.g., whether its content is substantive and valuable). Your content will either pass or fail this review; there is no opportunity to revise in response to feedback. If rejected, you may resubmit the content after two years. If your content passes this review, it will move to the technical review. Technical Review: Bookshelf staff will assess whether your content meets the platform’s technical requirements (e.g., an XML document with proper formatting and accessibility). This is typically the longest stage of the process, as there can be some back and forth between Bookshelf staff and applicants, as applicants strive to address any technical issues with the content. An applicant can contract with a commercial vendor to produce the necessary XML document, if needed. If your content is accepted: Bookshelf will give you an opportunity to preview the content. Make sure you’re comfortable with how the content looks, as this preview represents how the content will look on the platform. Ensure there are no typos or formatting issues! Sign the participation agreement, discussing questions with NIH Bookshelf staff as relevant. Celebrate your success, and share the link with peers and partners! Additional Resources from NIH How to Include Content in Bookshelf: Summarizes the Bookshelf application process. Bookshelf Copyright Notice: Summarizes relevant copyright restrictions that apply to Bookshelf. NLM Retention Policy: Summarizes the National Library of Medicine’s retention policies, which apply to Bookshelf. Background This product was created by the Island Areas Workgroup (IAW) — Data Capacity Subgroup. Established in October 2021, IAW brings together representatives from island jurisdictions, federal agencies, and trusted partners to address key administrative challenges impacting health outcomes in island jurisdictions, including efforts to strengthen procedures and organizational policies affecting health financing, data capacity, and workforce development. The Data Capacity Subgroup drafted this resource to support territorial and freely associated state public health leadership and researchers in their efforts to expand the reach of local population health data and research. OE22-2203 and PW-24-0080 article yes

This article in the Journal of Public Health Management and Practice assesses the impact of COVID-19 on health service utilization of adults with intellectual and developmental disabilities through an analysis of Medicaid claims data..

ASTHO and de Beaumont Foundation Commit to Improve the Public Health Workforce ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) and the de Beaumont Foundation announce a new project building upon their successful Public Health Workforce Interests and Needs Survey (PH WINS). The new project will enhance public health workforce policies and practice and is called “PH WINS: Research to Action.” Earlier this year, ASTHO and de Beaumont released PH WINS, the first nationally representative survey of the governmental public health work force. PH WINS surveyed more than 10,000 public health workers, exploring their attitudes, morale, and climate, and developing a baseline of key workforce development metrics. Analyses of the PH WINS data set were published in a special supplemental version of the Journal of Public Health Management and Practice in November 2015. “PH WINS: Research to Action” builds on these findings to meet the training and development needs of the public health workforce. Together, the de Beaumont Foundation and ASTHO will: Create and maintain a community of practice focused on the development of the public health workforce. Craft and implement a standardized training needs assessment that goes beyond PH WINS. Develop and test a web-based tool for high-quality online training for the public health workforce. To achieve these objectives, ASTHO will utilize focus groups and a newly developed community of practice to develop innovative ideas to encourage the uptake of recommended policies and practices. The outcomes of “PH WINS: Research to Action” will be made available to all state and local health departments. ASTHO Press Release Boilerplate de Beaumont Boilerplate website yes

As the overdose epidemic continues, it is imperative for the medicolegal death investigative community to understand the importance of continuous training and the role that accurate death certification plays in protecting the nation’s health.

This summary of our annual environmental scan identifies public health concerns and trends and health agencies’ top current and emerging priorities.

A discussion with Meredith Allen, ASTHO’s Vice President for Health Security, about how the first shipments of the COVID-19 vaccinations have been a major turning point for the pandemic and a milestone moment for U.S. public health history.

Every state and U.S. territory are at risk of vector-borne diseases. This year, dengue cases are on the rise in Puerto Rico. Florida has also reported locally transmitted cases of dengue this year. We are already seeing record numbers of cases in the Americas and the Caribbean, with 2019 seeing the highest number of cases on record in the Americas. Numbers of tickborne diseases continue to climb this summer, with Lyme disease continuing to be the most reported vector-borne disease in the U.S.

The COVID-19 pandemic has changed the landscape of we go about preparing and responding to public health threats. In collaboration with CDC, ASTHO embarked on an initiative to identify effective resources, policies, and model practices utilized by state and territorial health agencies throughout the pandemic response. In this blog, we highlight four areas of focus that are central to any successful preparedness effort.

State and Territorial Health Officials Respond to New CDC Report That Finds Zika Infection During Any Trimester Can Lead to Severe Birth Defects ARLINGTON, VA—In response to a new CDC report on the impact the Zika virus may have on pregnancy outcomes, the Association of State and Territorial Health Officials (ASTHO) calls on public health leaders nationwide to remain vigilant and focused on preventing the risk of Zika infection in the continental United States and the U.S. territories. The report includes data from pregnancy registries in the U.S. territories and Pacific freely associated states, including American Samoa, Puerto Rico, the Federated States of Micronesia, the Republic of Marshall Islands, and the U.S. Virgin Islands, and is the largest study of its kind to look at completed pregnancies with laboratory confirmation of Zika virus infection. Five percent of women in the U.S. territories who had a confirmed Zika virus infection during their pregnancy had a baby or fetus with Zika-related birth defects, consistent with the findings of a similar CDC study on Zika-related birth outcomes in the continental United States. “Our territorial health officials have unique public health needs and budgetary challenges that make addressing major public health threats different in many ways from those of the fifty states, even though we see similar rates of Zika-related birth defects,” says Michael Fraser, ASTHO’s executive director. “The new CDC study shows how Zika virus infection in the territories remains a concern and we must support our territorial health officials to sustain their responses to this public health threat.” Health officials say robust reporting, monitoring, and birth defects surveillance systems are key to understanding the magnitude of the risk of Zika infection during each trimester. The effects of Zika during pregnancy are not always recognizable at birth, and these systems provide important data to help identify and facilitate access to clinical care and support services for infants and their families. With this latest study, states and territories now have sufficient data to begin to develop preliminary estimates of risk for each trimester. Among the women with confirmed Zika infection during the first trimester, nearly 1 in 12 (8%) had a baby or fetus with Zika virus-associated birth defects. About five percent of women infected during their second trimester and four percent infected in their third trimester had babies with Zika-related birth defects. Zika poses a serious threat to pregnant women and their babies, regardless of when the infection occurs. Currently, CDC’s National Center on Birth Defects and Developmental Disabilities is operating the U.S. Zika pregnancy registry using FY17 emergency funds allocated for Zika response. States and territories report data from their registries to the CDC, which aggregates and publishes data for the nation. The Center’s emergency funding to states and territories for birth defects surveillance—a separate funding stream from pregnancy surveillance—expires July 31, 2017. Pregnancy surveillance funding, as well as emergency funding for additional epidemiology, laboratory services, and mosquito control, expires July 31, 2018, although states may expend those dollars sooner based on what occurs during this summer’s potential outbreak. Ensuring robust surveillance capacity is essential for local, state, territorial, and federal public health officials and healthcare providers to direct efforts to monitor and provide care for infants affected by Zika virus and their families. “It is too early to say that the threat of a major Zika virus infection outbreak this summer has passed,” Fraser adds. “Even though Zika cases have been on the decline, the conditions for increased local transmission this summer are good—and that should concern us all. A mild winter in many states and an active mosquito season early this year means we must be very, very vigilant in our surveillance and prevention efforts. We have models of mosquito-borne virus infection and models of sexually-transmitted virus infection. Zika involves both, which makes modeling very difficult. State and territorial health departments rely heavily on data to deploy coordinated public health responses to Zika virus, but the current funding landscape potentially jeopardizes these efforts, especially in the territories that have different needs, unique geographies, and a very different interface with CMS through their jurisdictions’ Medicaid programs.” ASTHO commends Congress for providing supplemental funding for FY17 to ensure rapid response capabilities to address the Zika crisis and health officials are concerned by the President’s FY18 proposed budget cuts to the CDC and other federal agencies that support public health efforts, including Zika response. ASTHO urges Congress to provide adequate funding in the FY18 appropriations bills to address this ongoing public health threat in our states and territories. ASTHO Press Release Boilerplate website yes

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

New platform will provide forum for data exchange, analysis, and visualization to support public health work