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This brief examines the ways states can support certification for community health workers.

This blog from ASTHO’s PH-HERO team touches on the importance of trauma-responsive leadership in the public health workforce.

Workplace connections boost employee well-being, reduce burnout, and improve feelings of belonging.

A mid-session legislative update on five of ASTHO's top 10 public health state policy issues to watch in 2023: data privacy and modernization, reproductive health, health equity, strengthening public health agencies, and immunization.

Continuing ASTHO’s Legislative Prospectus series—which highlights the top 10 public health policy issues for 2022—we are focusing this week on mental and behavioral health as well as supporting the public health workforce.

Public Health Leadership Starts in the Classroom Public Health Leadership Starts in the Classroom Ashley Nanthavongsa-Mosley Learn how states are integrating public health education into K-12 schools and building pathways for future public health professionals. Governmental public health agencies across the country are showing interest in integrating public health concepts into K-12 education. This interest has been driven by a growing realization that students should understand the importance of public health work early and see it as a viable and meaningful career option. In early 2025, ASTHO members asked how public health agencies were integrating public health into K-12 schools. This interest prompted ASTHO to convene a workshop series, through which it became clear that states are not only interested in the topic — they are already doing innovative and impactful work within their jurisdictions. Below are key examples and lessons learned from states that participated in these discussions and takeaways that may help other organizations exploring similar efforts. Classroom Partnerships in Action Montana: Classroom-Ready Public Health Curriculum Montana is leveraging funding from the Public Health Infrastructure Grant (PHIG) to collaborate with the Montana Public Health Training Center to bring public health concepts directly into classrooms through a comprehensive curriculum for teachers. The curriculum is ready to use with worksheets and answer keys. The materials fit into teachers’ busy schedules and make it easier to introduce public health topics in the classroom. The curriculum has already been accessed by more than 130 people across 37 states, one U.S. territory, and eight countries. Also, with support from the Montana Healthcare Foundation, the training center is developing a toolkit to help local health departments collaborate with schools and host community health fairs that connect students directly with public health professionals. Kentucky: Career Exposure Through the Health Occupations Students of America (HOSA) With support from PHIG, Kentucky is leveraging existing student career organizations, such as HOSA, to introduce students to public health concepts and careers. At past HOSA conferences, students participated in a simulated outbreak activity that exposed them to epidemiology, public health nursing, environmental health, the public health laboratory, and public health career pathways in an engaging, hands-on way. New Jersey: Youth-Led Immunization Campaigns New Jersey hosts the Protect Me With 3+ annual poster and video contest, a joint initiative between the Partnership for Maternal and Child Health of Northern New Jersey and the New Jersey Department of Health. The statewide initiative aims to raise awareness on the importance of adolescent immunizations among preteens, teens, and parents, increase vaccination rates for several important vaccines, and, most importantly, empower students to use their creativity and voice to spread the important message of getting vaccinated. The contest invites New Jersey students in grades 5-12 to display their creativity by designing a poster or a 30-second video highlighting the importance of vaccines for themselves, their families, and their communities. Over the years, the contest has proven to be a successful and impactful model for peer-to-peer education around immunization. Connecticut: Multiple Entry Points into Public Health Through PHIG funding, Connecticut builds sustainable, credit-bearing pathways that introduce students to public health and connects them to college and career opportunities. Through the CT Science Olympiad, the Connecticut Department of Public Health sponsors the “Disease Detectives” event, giving middle and high school students hands-on experience with outbreak investigation and direct exposure to public health professionals. Over the past three years, 188 students from 35 schools have participated. Connecticut also expands access to college-level coursework. In partnership with the University of Connecticut, high school teachers are trained to deliver Public Health 101 through Early College Experience, allowing students to earn transferable college credit while still in high school. Beginning in Fall 2026, students from participating schools can further their studies through Dual Enrollment with Connecticut State Community College, where they will have access to undergraduate public health courses. Washington: Teacher Licensure and Data-Driven Curriculum Washington state focuses on supporting educators while grounding public health education in real-world data. K-8 teachers are required to complete STEM hours for licensure renewal, and teams are exploring ways to integrate youth engagement into this process. With support from the Educational Service District, Washington created an asynchronous professional development model teacher training program on using Washington Tracking Network data in classrooms. This program provides licensure clock hours while helping educators incorporate local public health concepts and data into instruction. Cross-Cutting Lessons from States Across jurisdictions, several common strategies consistently supported successful efforts to introduce students to public health and build early career awareness. Build on Existing School Programs and Structures Many successful initiatives did not require creating entirely new programs. Public health agencies integrated public health concepts into existing school activities, competitions, and career organizations that already have student participation and administrative support. Agencies interested in this work can start with established programs to make it easier to introduce public health concepts while minimizing additional demands on teachers and school administrators. Co-Create Curriculum with Educators Programs are more likely to succeed when teachers are involved in the early design process. Educators understand their classroom needs, curriculum standards, time constraints, and their input ensures that materials are practical and usable. Several agencies emphasized the value of developing curriculum collaboratively with teachers and testing materials in classrooms before broader rollout. This pilot, revise, scale approach helps refine lessons, ensures alignment with educations standards, and increases the likeliness that teachers will adopt the materials. Elevate Youth Voice and Peer Engagement Agencies can get students more engaged in public health work when they can create and share their own public health messages. Youth-led campaigns, contests, and peer education initiatives allow students to translate what they learned into messages for their peers and community members. Agencies noted peer-to-peer approaches such as student-created posters, videos, or presentations can be effective for topics like prevention, immunization, and community health awareness. These activities not only reinforce public health knowledge but also help students develop communication and leadership skills. Support Teachers Through Professional Development and Data Tools Teachers are more likely to incorporate public health topics into their classrooms when they receive training, resources, and incentives that align with their professional requirements. Some states support educators by offering professional development that provides continuing education or licensure renewal hours while also teaching educators how to use public health data, case studies, or state/local health examples in the classroom. Providing ready-to-use activities, datasets, and lesson plans reduces the burden on teachers while strengthening the integration of public health into classroom education. Build Sustainable Communication Channels with Schools Successful programs often relied on consistent communication channels between health agencies and education partners rather than relying on one-time outreach. Agencies built systems that allowed educators to regularly receive information about public health learning opportunities. Examples include educator newsletters, resource portals, partnerships with school districts or health districts, and coordination with state and local education networks. These systems help ensure that teachers and schools can easily learn about new curriculum resources, competitions, professional development opportunities, and student engagement activities related to public health. Keep Evaluation Simple and Actionable Agencies also emphasized the importance of evaluating K-12 public health programs in ways that are practical for schools and partners rather than complex evaluation requirements. Many use simple feedback mechanisms such as teacher surveys, student reflections, participation counts, or brief post activity questionnaires. These short feedback loops help agencies understand what worked, what needs improvement, and how programs can be refined before expanding to additional schools. Barriers and Challenges While agencies shared many promising approaches, they also identified several common challenges when working within K-12 education systems. Limited classroom time and competing priorities. Teachers often face strict curriculum requirements and limited instructional time, which can make it difficult to introduce new topics. Programs that align with existing standards or integrate into science health or career exploration courses are more likely to be adopted. Navigating school approval processes. Introducing new curriculum or programs may require approval from school district administrators or curriculum committees. Building relationships with education partners and piloting programs with a small number of schools can help build trust and demonstrate value. Resource and staffing limitations. State and local health agencies may have limited staff capacity to support ongoing school engagement. Developing reusable curriculum materials partnering with

Learn about state and federal efforts to bolster the behavioral health workforce in response to the growing demand for behavioral health services.

ASTHO's 2024 Legislative Session Update: Part Two Beth Giambrone, Maggie Davis, Christina Severin ASTHO's Public Health Legislative Update on Tobacco, Mental Health, Environmental Health, Workforce, and Containing Infectious Disease By the end of April, at least 36 states will have concluded their regularly scheduled 2024 sessions, with several states passing laws on important public health issues. Earlier this month, ASTHO provided a brief update on five of the top 10 public health state policy issues to watch during the 2024 state and territorial legislative sessions; this update examines the remaining five. Containing the Spread of Infectious Disease Public health agencies have a responsibility to keep their communities safe and healthy by maintaining foundational public health services including identifying, containing, and preventing the spread of communicable disease. ASTHO supports maintaining and guaranteeing robust public health legal authorities allowing public health leaders to meet their responsibilities for containing the spread of infectious disease. Following the COVID-19 pandemic, state and territorial legislatures considered many bills to change public health agency’s legal authorities to meet their responsibility, a trend that ASTHO anticipated continuing into 2024. So far, at least 28 states have considered, and at least two legislatures passed, bills relating to public health authority to address the spread of infectious disease in 2024. For example, the Hawaii legislature passed SB 3122, expanding public health authority by providing the state health official broad authority to issue standing orders for people 18 years and older to receive evidence-based services recommended by the U.S. Preventative Services Task Force. In March, however, Utah enacted HB 405, which limits local public health official’s authority to issue an isolation or quarantine order to specific conditions unless the local legislative body agrees that a new, drug resistant, or reemerging pathogen likely to cause high mortality or morbidity needs containment. Environmental Health Under the Safe Drinking Water Act, the EPA has the authority to set national standards for public drinking water. These standards establish legally enforceable Maximum Contaminant Levels (MCLs) and non-enforceable Maximum Contaminant Level Goals for public water systems. In April 2024, EPA released a final rule establishing legally enforceable MCLs for six PFAS compounds that occur in drinking water. Public water systems have until 2027 to complete initial monitoring and inform residents of the levels of PFAS in their water, and until 2029 to act if their drinking water levels exceed the MCLs. To date in 2024, at least four states have enacted or are considering legislation that would aid in monitoring and remediating PFAS in drinking water. Virginia recently enacted HB 1085/SB 243, which requires that the Department of Health notify the Department of Environmental Quality (DEQ) of any results from their monitoring of public water systems that show MCL exceedances, at which time requires DEQ to implement a plan to prioritize and conduct assessments of the public water system's raw water source(s). The Rhode Island House of Representatives passed H 7439, which would require the Department of Environmental Management to determine the maximum number of PFAS detectable by standard laboratory methods, and specifies the types of water systems that will be required to monitor untreated drinking water for those PFAS by June 1, 2025. Massachusetts is considering H 853, which would require the Department of Environmental Protection to maintain a list of municipalities where PFAS levels exceed the MCL and provide vouchers to homes in those municipalities to purchase home water filtration equipment. Strengthening the Public Health Workforce With several successes in 2023, ASTHO anticipated legislatures to continue considering legislation to strengthen the public health and health care workforces that represent the communities they serve during the 2024 legislative sessions. One strategy is establishing career pathway programs that provide students training and support to pursue public health careers. At least six states have considered, and three have passed, bills creating or strengthening a career pathway program during the current legislative sessions. At least two states have enacted programs to address health care provider shortages in April. Maine’s legislature passed LD 2268, which would allow internationally trained physicians to receive a limited license to practice medicine and address provider shortages in rural areas of the state. Washington enacted SB 5582, directing community and technical colleges to develop a plan in consultation with local workforce development councils and health care employers to train more nurses over the next four years. In May, Hawaii’s legislature passed HB 1827 appropriating funds to support public high school health care workforce certificate programs to support graduates seeking entry-level positions in the health care industry. Supporting Mental Health Children and adolescents continue to experience mental health issues, with teen girls reporting significant challenges. Schools can play an important role in supporting the mental health of all students through direct services or policies that address prevention, education or coordination. In 2024, a number of jurisdictions considered legislation related to youth mental health, through training requirements for staff and students, and support for treatment flexibility in the school setting. At least six jurisdictions considered bills related to mental health education for students, including specific suicide and violence prevention content. Virigina enacted HB 603, which requires school health instruction to include information about common mental health challenges, helpful coping strategies, the importance of seeking help from a professional or other adult, and available school resources. Several jurisdictions, including Virginia (HB 224), Minnesota (HF 4363) and Missouri (HB 2471), also considered establishing or amending suicide prevention and related mental health training programs for teachers and other school staff. Finally, several jurisdictions considered legislation to explore or otherwise support using telehealth services in schools for mental health services. Minnesota is considering legislation that would create a pilot program to determine whether the availability of telehealth services in schools increases mental health access (SF 4236) as well as a requirement to provide space at secondary schools for students to receive telehealth mental health services (HF 3542). New York is currently considering S 8976, which would authorize telehealth services in schools to be delivered by licensed providers, while Maryland enacted HB 522 in April, which requires school districts to develop guidelines to allow telehealth appointments at schools starting in the 2025-26 school year. Tobacco and Nicotine Products According to the American Lung Association, 22 states do not have comprehensive smoke-free laws that help protect against the dangers of second-hand smoke in a variety of settings (e.g., multi-family homes, public spaces, restaurants), or reduce the number of people who start smoking. At least 16 states have introduced legislation aimed at creating, promoting, or expanding smoke-free environments. Connecticut recently enacted SB 132, which expands their clean indoor air act to prohibit vaping at dog race tracks. The Maryland legislature passed HB 238/SB 244, which would update their Clean Indoor Air Act to prohibit vaping in public indoor areas, indoor places of employment, and mass transportation. In addition, the Alabama Senate recently passed SB 37, which would prohibit vaping in public places. In addition, at least 14 states have introduced legislation to either prohibit or further restrict the sale of flavored tobacco products, including menthol products. For example, bills introduced in Hawaii (HB 2441/SB 3130), Minnesota (HF 2177/SF 2123), and New Jersey (S 1947) would prohibit the sale of flavored tobacco products, including menthol, within their jurisdiction. In addition, a bill in New York (A 699/S4477) would ban the sale of flavored smokeless tobacco products within five hundred feet of a public or private school. ASTHO’s state health policy team continues to monitor these important public health issues and will provide relevant updates. website yes

This blog post discusses mitigating risks of AI use in government agencies, emphasizing privacy, transparency, and ethical concerns.