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PHIG: A Transformative Infrastructure Grant for Health Equity and Inclusive Workforces ASTHO, Association of State and Territorial Health Officials, phig grant, infrastructure grant, public health, health equity, public health grant, inclusive workforce, public health infrastructure grant, health departments, public health funding, public health institutes, data systems, public health workforce, community engagement, federal grants, restrict spending, health disparities, community partnership, underserved populations, diversity equity inclusion, educational institutions, high risk and underserved, ethnic minority, rural communities, overall capacity, minority institutions Amber Williams, Lindsey Myers The Public Health Infrastructure Grant (PHIG) program provides flexible, non-categorical funding to help public health departments across the United States build their infrastructure and capacity to meet their unique needs and address barriers in health equity and workforce development. Following the COVID-19 pandemic, Congress made a historic investment in public health workforce and infrastructure, presenting a game-changing opportunity for public health transformation. In the fall of 2022, CDC rolled out a first of its kind, five-year grant program called the Public Health Infrastructure Grant (PHIG) to address critical governmental public health workforce and system improvement needs. This program is all about supporting health departments across our states, territories, and freely associated states to ensure every community has the people, services, and systems needed to promote and protect optimal health for all. Along with funding 107 health departments, CDC also partnered with three organizations: the Association of State and Territorial Health Officials, the National Network of Public Health Institutes, and the Public Health Accreditation Board to help agencies modernize data systems, recruit and retain a skilled public health workforce, and address longstanding public health infrastructure needs. Challenges in Public Health Funding and the Pivotal Introduction of PHIG The majority of public health department funding comes from topic-specific federal grants, which usually restrict spending to prescribed programmatic activities and do not allow agencies to build foundational capabilities—like improving hiring or procurement processes, communication, and community engagement. For example, while advancing health equity and addressing health disparities is often emphasized as a central goal of public health practice, many jurisdictions face barriers to fully incorporating health equity into their strategies. Additionally, the public health workforce often does not reflect the communities they serve, which can impact their ability to build community partnerships and fully respond to the needs of underserved populations. PHIG is different in that it provides flexible, non-categorical funding that health departments can use to build their infrastructure and capacity to meet their unique needs and address barriers. PHIG Impact: Advancing Health Equity and Promoting Inclusion in Public Health Agencies Many agencies are using their PHIG funding to boost efforts to tackle health disparities in their jurisdictions and promote diversity, equity, and inclusion within their agencies. Internally they are focusing on examining compensation, assessing equitable pay, developing leadership programs for staff of color, streamlining hiring processes, and assuring unbiased hiring practices. Some agencies are creating paid internships, hiring people with lived experience, and building new workforce pipelines through engagements with minority-serving educational institutions. Plus, they are training managers and staff to create more inclusive workplace environments and partner with and serve diverse communities better. Other approaches include: Taking lessons learned from other funded programs, such as the National Initiative to Address COVID-19 Health Disparities Among Populations at High-Risk and Underserved, Including Racial and Ethnic Minority Populations and Rural Communities grant, to focus and build on successes. Strengthening the overall capacity of the agency to address health equity, such as by incorporating health equity into agency-wide performance improvement offices and ensuring equity principles are embedded in health assessments and strategic plans. Improving partnerships with community organizations—looking at opportunities to simplify processes; support minority-owned institutions in competing for and managing federal funding; and hiring new staff dedicated to health equity, liaisons with special populations including tribes, and community health workers. This is a remarkable time for public health. Improving public health infrastructure and strengthening the workforce will lead to better health outcomes for all. These grants are critical, providing much-needed funding and flexibility to make real progress in promoting diversity, equity, and inclusion in the workforce and ensuring health equity in public health strategies. Author card spacing 2 Related Content-Blog - DELPH Magazine 3 OE22-2203 PHIG website yes

An ASTHO blog article about the importance of resiliency in the workplace, pertaining to leadership and organizational work environment.

Every year on Nov. 22, ASTHO—and countless other agencies and organizations worldwide—take a moment to acknowledge the public health workforce on Public Health Thank You Day. Like so many other days of recognition, it has become a blip on our yearly calendar. And, simply put, that’s just not enough. This year, ASTHO leadership took pen to paper to share some of our feelings, fears, and—yes, our thanks—for everything the public health workforce has always done to protect us.

State Public Health Leaders Urged to Increase Efforts to Prevent Injuries ARLINGTON, VA—State public health leaders responded to a new “The State of Safety” report released by the National Safety Council today showing that every state has work to do to enhance safety measures for its residents. “The fact that not a single state received an overall ‘A’ rating in the report demonstrates that we have an urgent and continued need to prevent injuries and address a leading cause of morbidity and mortality in the United States,” says Michael Fraser, executive director of ASTHO. “As the debate over healthcare continues, we have to ask ourselves whether or not we have invested appropriately in public health efforts to prevent injuries in the first place versus treating the impact of injury and violence through the healthcare delivery system.” While state and territorial health department injury and violence prevention programs work to promote and engage people in making safety behaviors to prevent injuries and violence before they occur, three areas identified in the report must be further addressed: Road Safety: Vulnerable road users, including motorcyclists, pedestrians, and bicyclists, are particularly at risk. Approximately 4,500 people a year are killed in motorcycle-related crashes, and another 90,000 are injured. Mandatory helmet laws, speed limits, and laws requiring motorists to stop when pedestrians are in the roadway are needed across states to reduce fatalities and injuries. Home and Community Safety: More than 70 percent of preventable injury deaths occur in homes and communities. Poisonings, suicides, and falls are the biggest threats to our safety, as well as drownings and home fire deaths. According to the report, the major culprit in drug-related deaths is opioid pain relievers. Workplace Safety: In 2015, almost 5,000 workers were killed and over 12,000 were injured each day. Transportation related deaths pose the greatest danger for workers. States can make the workplace safer by adopting drug- and smoke-free policies, implementing workplace violence policies, and offering occupational safety and health programs – including transportation safety policies and programs. “All Americans ought to have the opportunity to grow up and live safe and healthy lives. State health department injury and violence prevention programs play an essential role in providing leadership and support to ensure this vital work. The findings from this report reinforce the value of these efforts and highlight the grave need for consistent and continued investments in injury and violence prevention programs across the country,” says Amber Williams, executive director of the Safe States Alliance, a national organization representing injury prevention leaders in local, state, and territorial health agencies. ASTHO’s Executive Director added, “ASTHO and the Safe States Alliance are committed to partnering to advance the vital efforts of state and territorial health department injury and violence prevention programs. The National Safety Council’s report provides thoughtful insight into where states are succeeding in this regard and future steps they can take to further strengthen this work. I don’t think the issue is the will or interest in preventing injuries, I think the issue is having enough resource to truly move the needle on injury prevention in major ways across the country.” Preventable injuries, such as those due to falls, motor vehicle crashes, opioid drug overdoses, or incidents in the workplace, are the leading cause of death for Americans ages 1-44. The critical need for greater investments in prevention cannot be overstated; one person dies every three minutes due to injuries and violence, and the total lifetime costs of injuries and violence sustained in a single year amount to $671 billion in medical and work loss expenses. ASTHO Press Release Boilerplate Safe States Alliance Boilerplate website yes

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

The importance of having designated time for staff to connect, grow, develop and share has always been the driving force behind the decision to host “ASTHO Week,” a three-and-a-half daylong all-staff convening every quarter. Given our current work environment, having this time together seems necessary now, more than ever. So in the midst of the pandemic and our full-time telework, here’s what our team learned about planning a 100% virtual ASTHO Week.