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ASTHO and PIHOA Praise Approval of Medicaid Funding Fix for U.S. Territories ARLINGTON, VA—This week, Congress approved legislation to extend Medicaid funding for two years for the U.S. territories in their fiscal year 2020 appropriations bills and extenders package. Esther Muña, the chief executive officer of the Commonwealth Healthcare Corporation, Association of State and Territorial Health Officials (ASTHO) board member, and Emi Chutaro, executive director of the Pacific Island Health Officer’s Association (PIHOA), issued the following statements applauding the bipartisan and bicameral extenders package. The legislation avoided devastating cuts to the territories’ health care services for their most vulnerable residents, scheduled to take place at the end of the year—widely called the “Medicaid Cliff.” “The U.S. territories face unique healthcare and public health challenges and the support provided through the Medicaid program allows us to care for Americans who live on these islands in their communities,” says Chutaro. “It is vital that we prioritize public health for Americans living in the U.S. territories,” says Nate Smith, secretary of health at the Arkansas Department of Health and ASTHO president. “Ensuring access to care is essential to protect and ensure health equity among and well-being within this population. As state health officials, we know that what benefits the territories will help us in our quest to bring optimal health to all.” “We are grateful for the bipartisan and bicameral legislation which provides a two-year increase in funds and federal match for the Medicaid program in the U.S. territories," says Muña. “The increased funding will allow the health care and public health systems in the U.S. territories to further improve access and quality of care to the population. This funding continues to be vital to all of the U.S. territories, and while we are grateful for this temporary fix, we must find a long-term solution to Medicaid funding to provide stability to our system of care. In the upcoming year, we look forward to working collaboratively with Congress and the Trump Administration to further bolster health care and public health systems to build healthy and resilient communities throughout the U.S. territories.” ASTHO Press Release Boilerplate PIHOA Boilerplate website yes

Health Officials Seek to Prevent Adverse Childhood Experiences ARLINGTON, VA—At least five of the top 10 leading causes of death are associated with adverse childhood experiences (ACEs), according to a new report released yesterday by the Centers for Disease Control and Prevention (CDC). ACEs, such as abuse, neglect, and witnessing violence or substance misuse in the home, can lead to increases in chronic disease, mental health issues, and socioeconomic hardship later in life. The Association of State and Territorial Health Officials (ASTHO) and its members are committed to helping prevent ACEs to improve long-term health, access to life opportunities, and the overall health of Americans. According to CDC’s report, 61 percent of adults have at least one ACE and 16 percent of adults have four or more ACEs. Preventing ACEs before they occur could prevent up to 21 million cases of depression, up to 1.9 million cases of heart disease, and up to 2.5 million cases of obesity. State and territorial health departments can lead prevention efforts, including, improving health equity, and reducing health disparities among children and families, by bolstering protective factors. Focusing on community solutions, reducing stigma, and providing access to preventive services can reduce the risk of future ACEs from occurring and mitigate the impact of ACEs that have already transpired. "Childhood experiences can have a powerful and enduring impact on health and opportunity well into adulthood," says Nate Smith, ASTHO president and secretary of health at the Arkansas Department of Health. "We all know that children are our future. Fortunately, our communities can come together to prevent ACEs. We can provide to families the proper economic and social support to create safe and nurturing environments for society's most vulnerable. Protecting against violence and trauma and fostering secure and supportive relationships is how we build a strong foundation for our children and adults." For more information about ACES, access  ASTHO’s issue brief, Adverse Childhood Experiences: Primary Prevention. ASTHO Press Release Boilerplate website yes

Nation’s Public Health Officials Urge Americans to Stop Vaping ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) issued the following statement in response to the pulmonary illnesses associated with vaping. “We are alarmed by the current outbreak of severe pulmonary illnesses and deaths associated with vaping. This is a public health emergency with serious consequences. Until we know precisely what substances are causing these illnesses, we strongly urge all Americans to stop vaping immediately,” says Nathaniel Smith, MD, MPH, ASTHO president and secretary of health at the Arkansas Department of Health. “E-cigarettes are unsafe and unregulated. The FDA has never approved these devices for tobacco cessation. Given the highly addictive nature of these products, members of the public should discuss with their physicians the various FDA approved methods to assist with nicotine withdrawal symptoms. Some states have already acted by temporarily banning the sale of vaping products or banning the sale of flavored e-cigarettes. “We’re very concerned by the rapidly increasing rates of e-cigarette use by young people. This dramatic increase in youth vaping is being driven by fraudulent marketing practices that target young people with kid-friendly flavors. Federal, state, and local governments should take immediate action to address this epidemic by banning flavors, restricting marketing practices, raising taxes on tobacco products including e-cigarettes, supporting tobacco free air policies, expanding cessation programs, and raising the minimum age for tobacco purchases to 21.” ASTHO Press Release Boilerplate website yes

Supporting Governmental Public Health Should be a Congressional Priority Says Dr. Nathaniel Smith at Today’s House Appropriations Hearing ARLINGTON, VA—Nathaniel Smith, MD, MPH, director and state health officer for the Arkansas Department of Health and president-elect of the Association of State and Territorial Health Officials (ASTHO), testified today before the House Committee on Appropriations Subcommittee on Labor, Health and Human Services, Education and Related Agencies to discuss the importance of Congress providing enhanced resources for Centers for Disease Control and Prevention, HHS Office of the Assistant Secretary for Preparedness and Response, Health Resources and Services Administration, and other federal agencies to improve our nation’s health. “Governmental public health agencies work everywhere, every day to protect and improve the health of the entire U.S. population. Our work is often invisible and sometimes it is only in a crisis when the value and importance of sustained investment in public health becomes apparent. These crises unfortunately happen all too often – the current measles and hepatitis A outbreaks, the obesity and opioid epidemics, and many others, highlight the important work of disease prevention and health protection at the core of public health’s mission,” says Smith. “ASTHO urges Congress to sustain and increase funding for federal public health agencies so that state, local, tribal and territorial health departments can continue and enhance their work to prevent drug overdoses, save lives through chronic disease prevention, prepare for and respond to disasters and public health emergencies, combat infectious disease, and prevent and remediate environmental health hazards.” For more information about the hearing visit the committee’s website. To read Dr. Smith’s full written testimony, visit ASTHO’s website. ASTHO Press Release Boilerplate website yes

Arkansas Department of Health Secretary Nate Smith Named ASTHO President BETHESDA, MD—The Association of State and Territorial Health Officials (ASTHO) announced the appointment today of Nate Smith, MD, MPH, secretary of health at the Arkansas Department of Health, as ASTHO’s new president, effective Sept. 25. “I’m thrilled to serve as president and look forward to working hard to ensure that everyone has the access and ability to be healthy,” says Dr. Smith. “I look forward supporting my colleagues at the federal, state, and local levels to address the many public health challenges and opportunities affecting the United States.” Dr. Smith has served as Arkansas’ state health official since 2013, where he provides senior scientific and executive leadership and strives to help colleagues achieve their full potential using public health best practices supported by science-based decisions. Dr. Smith previously served the Arkansas Department of Health as branch chief for infectious diseases, state epidemiologist, and deputy director for public health programs. He is board certified in internal medicine and infectious diseases and holds voluntary faculty positions in the Division of Infectious Diseases at the University of Arkansas for Medical Sciences (UAMS) College of Medicine and in the Epidemiology department at UAMS’ Fay W. Boozman College of Public Health. He was elected president-elect of ASTHO in September 2018. Born in Massachusetts, Dr. Smith lived in multiple countries and U.S. cities before attending Rice University, Baylor College of Medicine, and the University of Texas School of Public Health. He is also an ordained minister in the Anglican Church. Dr. Smith and his wife, Kim, served two terms as medical missionaries at Kijabe Hospital in Kenya, where he was involved with the President's Emergency Plan for AIDS Relief, a program that reduced the adult HIV prevalence from over 10 percent to less than 6 percent. In Kenya, Dr. Smith’s roles included chief of internal medicine, medical intern program director, infectious diseases consultant, country medical director for the University of Maryland School of Medicine in Kenya, and senior medical technical advisor for the AIDSRelief program in East Africa. “We are thrilled to have Dr. Smith as our new president,” says ASTHO Chief Executive Officer Michael Fraser. “His impressive background in infectious disease demonstrates an expertise that will be crucial to facing the threat of antimicrobial resistance in the United States. His compassion, public health insights, and wealth of medical and scientific knowledge, sharpened during his work abroad and in his service to the state of Arkansas, will be truly valuable assets as the nation contends with public health emergencies like the ongoing opioid crisis. I know that Dr. Smith will move our organization—and public health—forward in the year to come.” Rachel Levine, MD, secretary of health at the Pennsylvania Department of Health, will serve as ASTHO president-elect. ASTHO Press Release Boilerplate website yes

ASTHO Applauds Administration’s Decision to Halt Sales of Flavored E-Cigarettes ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) applauds the Administration and the U.S. Food and Drug Administration (FDA) for its announcement to halt sales of non-tobacco flavored electronic cigarettes (e-cigarettes) in the coming weeks. “ASTHO applauds the Trump Administration’s move to ban non-tobacco flavored e-cigarettes. Regulating the tobacco industry in a way to protect the public’s health is an essential part of the puzzle to protect our population, especially youth, from the harms of tobacco products,” says Nathaniel Smith, MD, MPH, president-elect of ASTHO and secretary of health at the Arkansas Department of Health. “Federal policy to support and bolster the vital work that state, territorial, tribal, and local public health do to prevent youth from becoming addicted to nicotine is bold and necessary. Governmental public health cannot always do it alone, and on tobacco policy, the force of the FDA is one that cannot be underestimated in the effort to curb tobacco use in our country—especially among young populations.” ASTHO has long advocated that flavored tobacco products threaten and undermine the progress made to prevent youth from smoking combustible tobacco. ASTHO members strongly support the notice of proposed rulemaking to regulate flavoring in all tobacco products. This announcement is a step in the right direction in maintaining this momentum. ASTHO Press Release Boilerplate website yes