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State and Territorial Health Leaders Praise Surgeon General’s Report on E-Cigarettes ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) praises U.S. Surgeon General Vivek Murthy for issuing a first ever report on e-cigarette use among youth and young adults, and calls on local, state, and national partners to redouble efforts to prevent tobacco use and support tobacco cessation efforts nationwide. The new report indicates a dramatic rise in e-cigarette use among youth and young adults. E-cigarettes are now the most commonly used tobacco product among youth, surpassing conventional cigarettes in 2014. Emerging data suggests that youth who use e-cigarettes are more likely to use combustible tobacco products. ASTHO members have a strong history of supporting programs that improve tobacco prevention and control efforts in their states, and this new report reiterates that tobacco use, in any form and at any age, is harmful to our health. “The report’s main message, that there is no acceptable level of nicotine when it comes to our children, is a strong one and one that I support as a physician, father, and champion for health in my state. That's why in Vermont we added e-cigarettes to the tobacco products restricted under our Clean Indoor Air Act,” says Harry Chen, MD, chair of ASTHO’s Prevention Policy Committee and commissioner of the Vermont Department of Health. “While there is still a lot we do not know about e-cigarettes, we do know that vaping products contain chemicals that could cause harm, especially in young people. Our research on the health effects of smoking clearly shows that nicotine, regardless of how it is delivered, is addictive and can harm the developing brain.” ASTHO President and Chief Medical Officer for the Alaska Department of Health and Social Services, Jay Butler, MD, states that “our nation’s state and territorial health leaders are committed to aggressive efforts to reduce all tobacco use and address the issues posed by electronic cigarettes. This is an area where health, policy, and science can converge to prevent harm and potentially prevent addiction and substance misuse among our youth.” While all state and territorial public health agencies have experience addressing tobacco control and prevention, e-cigarettes pose new challenges to health leaders. “We are concerned about tobacco-attributable health disparities, tobacco-related morbidity and mortality, and the limited regulation and lack of definitive research on e-cigarettes and their components,” says ASTHO’s Executive Director Michael Fraser, PhD. “To this end, we support further investment in prevention efforts and research to inform local, state, and national policymakers. I think the surgeon general’s report is going to focus more attention on the unique issues raised by e-cigarettes and the need for additional policy work and investment at the state and national level to promote healthy behaviors among our nation’s young people.” ASTHO is currently updating its position statement on tobacco prevention and control to include the public health consequences of e-cigarettes and related vaping devices. ASTHO Press Release Boilerplate website yes

The Association of State and Territorial Health Officials Challenges Members to Promote Health Equity and Health in All Policies ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) and ASTHO President and Minnesota Department of Health Commissioner Edward Ehlinger have issued the 2016 ASTHO President’s Challenge: Advancing Health Equity and Optimal Health for All. The challenge is based on the Triple Aim of Health Equity, a framework weaving together three core elements of public health practice and policy which recognize that health status is influenced by a host of factors—most of them outside the healthcare system. The 2016 challenge calls upon states and territories to: (1) expand their understanding of what creates health, (2) implement a Health in All Policies (HiAP) approach with health equity as the goal, and (3) strengthen community capacity to create their own healthy future. The challenge encourages states and territories to broaden their approaches to advancing health equity and improving the health of all their residents by adopting the foundational public health practices embodied in the Triple Aim of Health Equity. The challenge will be to use these practices to address a policy, program, or activity issue within their jurisdictions in the next year. “The dominant narrative in America is that health is the responsibility of individuals until they get sick, and then health becomes the responsibility of the healthcare system,” Ehlinger says. “This outdated narrative allows little room for community or social influences, and its deficiency is clear when you look at the health disparities in this country and our overall health outcomes relative to other developed nations.” The challenge specifically targets health inequities that plague a number of groups that have been disadvantaged in America. As the nation becomes more diverse, the impact of unaddressed inequities will become more evident and alarming. According to the U.S. Census Bureau, 50.4 percent of children 1 year of age and younger belong to a minority group as of July 2011. By 2044, a majority of the entire U.S. population will belong to a minority group. Yet research shows that minority populations are disproportionately affected by higher rates of poverty, decreased graduation rates, and food and housing insecurity—factors that decrease their opportunities to be healthy. The new challenge will use three core elements of public health practice that make up the Triple Aim of Health Equity approach to elevate the profile of advancing health equity and creating optimal health for all. ASTHO will support state and territorial health officials and partners who accept the challenge by providing technical assistance and support, sharing best practices and success stories, and facilitating information exchange and opportunities for collaboration around health equity and HiAP approaches. Ehlinger has recently presented on the challenge to CDC, the Institute of Medicine Committee on Community Based Solutions to Promote Health Equity in the United States, and multiple professional groups around the country. “The 2016 ASTHO President’s Challenge recognizes that good health does not begin with treating illness. Our health status arises from our everyday environments, activities, and the people around us,” says Sharon Moffatt, ASTHO interim executive director. “We are proud to work with Dr. Ehlinger to promote health equity and optimal health for all. When we build healthier communities, we all benefit.” In November, U.S. Surgeon General Vivek Murthy joined Ehlinger during the Health Equity in All Policies panel at the American Public Health Association’s 2015 Annual Meeting, where Murthy voiced his support for the new President’s Challenge. “Reducing disparities in health will give everyone a chance to live a healthy life and improve the quality of life for all Americans,” says Murthy. To learn more about the 2016 ASTHO President’s Challenge, visit: www.astho.org/Health-Equity/2016-Challenge. ASTHO Press Release Boilerplate website yes

State and Territorial Health Officials Applaud Surgeon General’s First Ever Report on Alcohol, Drugs, and Health ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) commends U.S. Surgeon General Vivek H. Murthy for issuing a landmark report on alcohol, drugs, and health, and remains committed to helping state and territorial health departments enhance prevention efforts, expand access to treatment, and ensure that recovery is possible for everyone struggling with substance use disorders and addiction. “Substance misuse and addictions must be recognized as public health issues, and not just a concern of the criminal justice system,” says Dr. Jay Butler, ASTHO president and chief medical officer for the Alaska Department of Health and Social Services. “We now know that addictions are chronic conditions involving brain function, and substance misuse is often deeply rooted in early life events and social factors. To truly make an impact, we must make these connections to create and implement effective, science-based responses.” Launched in September 2016, ASTHO’s President’s Challenge, led by Dr. Butler, centers around public health approaches to preventing substance misuse and addictions. Through the challenge, ASTHO hopes to further unite and rally state health officials, affiliates, and partners to take action over the next year on this critical and urgent public health issue within states and communities. Since 2012, ASTHO has convened state agencies, healthcare and mental health professionals, third-party payers, researchers, and community-based partners to identify actionable steps to better understand and address prescription drug abuse. “This report marks an important turning point in our nation’s response to substance use disorders and addiction, and further exemplifies the need to support health departments in taking steps to address substance misuse through a comprehensive approach,” says Dr. Michael Fraser, ASTHO Executive Director. “We look forward to continued partnership with our members, federal agencies, local health departments, and other organizations working to address the many issues we face related to misuse and abuse of drugs and alcohol.” Substance misuse and addictions to alcohol, prescription drugs, and illicit substances are long-standing but growing problems in the United States. Over 20 million people have substance use disorders, and 12.5 million Americans reported misusing prescription pain relievers in the past year, according to HHS. Addressing drug and alcohol misuse has been a top priority for health officials across the nation. The Surgeon General’s report includes many ways that all Americans can get involved in preventing drug and alcohol misuse. Specific actions that state health leaders can take include: Providing leadership, guidance, and vision in supporting a science-based approach to addressing substance use-related health issues. Improving coordination between social service systems and the health care system to address the social and environmental factors that contribute to the risk for substance use disorders. Implementing criminal justice reforms to transition to a less punitive and more health-focused approach. “We aren’t going to treat our way out of this problem of misuse and addiction, nor are we going to arrest our way out of it,” says Fraser. “Instead, we have to focus on preventing misuse in the first place. The Surgeon General’s report is a great way for all Americans to get engaged on this issue and promote healthy behaviors at home, at work, in our communities, and in our states.” For more information about ASTHO’s 2017 President’s Challenge, visit www.astho.org/addictions. ASTHO Press Release Boilerplate website yes

Health Officials and Attorneys General Convene to Discuss Legal and Public Health Solutions to Opioid Epidemic ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) and the National Attorneys General Training and Research Institute, a branch of the National Association of Attorneys General, held an inaugural three-day summit with health officials and attorneys general on Nov. 14-16 to promote coordination across public health, law enforcement, and medical professionals to address opioid abuse and misuse, an epidemic that claims the lives of 78 people each day and has now become one of the nation’s most urgent public health threats. At the meeting, health officials and attorneys general discussed the importance of working together to change the conversation about people with substance use disorders, and the need to move from punitive approaches toward compassionate, evidence-based treatment. Health and law enforcement officials are intensifying efforts to improve prescribing practices, apply effective regulatory and enforcement measures, and eliminate stigma and misconceptions about individuals who seek addiction treatment. “We need to reframe the conversation about addiction, from one about bad choices and moral failings to one about chronic health conditions that affect the brain,” says Jay Butler, ASTHO president and chief medical officer for the Alaska Department of Health and Social Services. “Together, public health and law enforcement officials have a critical role to play in ending this epidemic that continues to devastate our families and communities.” ASTHO’s 2017 President’s Challenge, led by Butler, centers around public health approaches to preventing substance misuse and addictions. Through the challenge, ASTHO will unite and rally state health officials, affiliates, and other cross-sector partners to take action on this critical and urgent public health issue within states and communities. State health officials will work to expand primary prevention efforts in their states to educate consumers, prescribers, families, policymakers, and other partners about opioid use, and address risk factors in communities to reduce demand for drugs and other addictive substances. U.S. Surgeon General Vivek Murthy and Office of National Drug Control Policy Director Michael Botticelli also delivered remarks on Monday, calling for greater integration of substance use disorder services into the healthcare system so that addiction can be treated with the same precision and urgency as other health conditions like diabetes, heart disease, or cancer. Nationally recognized experts and thought leaders from the National Institute on Drug Abuse, CDC’s National Center for Injury Prevention and Control, the Substance Abuse and Mental Health Services Administration, the American Medical Association, and the Johns Hopkins Bloomberg School of Public Health also described federal and state policy options, strategies for engaging medical professionals, and promising community-based prevention initiatives. ASTHO Press Release Boilerplate website yes

ASTHO Awards Public Health Leaders for Outstanding Service ARLINGTON, VA—The Association of State and Territorial Health Officials (ASTHO) honored public health leaders with several awards this week at its 2017 Annual Meeting in recognition of their outstanding service and dedication to improving state and territorial public health.  “On behalf of ASTHO, I am truly honored to present this year’s awards to a group of individuals who bring transformative leadership to the field of public health and embody a genuine desire to improve our nation’s health. Their accomplishments have made a difference in the lives of others, and we are inspired by their commitment to lead with compassion, integrity, and perseverance,” says ASTHO Executive Director Michael Fraser. The 2017 ASTHO awardees include:  Georges Benjamin, MD, executive director of the American Public Health Association Ed Thompson 2017 Lifetime Achievement Medal With over 35 years of experience in public health as a physician, state health official, and executive director of the American Public Health Association, Benjamin has inspired countless public health leaders and has been named among the 100 most influential people in healthcare. Michael Botticelli, executive director of the Grayken Center for Addiction Medicine at Boston Medical Center ASTHO 2017 Presidential Meritorious Service Award Botticelli, former director of the White House Office of National Drug Control Policy, was the first person to hold this position while also in long-term recovery from a substance use disorder. Vivek Murthy, MD, 19th Surgeon General of the United States ASTHO 2017 Presidential Meritorious Service Award As surgeon general, Murthy created initiatives to tackle our country’s most urgent public health issues, including the first-ever Surgeon General’s report issuing a call to action on addiction as a chronic illness. Tom Frieden, MD, former director of CDC National Excellence Award On the national level, Frieden, who served as director of CDC from 2009-2017, led work to end the Ebola epidemic and control the largest outbreak of drug-resistant tuberculosis in the United States, among other initiatives. J. Patrick O’Neal, MD, commissioner of the Georgia Department of Public Health State Excellence Award On the state level, O’Neal brings a great deal of medical and military experience to the public health community, greatly enriching ASTHO’s mission and the health of all Georgians. Paul Jarris, MD, chief medical officer for the March of Dimes ASTHO Alumni 2017 Award As a nationally recognized expert in healthcare policy, clinical quality initiatives, public health, and disease prevention and wellness, Jarris used his expertise to serve as commissioner of health at the Vermont Department of Health from 2003-2006 and ASTHO executive director from 2006-2016. Rep. Tom Cole, chair, House Labor, HHS and Education Appropriations Subcommittee 2017 ASTHO Legislative Champion Award Cole was elected to Congress in 2002 and is currently serving in his eighth term in the U.S. House of Representatives. Cole has been supportive of important public health initiatives, such as the CDC’s Public Health Emergency Preparedness program. Rep. Rosa DeLauro, ranking member, House Labor, HHS, and Education Appropriations Subcommittee 2017 ASTHO Legislative Champion Award DeLauro is the Congresswoman from Connecticut’s Third Congressional District. DeLauro spearheaded bipartisan legislation to raise awareness of gynecologic cancers and the WISEWOMAN program, and has supported food safety measures, youth tobacco use prevention, and mental health and substance abuse prevention. Edward Ehlinger, MD, commissioner of health for the Minnesota Department of Health Arthur T. McCormack 2017 Award In addition to directing the work of the Minnesota Department of Health, Ehlinger formerly served as ASTHO president, where he exemplified his dedication to advancing the important work of public health and improving health for all. Keith Yamamoto, MPA, deputy director of the Hawaii Department of Healt Noble J. Swearingen 2017 Award Yamamoto, a key member of ASTHO’s Senior Deputies Committee, has provided critical guidance and expertise in state and territorial public health leadership. In addition, ASTHO presented its 2017 Vision Awards and the de Beaumont Foundation PH WINS: Research to Action Model Policies and Practices Challenge Awards. ASTHO congratulates the 2017 award winners for demonstrating excellence in public health leadership and working tirelessly to protect and promote our nation’s health. ASTHO Press Release Boilerplate website yes

As the response to COVID-19 transitions from response to recovery, advocacy efforts continue to intensify on Capitol Hill, to help shape negotiations on the fifth emergency supplemental package.