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In February 2019, ASTHO surveyed its members to understand how data is being utilized to address these harms in their jurisdictions. This brief summarizes the results of this survey and highlights data-based approaches used to address four types of opioid-related harms.

This guide captures the experiences and best practices of state and local public health agencies and their partners who are currently in the Cardiff Model implementation phase.

Following disruptions to daily life caused by the COVID-19 pandemic, emergency departments saw an increase of mental health-related visits. A June 2021 study showed a significant increase of mental health-related visits among 12–17-year-olds compared to the previous year. States and territories that implement a comprehensive public health approach to suicide prevention across all domains of life—an approach known as the socio-ecological model—can reduce contributing risk factors.

ASTHO Statement on Media Reports Regarding “Banned Words” at CDC ARLINGTON, VA—Michael Fraser, executive director of ASTHO, issued the following statement on recent media reports regarding “banned words” at CDC: “It is critical that public health professionals use science and evidence to make informed decisions to improve the health of the population. Today, ASTHO sent a letter to Acting HHS Secretary Eric Hargan expressing that science must remain the bedrock of policies formulated at HHS. Public health professionals should be empowered by both the Administration and Congress to use the language necessary to convey the importance of their work to the public, policymakers, and other stakeholders. We are encouraged by CDC Director Brenda Fitzgerald’s clarification that there are no ‘banned’ words at CDC and we look forward to continued collaboration across HHS to implement scientifically-sound, evidence-based best practices at the state and territorial levels.” ASTHO Press Release 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.

States have largely dismissed weakening policies, but legislatures are likely to continue considering vaccine-related bills, which may allow public health leaders to work collaboratively toward improving vaccination rates and bolster the positive impact vaccines have on population health.

Two rising health trends are negatively affecting women’s health across the United States: maternal mortality (death from pregnancy or delivery complications) and severe maternal morbidity (mental and physical health consequences from a pregnancy or delivery.) Maternal mortality review committees (MMRCs) are one of the best ways to gather information on why pregnancy-related deaths occur and how to prevent them. Studies show that MMRCs can reduce maternal mortality by 20-50% since they examine the underlying causes of maternal mortality, use data to identify gaps in care, and inform a focused approach to prevent deaths and reduce disparities.

With many of the state and territorial legislatures reconvening over the next few weeks, we can look forward to new (and not-so-new) legislation start to crop up that will impact public health. To help navigate the new legislative sessions, ASTHO’s "2021 Legislative Prospectus" series highlights eight priority policy areas jurisdictions will address during this year. Each prospectus in the series provides a brief overview of the issue, the issue’s impact on health, and recent legislative trends aimed at addressing the issue. This year, ASTHO developed prospectuses on COVID-19, e-cigarettes, HIV, influenza, maternal mortality and morbidity, neonatal abstinence syndrome (NAS), polyfluoroalkyl substances (PFAS), and rural health.

The Catalyst Center for Firearm Injury Prevention will take action to address firearm injury and death as a public health issue using evidence-based and equity-driven public health approaches.

The unintended consequences of substance use disorder policies can be significant for women and families impacted by substance use disorders (SUD).

Evidence-Based Approaches to Promoting Health Equity in Retail Food Safety ASTHO, Association of State and Territorial Health Officials, health equity, food safety, health in all policies, foodborne illness, public health, food code, food service employees, food safety resources, safety standards, barriers to food safety, retail food safety, communication barriers, diversity of language, understand and implement, educational resources, culturally respectful, food science, impacted populations, equitable enforcement, best practices, food safety training, community health, conduct inspections, control measures, jurisdiction demographics Heather Tomlinson ASTHO | Public health agencies can incorporate health equity into their food safety work by tailoring their messages and strategies to their communities. Foodborne illness is costly, preventable, and all too common. Public health agencies are responsible for food safety and reducing foodborne illness by educating and inspecting retail food establishments. Several studies have found that independent ethnic restaurants—those that serve food originating from a culture or heritage of certain ethnic groups—had more violations and, as a result, were inspected more frequently than the average. Some of these violations may be related to a misunderstanding of the food code and/or language barriers. Currently, more than one in four food service employees speaks a language other than English at home and 22% of employees have less than a high school diploma. It is crucial that food safety resources and messaging provided by public health agencies be made available to reflect varying languages and literacy proficiencies to ensure accessibility and comprehensibility for all. Achieving health equity, in which everyone has a fair and just opportunity to attain their highest level of health, requires health agencies to evaluate their approaches to food safety so all food establishments can meet retail food safety standards. Addressing Communication Barriers Health agencies should be familiar with the diversity of languages and cultures in their jurisdiction so materials can be tailored to each community’s differing needs. Providing food safety training courses, regulations, and other materials in languages spoken by local restaurant staff can reduce barriers so restaurant operators and workers who don’t speak or read English fluently have access. Having interpreters or multilingual inspectors can drastically improve communication between inspectors and restaurant staff. For health agencies without these resources, inspectors can utilize photos or translation services, such as Google Translate or language lines, to communicate effectively with restaurant operators. Demonstrating proper practices in person or through videos can also help communicate through observation. With more than half of U.S. adults aged 16 to 74 years old reading below the equivalent of a sixth-grade level, food safety educational resources should be developed so that all populations have access to documents written at educational levels tailored for their community. Educational materials should meet plain language accessibility requirements, including limited text in the appropriate language and simple cultural appropriate imagery. Food safety inspectors can carry materials in multiple languages or have online resources they can share with the retail food facility, such as Washington’s Food Worker Manual or FDA’s Educational Posters that provide flyers on common food safety topics. Finally, newly developed resources should include the target audience in development and pilot testing to ensure they are achieving the desired impact. Designing Materials to Support Your Audience Being familiar with cultural norms and communicating in a culturally sensitive way can enhance the delivery of food safety messaging. One study found that produce safety education materials developed for produce growers in the U.S. Virgin Islands were not seen as culturally appropriate. After redesigning the materials based on community feedback, the managers saw improvements in food safety knowledge and hygiene practices among produce growers. These results and similar studies suggest that educators should partner with impacted populations to evaluate the utility of potential interventions before implementation and ensure they are interpreted as intended. In addition to culturally appropriate food safety education materials, agencies can ensure that they meet the practical needs of the retail environment. For example, materials targeted for mobile facilities (i.e., food trucks) may need to be durable and waterproof to withstand operation and transportation. Ensuring Equitable Enforcement at Your Health Agency Health agencies can incorporate concepts such as equitable enforcement and health equity into their staff’s annual training curriculum. Equitable enforcement promotes compliance with law and policy that considers and minimizes harm to people affected by health inequities. ChangeLab Solutions’ guide on Equitable Enforcement to Achieve Health Equity educates policymakers, advocates, and enforcement officials on best practices in the design and development of enforcement provisions to avoid inequitable impacts and promote community health. A study from Michigan State University found that food safety professionals throughout the United States, especially at the local level, encountered a variety of ethnic food establishments and ethnic foods for which they lacked relevant food safety training. The smartphone application, Cultural Food Safety App, offers searchable information on food safety issues and control measures associated with specific culturally based foods. This app can help regulators better understand cultural foods and their production to ensure foods are being safely prepared and be more familiar with what to look for when conducting inspections. Lastly, health agencies can incorporate a Health in All Policies framework into their food safety practices through ASTHO’s Food Safety Guides. ASTHO strongly supports health agencies in promoting a diverse and culturally competent food safety workforce. By assessing jurisdiction demographics, addressing communication barriers, tailoring resources to fit the audience, and building a culturally competent workforce, health agencies can improve equity in their jurisdiction’s food safety programs. 5U18FD007739-02 website yes

During the the 2021-2022 legislative sessions, several states have enacted laws addressing flu prevention efforts.

The recent mass shootings in Buffalo, Uvalde, and elsewhere across the country, have drawn renewed attention to firearm violence as a major public health issue in our nation. It’s a particularly important issue to consider during Men’s Health Month because men are disproportionately victims and perpetrators of firearm violence.

Across the nation, public health agencies have mounted herculean efforts to stem the COVID-19 pandemic while addressing a pre-existing HIV epidemic and an opioid crisis that is serving as a source for many new HIV outbreaks. Tackling these public health crises simultaneously presents significant challenges as overdose deaths have spiked in the past year while HIV resources have been diverted leading to lower testing rates, fewer prescriptions for as pre-exposure prophylaxis (PrEP) and a decrease in HIV treatment, all of which will are likely to increase the number of acute HIV infections.

Over the past several years, states and jurisdictions have continued to implement important policies to reduce tobacco and nicotine use, including increasing tobacco prices, expanding areas deemed “smoke-free,” limiting the sale of flavored tobacco products, and supporting tobacco cessation programs.

While COVID-19 remains a top public health priority, the pandemic has also intensified the need for strong tobacco control policies and marketing campaigns. CDC recognizes current or former tobacco users as one of several groups at higher risk of severe illness, including hospitalization and death, after contracting COVID-19. It is distressing to see signs that our success in encouraging tobacco users to quit has been slowed over the course of the pandemic. Fortunately, amid these challenges, many tobacco control groups have stayed focused.