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States Partner Across Sectors to Address Lead Poisoning Kayley Humm, Kerry Wyss, Ali Aslam Learn in this brief how three states are using partnerships to improve lead testing and reduce cases of lead poisoning. ASTHO partnered with the National Center for Healthy Housing (NCHH) to provide technical assistance and capacity-building support for lead poisoning prevention efforts in three state health agencies: Maryland Department of Health, North Dakota Department of Health and Human Services, and Arkansas Department of Health. This brief highlights each agency’s strategies for collaborating across sectors along with accomplishments for strengthening lead poisoning prevention capacity in each jurisdiction. Many of these strategies align with those used in a health in all polices (HiAP) approach to lead poisoning prevention. State Examples Maryland Department of Health Maryland adopted a collaborative approach to prevent lead poisoning. The Maryland Department of Health (MDH) has an established lead poisoning prevention program that partners with the Maryland Department of the Environment. The Department of the Environment oversees the childhood lead registry and case management, while MDH focuses on lead testing regulations and Medicaid services. This partnership has been implemented across the 24 local health departments in the state. Maryland enhanced lead case management by providing staff support and tackling complex cases that require additional assistance. In addition to supporting an increase in lead case management activities and lead awareness, ASTHO funding also helped strengthen collaboration and coordination among local health departments, state agencies, and local health care providers. The MDH Environmental Health Bureau also improved efficiency by moving data from the lead registry to MDH for lead surveillance and case management. They also developed and launched sub-county lead testing data as part of their Environmental Public Health Tracking public portal. These activities align with HiAP strategies of developing and structuring cross-sector relationships, coordinating funding and investments, and synchronizing communications. North Dakota Department of Health and Human Services The North Dakota Department of Health and Human Services (NDHHS) made significant strides in building up the state lead program, which recently transitioned from the department of environmental quality to NDHHS. With support from ASTHO and NCHH, NDHHS developed a lead prevention website with a data dashboard, developed a lead screening questionnaire, and built collaborative partnerships. The activities in North Dakota align with the HiAP strategies of developing and structuring cross-sector relationships, synchronizing communications, and integrating research, evaluation, and data systems. Building collaborative partnerships is a key initiative for the NDHHS lead program. Already developed partnerships include stakeholders such as Health Tracks and WIC. Health Tracks developed a newsletter article for their provider network so physicians can stay up to date and aware of the lead program transition and lead testing changes, and WIC will host informational lunch and learns to raise awareness about lead testing within their network. North Dakota is also prioritizing building partnerships with tribal communities. A tribal communications plan was developed with the goal of establishing an effective communication plan between the state of North Dakota and each tribal government for lead-related events. Anticipated outcomes from the communication plan include testing for blood lead levels, conducting environmental assessments on tribal lands, and seeing if a tribal member or government is interested in hosting a lead screening event. Progress has been made with the Standing Rock Sioux Tribe, Turtle Mountain band of Chippewa, and NDHHS is hopeful to establish intertribal meetings with all four governmental tribal representatives. Arkansas Department of Health The Arkansas Department of Health established its lead program in 2011 to support abatement of lead-based paint in residential and commercial properties. With support from ASTHO and NCHH, Arkansas has been using a data-driven approach to gain a more comprehensive understanding of lead exposure burden in the state. These activities align with the HiAP strategy of incorporating health data into decision-making and integrating research, evaluation, and data systems. The Arkansas Department of Health conducts periodic audits on its data system to support access to timely and accurate data. To improve data quality and frequency of blood lead testing reports, the health department is establishing incentive programs to encourage facilities to report cases of elevated blood lead. In addition to conducting outreach to its partners, the Arkansas Department of Health has been working to improve lead case data access and data quality through data mining efforts, case report matching, and migration to a new lead surveillance system. Arkansas has been working to modernize the current reporting system to facilitate automation and promote overall efficiency of data analysis and case identification. Conclusion The collaborative efforts of Maryland, North Dakota, and Arkansas highlight the importance of multi-sector partnerships and data sharing in addressing lead poisoning prevention and align with many of the strategies used in a HiAP approach. Each state implemented tailored strategies that sought to grow collaboration in its unique context. These initiatives highlight the importance of cross-sector collaboration in public health initiatives and may serve as valuable models for other jurisdictions. article yes

Learn about the role and impact of State offices of Rural Health in a Q&A with Alisa Druzba.

Partnering with Community Action Agencies Can Improve Trust in Vaccines astho, association of state and territorial health officials, association of state and territorial health officials astho, state health official, public health official, territorial health official, island jurisdictions, state health, health department, public health, state and territorial health, social determinants of health, johns hopkins, advance health equity, socially determined, health inequities, race ethnicity, covid-19 vaccines, health disparities, vaccine supply, high income countries, vaccine equity, vaccine distribution, vaccine hesitancy, immunization, centers for disease control, community action agencies, covid19 pandemic, at-risk populations, healthy equity Geetika Nadkarni Learn how community action teams are working to improve COVID-19 vaccine acceptance and uptake in their own communities. In the current climate surrounding vaccinations and other large-scale public health measures, it’s more important than ever for public health to engage communities. One way to do this is through working with community action agencies (CAAs), local entities that work to reduce poverty and reduce disparities among the populations they serve. Funded through the Community Services Block Grant (CSBG), CAAs are an ideal complement to public health’s mission to address the social determinants of health and achieve greater equity. With support from CDC, ASTHO is working with the National Community Action Partnership and five CAAs in the Partnering for Vaccine Equity project, which aims to increase acceptance and uptake of vaccines among racial and ethnic minority groups and in rural communities. ASTHO chose to partner with CAAs as trusted community agents for this project because of their existing relationships within communities through programs such as Head Start, food banks, federal nutrition programs, and employment and housing assistance. Through their internal and external partnerships, they can reach people who may be concerned about vaccine safety and/or lack access to vaccination sites. Through this project, CAAs are partnering with residents, faith-based organizations, local schools and universities, state and local public health departments, and non-profits active in the community. They are also engaging a range of local providers, such as federally qualified health centers (FQHCs), physicians, community health workers, medical and nursing students, and emergency medical technicians (EMTs). These community action teams are working together to improve vaccine acceptance and uptake and to customize evidence-based strategies to their own communities and neighborhoods. article yes

SepticSmart Week is an annual opportunity for health agencies at all jurisdictional levels to share educational resources about onsite wastewater treatment system upkeep. This post highlights efforts in North Carolina and Virginia to promote safe septic system practices.

An interview with DELPH scholars Halina Palacios and Nathifa Miller about the importance of developing a strong leadership style, advice for future public health leaders, and using the DiSC Personality Assessment.

A Q&A with DELPH participants James Bell III and Sandy Noel about their experiences in the program and why it is so important to develop your own brand as a leader.

The COVID-19 pandemic highlighted the importance of having in-house skills to respond to worldwide public health emergencies. Because of this, the American College of Preventive Medicine recommends that health departments consider bringing a board-certified preventive medicine physician on staff or to have one available to assist with preparedness and population health interventions.

This interview is part of ASTHO’s Leadership Trailblazers series, which shares outstanding public health leaders’ inspirations, motivations, and accomplishments. This post features CDC Director Rochelle Walensky, MD, MPH.

While governments have faced challenges in adopting a Health in All Policies (HiAP) approach to respond to COVID-19, the impact of the public health emergency across sectors such as housing, transportation, and employment has created a unique opportunity for stakeholders to build and strengthen collaborative systems to address the inequities exacerbated by COVID-19.

In the late fall of 2021, ASTHO leadership visited select jurisdictions in the Pacific and the Atlantic for the first time since COVID-19 curtailed travel to these regions. It was a fantastic to reconnect with our leadership and dedicated staff. Unsurprisingly, we heard about the jurisdictions’ challenges, including chronic ones related to funding and infrastructure, as well as new challenges resulting from the global pandemic.

As we anticipate the likely approval of COVID-19 vaccination for children, our nation faces the final step to bring the COVID-19 pandemic under control. If approved for children ages 5-11, the COVID-19 vaccine will dramatically improve our efforts to resume in-person learning in our nation’s schools and will help break the cycle of transmission from children to adults.

Nov. 3, 2021, marks the sixth annual One Health Day, a global campaign to recognize and embrace how public health is connected to the health of animals and our shared environment. In this post, ASTHO talks about One Health with Wayne E. Cascio, MD, who serves as the Acting Principal Deputy Assistant Administrator for Research and Development at EPA.

The Special Supplemental Nutrition Program for Women, Infants, and Children is a targeted public health nutrition program designed to support nutrition and health behaviors that reach low-income families. The program is funded through discretionary funds to the United States Department of Agriculture and administered by each state’s health or public health department. The department then contracts with county health departments, local health centers, hospitals, federally qualified health centers, and private nonprofits to deliver community-based clinic services.

In 2020, the COVID-19 pandemic exacerbated barriers to care and treatment for individuals experiencing opioid use disorder. Experts estimate a record-setting 90,000 people died of a drug overdose in 2020. Additionally, as the pandemic continues, it has understandably diverted attention, funds, and personnel usually focused on the opioid crisis. State and local public health departments are experiencing an all-time low in staffing, especially among Maternal and Child Health programs.

Six questions with Scott Becker, CEO of the Association of Public Health Laboratories. Becker is active in national and international public health initiatives. He chairs the Governance Working Group for the Global Laboratory Leadership Program, a collaboration with the World Health Organization, CDC, and others to develop a competency-based curriculum for laboratory leaders. Additionally, Becker is a member of the Affiliate Council of ASTHO, which he formerly chaired.

Pharmacies have long been instrumental partners in providing lifesaving vaccines nationwide. As state and territorial health officials evaluate their COVID-19 response, planners must include input from the pharmacy community when identifying areas for improvement, as well as best vaccination practices in advance of future public health emergencies.

Each year, ASTHO tracks and analyzes key legislation that impacts public health, and highlights the emerging trends for our members. While the bulk of the tracked legislation arises in state legislatures, ASTHO also follows legislation from the territories and Freely Associated States, jurisdictions collectively referred to as the insular areas. The insular areas often face different challenges than the states, while also sharing many common concerns. This post contains a brief look at some of the public health related legislation introduced in the insular areas during their current legislative sessions.

Although suicide was a critical public health issue in the U.S. long before the COVID-19 pandemic began, Americans are now reporting increased mental health challenges like depression, anxiety, and suicidal behaviors. In addition, millions have experienced financial hardships, social isolation and loneliness, and increased stress—all of which are shared risk factors for mental health conditions, suicidal behaviors, and substance misuse. State public health officials have taken bold action over the past 12 months to mitigate the physical impacts of COVID-19, and the same swift action should be applied to mitigate the acute and potential long-term mental health, suicide, and substance use impacts. The National Response’s "An Action Plan for Strengthening Mental Health and Prevention of Suicide in the Aftermath of COVID-19" provides a roadmap for addressing the mental health, suicide prevention, and substance misuse prevention needs spurred by COVID-19.

May is Mental Health Awareness Month and the importance of continued mental health promotion and suicide prevention efforts during the COVID-19 pandemic. As we address the physical effects of COVID-19 through social distancing, mask wearing, and vaccination, we still need to prioritize mental health and well-being during and after the pandemic. A recent Morbidity and Mortality Weekly Report found increases in adults reporting symptoms of anxiety or depression (36.4% to 41.5%) and unmet mental health care need (9.2% to 11.7%) between Aug. 2020 to Feb. 2021.

In recognition of National Infant Immunization Week, ASTHO and AMCHP interviewed Michael Warren, MD, MPH, FAAP, and Associate Administrator of the Maternal and Child Health Bureau (MCHB) at the Health Resources and Services Administration (HRSA), for his thoughts on how we can protect our infants and children from vaccine-preventable diseases during this extraordinary time. Especially now, as COVID-19 vaccination expands across the country—including the hope for a vaccine for children (five years and older), and with the promise of a return to in-person education, families and communities must quickly catch up on missed vaccinations.