Displaying 1-20 of 52 results for

2020 has been a year of unprecedented events, and the past few months have already shown that they do not exist in a vacuum. While the country continues to respond and cope with the COVID-19 pandemic, many extreme weather events have already occurred, and are additional infectious disease challenges to consider. Responding to these events in the current conditions presents unique challenges to responders and communities.

On Dec. 3, the International Day of People with Disabilities commemorates disability rights and brings awareness to essential issues for those with disabilities by promoting the “well-being of persons with disabilities in all spheres of society.” While the ADA laid a critical foundation for disability rights, the work to ensure equitable access to services and needs continues, including access to state and local emergency preparedness and response activities like crisis communication, access to resources, allocation of vaccine and other medical countermeasures, and transportation.

People who use electricity-dependent durable medical equipment (DME) at home—such as ventilators and oxygen concentrators—can face life-threatening consequences during a power outage. HHS reports that 2.7 million Medicare beneficiaries rely on electricity-dependent DME to live independently. This ASTHOBrief details the significant challenges that individuals who rely on electricity-dependent DME face during power outages and discuss recent efforts to increase support for this population.

Better Defining Disability Will Make Data More Inclusive and Usable ASTHO, association of state and territorial health officials, access to health care, centers for disease control, syndromic surveillance systems, health outcomes, person with a disability, disaster medical assistance team dmat, mental health conditions, people with disabilities, health disparities, mental health, health equity, public health emergencies, syndromic surveillance, disaster medical assistance teams, disability data, people living with disabilities, disability inclusion Margaret Nilz ASTHO | Syndromic surveillance data on disability prevalence will help people with disabilities in emergencies. Over the past two decades, the frequency and intensity of natural disasters have increased — and will continue to do so. While disasters impact whole communities, past incidents highlight specific effects on people with disabilities, as it is more challenging for them to prepare for and recover from an incident. Understanding the prevalence of disability in a jurisdiction helps fully address the population’s needs.​ There is not a universally accepted way to collect data on people with disabilities. However, the need for disaggregated data by disability status is critical to helping measure health disparities and underlying factors contributing to inequities. Such data will support the development and continuous evaluation and improvement of public health programs and policies. Key Considerations for Collecting Data on People with Disabilities Disability data is essential for inclusive public health practice. Several factors are important to keep in mind when gathering data on people with disabilities. Participation is critical as exclusion from research can further marginalize already vulnerable groups and limit access to advancements. Accounting for historical trauma/negative impacts helps people with disabilities who are at increased risk of coercion, inclusion without consent, and other exploitation. Unwarranted disability assessments, particularly those implemented with limited evidence of effectiveness, have been shown to have negative mental health impacts on participants with disabilities. Different models of disability provide a reference as programs, services, laws, and regulations are developed. Primary models of disability include the Medical Model, Functional Model, Social Model, and Medical/Rehabilitative Model. Current Measures and Definitions of Disability - Brief - Better Defining Disability Disability Inclusion in National Syndromic Surveillance Program (NSSP) NSSP includes electronic health record (EHR) data from 73% of the nation’s emergency departments (EDs). However, it contains no systemic way to identify people with disabilities. Including disability data within a system as valuable as NSSP can help close gaps in monitoring the impacts of emergencies on people with disabilities. Syndromic surveillance data can guide decision-making during emergencies and policy formation at the local, state, and national levels. There are limitations of using syndromic surveillance data. First, diagnostic codes may not map directly onto functional limitations. Second, codes do not provide information about residual functioning, loss of functioning, or disability severity. Additionally, reporting in EHRs may not be accurate due to input or data errors. Codes can be related to a visit or encounter, even if it does not end up being true for a patient. Furthermore, diagnostic codes reflecting disability may not be used in every encounter and people with disabilities may be missed through using ED data as it only represents a snapshot in time. Benefits of Expanding Disability Data Access and Use Expanding the collection, access, and use of disability data for public health program development and emergency preparedness promotes health equity for people with disabilities. More specifically, this data can inform fiscal, programmatic, service policy, and public health planning decisions. When Disaster Medical Assistance Teams (DMATs) deployed to shelters in North Carolina, CDC’s NSSP team asked health officials if they wanted to integrate these data. Within 24 hours, data from DMATs were available in NSSP, providing a snapshot of health in those shelters. Data were monitored along with ED visits to give a complete picture of the storm’s health impacts. In 2017, Hurricane Harvey made landfall in Texas, resulting in 88 deaths and $125 billion in infrastructure damage. Public health officials used syndromic surveillance to understand increases in ED visits by those who evacuated to the Dallas–Fort Worth (DFW) area. Area hospitals saw roughly 4,400 more ED visits than normal; at least 600 were evacuees. Syndromic surveillance data demonstrated extensive health care services use outside the affected areas by highlighting the importance of surge capacity planning one to four hours outside the disaster area. Ongoing Efforts Through a cooperative agreement with CDC, ASTHO is working with subject matter experts to create a definition of disability for syndromic surveillance. ASTHO conducted key informant interviews with disability professionals to inform the development of this new diagnostic code-based definition, along with four scientific panels to assess the drafting and review of national and state-level pilot testing. An expansion of this kind benefits jurisdictions through increased data capacity for fiscal, programmatic, and service policy decision-making and supporting longitudinal tracking of prevalence and risk. Conclusion Efforts to expand data about people with disabilities can help build public health capacity to monitor the health and well-being of people with disabilities before, during, and after public health emergencies. However, efforts in data collection on disabilities require interoperability and standardization across all systems to be successful. Efforts to contextualize public health emergency data and gather supporting data on impacted populations allow health officials to better turn data into action in pursuit of health equity across public health emergencies. NU38OT000290 website yes

This infographic breaks down the top 10 takeaways from the 2022 Climate and Health Capacity Survey.

Danny Staley (alumni-NC) discusses his role as ASTHO’s Chief of Caribbean Operations and how his time as North Carolina's state health official helped him prepare for his current position.

States are preparing to keep their communities safe during severe storms and low temperatures this winter.

Health agencies play a key role in preparing for and responding to hurricanes and other severe weather events.

While communities transition from emergency response to long-term monitoring and recovery, the federal government and states are taking legislative action to improve emergency preparedness capabilities.

Wildfire and Wildfire Smoke Guidance and Resources ASTHO and various public health agencies list of wildfire resources and guidance. Following the 2023 wildfire smoke events that impacted several states in the Midwest, Northeast, and Mid-Atlantic, as well as the devastating wildfires that impacted Hawaii, ASTHO developed a document that included a list of federal, state, and partner organization resources on wildfire smoke information and how to message that information to the public to support public health officials, clinicians, schools, and communities. These include air quality data, health guidance, masking and ventilation tips, and communication tools to protect specific groups, pets, and outdoor workers. Get the Resource (PDF) article yes

As the United States begins to see more wildfires, it is important for health agencies to be ready to address concerns from the public and collaborate with other state agencies to mitigate the health risks of wildfire smoke.

Learn how health agencies are prioritizing children’s health as they develop public health emergency preparedness planning in this blog.

Communicating the Health Risks of Wildland Fire Smoke Communicating the Health Risks of Wildland Fire Smoke Kerry Wyss, Ali Aslam Learn how state agencies effectively communicate the dangers of wildfire smoke to local communities in this report. Wildfires continue to be a growing risk across large swathes of North America, one of the largest effects of these fires being severe smoke. Smoke from wildland fires — wildfire and prescribed burns — can pose serious health risks to communities, particularly for sensitive or vulnerable populations such as children, older adults, and those with respiratory or cardiovascular conditions. Wildfire smoke can spread rapidly over long distances, so timely and accurate risk communication is essential during wildfire events to help communities understand the dangers of smoke exposure and take protective actions. ASTHO hosted a wildland fire focus group in January 2025 to talk through lessons learned by state and territorial health and environmental agencies in managing wildland fire response. The group identified needs to improve community health in wildland fire response through health risk communication, disseminating information, and developing programs to support public health action (i.e., exposure reduction). Learn more about these takeaways and actionable strategies for wildland fire response in the full report. Get the Report (PDF) article yes

Building a Resilience Framework in Colorado Creating Resilient Communities in Colorado Heather Tomlinson, Kerry Wyss Learn how Colorado public health is building community and cross-sector partnerships to build community resilience. Following the 2012 wildfire season and the 2013 Colorado Floods, Colorado recognized the opportunity to better prepare for natural disasters and coordinate efforts across state agencies to build resilience into their regular operations. In 2015, Colorado became the first state to develop a resilience framework and created the Colorado Resiliency Office (CRO) with the goal of building more resilient systems in the face of shocks and stressors. The Colorado Resiliency Working Group (CRWG) is an interagency group that meets on a quarterly basis to collaboratively implement and advance resilience actions and goals. The Colorado Resilience Framework serves as interagency guidance on strengthening resilience and emphasizes finding co-benefits across community sectors, reducing community risk and vulnerability to disruptions, and supporting the state in anticipating and preparing for current and future conditions. The framework is updated every five years to adapt priorities and to keep up with current conditions. Changes from 2015 to 2020 included a shift from focusing heavily on long-term recovery to taking a more holistic approach to resilience. The CRWG is currently working on the 2025 update with a focus on statewide vulnerability where they can have the most impact and prepare for future conditions with available resources. They are also focusing on clear metrics and being able to communicate progress effectively. The state also created a statutory definition of resilience, which has helped with coordination across long- term projects and agencies. Coordination with Partners Resiliency work in Colorado is greatly enhanced by working with a wide range of partners that bring their subject matter expertise to the table. As a state with strong local control, Colorado has prioritized working collaboratively with local partners, providing technical assistance and subject matter expertise to support their work on the ground, from planning support to targeted grant programs. This collaboration helps ensure continuity from the state to the local communities. Colorado’s approach to resilience ensures resilience is integrated within its many agencies. For example, the Colorado Department of Public Health and Environment (CDPHE) has continued to evolve and advance their agency’s resiliency work. Beginning March 2025, CDPHE developed a monthly internal working group to funnel knowledge into resilience leadership across CDPHE — including environmental health, chronic disease, environmental justice, disease and public health, and air pollution. Their goal is to build partnerships across internal programs and state agencies. The CRO was first established in the Governor's Office and moved to the Department of Local Affairs (DOLA) in 2018. This move strengthened continuity of its long-term work and, given Colorado’s strong local control governance structure, enabled the CRO to further the goals of building a more resilient Colorado by partnering with and supporting local governments with planning and technical assistance to build greater resilience. The CRO offers flexible Future-Ready Technical Assistance Opportunities for state agencies, which helps them apply adaptability and future-visioning lenses to their resiliency principles in programs and operations. To involve the wider network of resilience practitioners within communities across the state, the CRO launched a community of practice on LinkedIn to foster peer-to-peer learning and dialogue and ensure all voices are heard in a collaborative environment. The Governor’s Office of Climate Preparedness and Disaster Recovery (CPO), facilitates cross agency coordination and collaboration while driving proactive state-wide climate preparedness priorities and supports development of the state’s disaster recovery capacity and capabilities. The CPO also coordinates efforts to ensure that the state budget and legislative processes reflect statewide climate preparedness, disaster recovery, and resilience priorities and leads the development of Colorado’s Climate Preparedness Roadmap — a strategic guiding document updated every three years that uses the best available science and data to prioritize near-term climate adaptation actions across Colorado state government. In collaboration with the implementing state agencies, the first Roadmap, released in 2023, set achievable near-term action items ensuring clear steps to strengthen climate resilience and adaptation. Among the actions, the Roadmap outlined the need to tackle extreme heat through a collaborative interagency approach, while better understanding the unique ways that heat affects Colorado. Social and community capacity were also outlined in the framework as a priority. CDPHE has worked with the Governor's Office to evaluate best practices and strategies tailored for each unique region and implemented their first heat plan in 2024. Extreme heat can be deadly and is projected to continue to intensify. CPO takes the lead in coordinating extreme heat work across agencies. They are partnering with the Colorado State Forest Service to pilot solutions such as climate-smart tree planting to help keep people safe during high-heat events by reducing ambient neighborhood temperatures and shading individual homes to lower indoor temperatures and reduce cooling costs for residents. Building Disaster Recovery Capacity Colorado is investing in disaster preparedness and recovery capacity to reduce the impacts of disasters, help communities recover more effectively, and build resilience into recovery efforts. Ensuring strong recoveries allows for the integration of strategic investments in resilience and hazard mitigation, which the state did in partnership with Xcel Energy — in the wake of the Marshall Fire, the state provided financial assistance to rebuild home to high performance standards and integrated wildfire mitigation actions during the rebuild process. In recent years, Colorado has expanded their recovery investments, including the addition of key positions in targeted recovery areas including within CPO, at DOLA within the Division of Housing and within the Division of Local Government, at the Colorado Department of Agriculture, and at the Department of Public Health and Environment. Technical expertise and capacity at the agency level is leveraged to strengthen preparedness and to support recovery from state declared disasters through the Colorado Department of Public Safety's State Recovery Task Force, providing recovery expertise when activated according to their assigned Recovery Support Function (RSF). Colorado partnered with FEMA’s State Technical Assistance for Recovery Strategies Program to develop processes and strategies that can be integrated into the RSF plan updates within the State Emergency Operations Plan, and to refine RSF functions, capabilities, and partnerships. Over the last year, the state has additionally conducted numerous discussion-based exercises to strengthen RSF relationships and operational capability. The state continues to identify and enhance new opportunities in supporting local communities with pre- disaster recovery technical assistance. Examples include: Hosting Department of Public Safety-led regional recovery symposiums. Piloting additional focused recovery workshops that prioritize rural and less resourced communities. Developing and refining disaster recovery planning tools. Offering recovery and resilience toolkits and expertise to local governments led by DOLA. Strengthening integration of disaster considerations into local planning processes. Colorado implemented this work in summer 2025 when the state experienced numerous wildfires in short succession that received state disaster declarations, activation of the State Recovery Task Force, and required close state-local disaster recovery coordination. Ensuring strong recovery capacity and capabilities is critical to long-term resilience, enabling communities to recover more quickly, more completely, and in ways that integrate proactive resilience strategies. A Path Towards Long-Term Sustainability A key element in Colorado’s long-term approach to building resiliency is closely involving the local community. Building robust community planning and response capabilities at the local level allows for agencies to tailor plans to community needs and ensures everyone is engaged in the process. The CRO, in collaboration with state agency partners in the CRWG, developed the Guidance for Local Government Climate Adaptation, which provides comprehensive guidance, funding resources, case studies, and connections to state and federal programs that can provide support in over 25 implementable actions. The CRO has also focused their resiliency work on anticipating what is to come down the road by assessing current and future community needs. An example is the Rural Resiliency and Recovery Roadmap Program, which brought together 16 different regional community teams with over 150 rural jurisdictions and non-governmental partners to support diversifying and strengthening their economies while building regional resiliency following the COVID-19 pandemic. Each regional team developed a roadmap that evaluates local stressors and how conditions may change in the future. This program also looks at what may impact the community from perspectives of housing availability, workforce, and potential resiliency stressors. Another example is the Camp Resilience: A Rural Prosperity Leadership Academy program, which offers a summer camp themed workshop to build rural community capacity to long-term stressors such as droughts, population loss, climate change, and lack of affordable housing. While funding cycle ebbs and flows

Environmental health and public health preparedness staff work closely together to respond to natural disasters and climate change—learn how in this report.

This report provides critical insight into the top environmental health and natural disaster preparedness concerns across the nation.

How Mississippi Prioritizes Environmental Justice During Disaster Response Association of state and territorial health officials, astho, environmental health, environmental justice, public health, cross sector partnerships, emergency preparedness, natural disaster response, emergency response, health equity, social determinants of health, missisippi state department of health, office of environmental health, office of health equity, covid 19 pandemic, emergency planning and response Ali Aslam, Yaryna Onufrey, Beth Giambrone This case study dives into the Mississippi State Department of Health’s environmental justice initiatives, conducted using cross-sector partnerships. Environmental justice is defined as all people enjoying the same degree of access and protection from environmental and health hazards. This happens by intentionally involving all people—regardless of race, color, national origin, or income—while developing, implementing, and enforcing environmental laws and policies. The Mississippi State Department of Health incorporates environmental justice principles into their disaster response and emergency preparedness efforts. Mississippi's environmental justice work has been community-based and equity-driven. This case study dives into Mississippi’s cross-sector partnerships, community health initiatives, and health equity work as the state has worked to address environmental health concerns. Get the Report (PDF) website yes

Implementing Health in All Policies in the Climate Space ASTHO, Association of State and Territorial Health Officials, HiAP lens, Health in all policies, climate change, climate space, flooding and rain, extreme weather, extreme heat, wildfire damage, seven strategies, Texas workgroup, national disaster operational workgroup, Washington state department of health, emergency preparedness and response, hiap implementation, Wisconsin department of health services, new mexico taskforce, interagency climate change taskforce, climate action teams, Climate and Health Capacity Survey, HiAP Task Force; Climate Change Commission, Resilience Initiative Kerry Wyss, Ali Aslam ASTHO | A Health in All Policies approach can help public health agencies better address the impact of climate change on population health and well-being. Each year, we face hurricanes, floods, extreme heat events, destructive wildfires, as well as other natural disasters and homeland security threats that test the resiliency of state, territorial, and freely associated state agencies and the communities they serve. To address the health threats posed by natural disasters and by climate change, more health agencies are integrating a Health in All Policies (HiAP) approach. This cross-sector approach can make these climate efforts more effective and impactful, and help promote health equity and optimal health. This report outlines strategies for health agencies to apply the HiAP lens and utilize cross-sector collaboration to optimize their climate and health responses. Get the Report (PDF) website yes

This report analyzes the results from a survey of state and territorial health agency staff to collect information regarding health agency efforts to address climate change and extreme weather.

This post features input from departments in North Carolina, South Carolina, and Texas to learn more about their experiences of post-hurricane environmental health issues, as well as advice and best practices for responding to these challenges.