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ASTHO President's Challenge Initiatives

A yearly initiative of ASTHO to improve population health through the work of state public health agencies.

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  • States Enact Tobacco 21 Laws

    CDC recognizes tobacco use as the leading cause of preventable disease, disability, and death in the United States and estimates that each day, approximately 2,000 people under age 18 smoke their first cigarette, with more than 300 becoming daily cigarette smokers. In 2015, the Institute of Medicine projected that if the age of sale for tobacco products was set at 21 years of age across the country, there would be 249,000 fewer premature deaths. Since the report was published, several jurisdictions have increased the age of sale for tobacco products to 21. By the end of 2018, laws to increase the age of sale, also known as tobacco 21 laws, were enacted in six states—California, Hawaii, Maine, Massachusetts, New Jersey, and Oregon—as well as Washington, D.C. and Guam.

  • Women, Syphilis, and Drug Use: A Renewed Convergence

    Women’s health is again threatened by the convergence of syphilis and drug use. In 1988, the health risk was driven by the co-epidemics of crack cocaine and syphilis. Today, the threat again comes from syphilis, this time combining with the epidemics of methamphetamine, heroin, and other injection-drug use. To protect women’s health, we should rethink how we can address this syndemic (i.e., two or more health problems interacting synergistically) while drawing on the lessons learned from prior syphilis increases and from the longitudinal relationships between healthcare providers and people living with HIV.

  • Public Health and Interoperability: A State Perspective

    Karen Smith, MD, MPH, is state health officer for the California Department of Public Health (CDPH). Formerly a public health officer for Napa County Health and Human Services Agency, Smith brings a wide array of knowledge as a physician specializing in infectious disease and public health. ASTHO recently spoke with Smith about the department’s capacity to address population health outcomes through informatics, analytics, and interoperability.