ASTHO Leads in Public Health Prevention
ASTHO’s community health and prevention team supports a variety of policies and programs related to chronic disease prevention and heart promotion, healthy aging, injury prevention, and behavioral health, as well as tobacco prevention and control. Additionally, ASTHO assists state and territorial public health agencies in the development, coordination, and implementation of comprehensive, evidence-based approaches to wellness, with the goal of addressing America’s major health problems and leading causes of death and disability.
Through learning collaboratives, ASTHO supports multiple states working on quality improvement activities to provide targeted technical assistance and facilitate state-to-state collaboration. Two such learning collaboratives that have been particularly successful are the Long Acting Reversible Contraception (LARC) Learning Community, as well as the Increasing Access to Contraception Learning Community, both of which fall under ASTHO’s work to support maternal and child health.
The LARC Immediately Postpartum Learning Community launched in 2014 with the goal of assisting state health agencies in LARC implementation, specifically via initiatives focusing on postpartum insertion following delivery. The learning community began with six states and expanded to 13 states in 2015. In 2016, given the success of the first learning community, ASTHO launched its second iteration, the Increasing Access to Contraception Learning Community, a collaboration with CDC’s Division of Reproductive Health, the Centers for Medicare and Medicaid Services, and the Office of Population Affairs. Since 2016, the learning community has expanded to 27 states and territories—meaning that participation has more than doubled in each year that the learning community has been in existence.
“The intention of the learning community is to help reduce unintended pregnancies, improve birthing outcomes for infants and maternal outcomes for women, and provide a whole host of other wonderful benefits,” says Ellen Pliska, director of the family and child health team at ASTHO. “Through our work, we hope to disseminate strategies and best practices to states and help implement policies and programs that provide access to a full range of contraception, whether it’s immediate postpartum LARC or other methods. To this end, we are working to develop a whole menu of things that states can do to increase access to contraception.”
Another area of success for ASTHO has been its work to prevent and reduce infant mortality. While U.S. infant mortality rates have been slowly declining in recent years, the rate remains consistently higher than that of other developed countries and preliminary data suggests that rates may be trending upward. To help address and mitigate this difficult problem, ASTHO joined the Infant Mortality Collaborative Innovation and Improvement Network (CoIIN), a multiyear national initiative led by HRSA’s Maternal and Child Health Bureau and the National Institute of Child Healthcare Quality. By engaging federal, state, and local leaders, as well as public and private agencies, professionals, and communities, ASTHO hopes to reduce infant mortality and improve birth outcomes through collaborations with CoIIN.
“ASTHO’s primary role is to help inform the infant mortality CoIIN strategy and direction, support and engage state health leadership and state health agency staff, as well as develop and disseminate resources for new and innovative strategies,” says Christine Macki, senior director of the family and child health team at ASTHO. “ASTHO serves as a thought leader on public health practice, quality improvement, and policy related to pre- and inter-conception care and risk appropriate perinatal care. We have the capacity to reach state health officials and their leadership teams to highlight promising, evidenced-based practices to improve social and behavioral factors and address health and health outcomes of women, infants, and their families.”
Another key success has been ASTHO’s work as a Million Hearts partner. Million Hearts is a national initiative aimed at preventing one million heart attacks and strokes by 2017. Launched in 2011, the initiative brings together public and private partners to enhance cardiovascular disease prevention activities and improve care by encouraging a focus on the ABCS—i.e., aspirin for people at risk, blood pressure control, cholesterol management, and smoking cessation. State public health agencies are a key partner in preventing heart attacks and strokes, as they play a critical role in the identification of best and promising public health interventions for prevention and early identification of heart disease and have unique opportunities to link with clinical care. As a Million Hearts partner, ASTHO supports state health agencies and other state partners in addressing components of the Million Hearts initiative, particularly around blood pressure control.
“Our Million Hearts work has spawned long-term sustainable relationships,” says Elizabeth Walker Romero, senior director of the health improvement team at ASTHO. “And that is what public health does. It’s about helping people, and it’s also about putting in place a framework and building relationships. Our work with Million Hearts has really helped us accomplish that important work.”
ASTHO’s community health and prevention team has also led successful work surrounding prescription drug misuse and addictions. This important work began in 2014, with a challenge led by Terry Cline, commissioner of health at the Oklahoma State Department of Health, who served as ASTHO’s president from 2013-2014. Through Cline’s initiative, “15 by 15: Reduce Prescription Drug Abuse and Deaths 15 Percent by 2015,” ASTHO challenged U.S. state and territorial health agencies to reduce the rate of nonmedical use and the number of unintentional overdose deaths involving controlled prescription drugs 15 percent by 2015.
“When we first started, four years ago, with Cline’s challenge, public health wasn’t even considered a normal partner at the table on prescription drugs. Cline helped to elevate public health’s role in addressing this critical issue, and now we’re cementing and expanding on that work,” says Walker Romero. ASTHO President Jay Butler’s 2017 President’s Challenge continues Cline’s work by focusing on public health approaches to mitigating the health impacts of substance misuse and addictions.
“It’s a great success for ASTHO and public health that we are now seen as an integral partner in addressing the opioid and substance abuse epidemic.”
For more information about these and other successes, visit ASTHO’s prevention web page.