Featured Story

FeaturedStory

May is Mental Health Month, a time to recognize the ways mental health is tied to state health agency priorities, such as chronic disease, substance misuse, and suicide prevention. According to the National Institute of Mental Health, there is a strong link between mental illness and chronic disease with, for example, depression increasing the risk of cardiovascular disease, diabetes, stroke, and Alzheimer’s disease.Read More »

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Increasing Number of States Require Naloxone to be Co-Prescribed with Opioids

August 15, 2019|1:22 p.m.| ASTHO Staff

This month’s "Vital Signs" report from CDC examines the prescribing and dispensing of naloxone by retail pharmacies. The availability of naloxone, a medication that can reverse the effects of an opioid overdose, has been identified by the U.S. Surgeon General as a key component in the public response to the opioid epidemic. The CDC report reveals that the prescribing and dispensing of naloxone has increased over the last few years while acknowledging additional room for improvement. For example, in 2018, only one naloxone prescription was dispensed for every 69 high-dose opioid prescriptions (i.e., prescriptions for opioid dosages equal to or greater than 50 morphine milligram equivalents, or MME, per day). . Read More »

State Legislative Approaches to Address Disparities in Maternal Mortality

August 08, 2019|2:35 p.m.| ASTHO Staff

The United States is the only developed country with an increasing rate of maternal mortality. The maternal mortality rate has doubled over the past two decades, with evident racial and ethnic disparities. According to data from CDC’s Pregnancy Mortality Surveillance System, non-Hispanic black women are three times more likely to die from pregnancy-related complications compared to their white non-Hispanic counterparts. In fact, reports show that a higher proportion of African American women do not receive the recommended number of pre-natal visits, which is a factor in pregnancy-related deaths. African American women are also more likely to die from pregnancy-related deaths, even after controlling for factors such as age, pre-natal care, and income, according to recent studies. Data from CDC indicates that nearly 60 percent of maternal deaths in the United States are preventable and most occur within 42 days of the postpartum period. . Read More »

Member Spotlight: Alexander Billioux

August 08, 2019|2:13 p.m.| ASTHO Staff

Alexander Billioux, MD, DPhil, is assistant secretary of health for the Louisiana Department of Health's Office of Public Health. Billioux is an internal medicine physician focused on improving individual and community health through innovative public health approaches, including cross-sector population health strategies, business and community engagement, and sharing data to foster coordinated learning health systems. Prior to his current appointment, he served as a senior advisor to the director of the CMS Innovation Center and director of the Division of Population Health Incentives and Infrastructure. Billioux was a 2015-2016 White House Fellow, serving at HHS under former HHS Secretary Sylvia Mathews Burwell. . Read More »

States Look to Address the Impact of Postpartum Depression

August 01, 2019|12:51 p.m.| ASTHO Staff

Seven percent of pregnancy-related deaths are associated with underlying mental health conditions. As the United States continues to see increasing rates of maternal mortality and morbidity, it is critical that we focus on improving the mental health of mothers. One of the better known maternal mental health conditions is postpartum depression, a mood disorder that can affect women after childbirth. Mothers with postpartum depression experience feelings of extreme sadness, anxiety, and exhaustion that may make it difficult to care for themselves, their children, and others. Data from the Pregnancy Risk Assessment Monitoring System (PRAMS), a CDC surveillance project that collects state-specific, population-based data on maternal attitudes and experiences before, during, and shortly after pregnancy, show that one in nine U.S. women experience symptoms of postpartum depression. . Read More »

Care and Cure: Hepatitis C

July 25, 2019|4:05 p.m.| Marcus Plescia, MD, MPH | Chief Medical Officer, ASTHO

On July 28, we recognize World Hepatitis Day, with the World Health Organization urging all countries and partners to “Invest in Eliminating Hepatitis.” The prospect of doing so in the United States is realistic. When antibiotics were first introduced with the discovery and mass production of Penicillin in the early 20th century, our ability to treat bacterial infections that once devastated communities and populations changed dramatically. The recent development and production of antiviral medications is a similarly historic and seminal event in modern public health. The development of multi-drug antiretroviral combinations in the 1990s curtailed the HIV epidemic by inhibiting the spread of the virus and preventing progression to AIDS. But the introduction of highly effective antiviral treatments for hepatitis C in 2014 marks the first time we have been able to cure a major and highly-infectious virus. . Read More »

State Legislation to Increase Access and Fund HIV Prevention Strategies

July 25, 2019|3:39 p.m.| ASTHO Staff

In 2017, 38,739 people received an HIV diagnosis in the United States. While the annual number of new HIV diagnoses has remained stable in recent years, annual new diagnoses have increased among some groups. For example, between 2012 and 2016, HIV diagnoses increased 12 percent among Hispanic and Latino gay and bisexual men. Building on these successes in reducing the spread of HIV, as well as facing the challenges of such an undertaking, President Trump announced during the 2019 State of the Union address the new “Ending the HIV Epidemic: A Plan for America,” a ten-year initiative to reduce new HIV infections to less than 3,000 per year by 2030. . Read More »

State Seek to Address PFAS Exposure Through Food Packaging

July 18, 2019|11:09 a.m.| ASTHO Staff

Over the past few years, rising health concerns related to per- and polyfluoroalkyl substances (PFAS) have resulted in state policymakers taking action to reduce and regulate PFAS exposure. PFAS are a family of man-made chemicals that have been used for decades in industrial and consumer products such as water-repellent clothing, stain resistant fabrics, paints, firefighting foams, and cookware. During production and use, PFAS can migrate into soil, water, and air. Because of their wide use and the fact that they do not easily breakdown in the environment, PFAS can accumulate over time in people and animals. In some instances, exposure to and absorption of certain PFAS has been associated with harmful health effects. . Read More »

Alexander Billioux: Public Health’s Role in Screening for Health-Related Social Needs

July 16, 2019|5:18 p.m.| ASTHO Staff

Alexander Billioux, MD, DPhil, assistant secretary of the Louisiana Department of Health, has a vision that moves beyond screening for health-related social needs toward investments in upstream improvements to SDOH in Louisiana. Having previously served as the Director of the Division of Public Health Incentives and Infrastructure at the Center for Medicare and Medicaid Innovation (CMMI), Billioux has dual expertise in the federal and state-level policy landscapes. His work illustrates the role public health agencies play in leading healthcare delivery system efforts to address both individual health-related social needs and community-wide SDOH. . Read More »

Legislation to Increase Access to Narcotics Testing Products

July 11, 2019|10:25 a.m.| ASTHO Staff

Pharmaceutical fentanyl is a synthetic opioid pain reliever that is 50-100 times more potent than morphine and approved for treating severe pain. While pharmaceutical fentanyl can be diverted for misuse, most recent fentanyl overdose deaths involve illicitly-manufactured fentanyl (IMF), which is sold through illegal drug markets for its heroin-like effects and often mixed with heroin or cocaine with or without the user’s knowledge. Confiscations, or seizures, of fentanyl increased by nearly seven-fold from 2012 to 2014 and in 2016, the number of overdose deaths involving IMF surpassed heroin and prescription opioid deaths in the United States for the first time. . Read More »

Delaware is Improving Birth Outcomes with Support from ASTHO

July 10, 2019|2:58 p.m.| ASTHO Staff

Karyl Rattay, MD, MS, is director of the Delaware Division of Public Health. Since joining ASTHO’s Increasing Access to Contraception Learning Community in 2015, Delaware has focused on developing a sustainable plan for improving access and choice around effective contraception for all women of reproductive age. ASTHO spoke with Rattay about these efforts and Delaware’s statewide plan to reduce infant mortality and improve birth outcomes. . Read More »

Summer Reading List: ASTHO CEO Michael Fraser

July 02, 2019|2:33 p.m.| Michael Fraser, Ph.D.

If you’re anything like me, it’s hard to choose just one book to read. As the July 4 holiday approaches and we gear up for a much-needed vacation, here’s what I currently have on my summer reading list. It’s an eclectic list, but that’s the fun of it. I hope there’s something on here for everyone. Read More »

Public Health Research and Practice Should Coexist

June 27, 2019|11:55 a.m.| Wendy Braund, MD, MPH

Practice-based research is the investigation of a topic of interest in a real-world setting and (ideally) the application of the findings in relevant programs, settings, or populations. It is commonly conducted in public health agencies and can take many forms. According to the 2016 ASTHO Profile, almost all state health agencies (SHA) participate in research, with 90 percent of SHAs reporting “collecting, exchanging, or reporting data for a study,” and “disseminating research findings to key stakeholders.” More than 80 percent of SHAs report “analyzing and interpreting study data and findings,” “applying research findings to practices within [their] organization,” or “identifying topics and questions relevant to public health practice.” . Read More »

Section 1332 Waivers: An Opportunity to Increase Access to Health Services Through Affordability

June 27, 2019|11:04 a.m.| ASTHO Staff

The individual commercial health insurance marketplaces are significant sources of insurance coverage that make access to healthcare services possible for thousands of individuals in the United States. Section 1332 waivers allow states to test new approaches to these marketplaces by waiving certain federal rules, as outlined in Section 1332 of the Affordable Care Act (ACA). There has been a flurry of activity at the state and federal levels about these waivers in recent months. Amid this activity, state and territorial health agencies (S/THAs) have an opportunity to play an important role in ensuring continued access to healthcare services by contributing to the development of 1332 waivers. Read More »

Ensuring Vaccine Coverage with School Vaccination Requirements

June 19, 2019|3:51 p.m.| ASTHO Staff

With the number of measles cases across the country reaching a level not seen in nearly three decades, policymakers continue to explore a variety of ways to increase vaccine coverage and prevent future outbreaks. When enough people are vaccinated against a communicable disease, such as measles, the spread of the disease is limited and exposure to the disease decreases. This is particularly important for those who, because of age or a medical condition, cannot be vaccinated. This community-wide vaccine protection is known as herd immunity. The amount of coverage needed to reach herd immunity varies with the disease and often depends on the disease’s contagiousness. For example, measles, a highly contagious disease, requires a high rate of vaccination, between 93-95 percent by some estimates. Read More »

Recognizing 25 Years of Tobacco Control Success and Collaboration

June 19, 2019|10:37 a.m.| ASTHO Staff

This year, the Tobacco Control Network (TCN), an ASTHO peer network, celebrates the 25th anniversary of its successful work supporting state and territorial tobacco control programs in their common pursuit of working towards a nation free from the health and disease burdens of tobacco use. TCN was formed in 1994 as an information sharing initiative between CDC, the National Cancer Institute, and the tobacco control programs in each state and territorial health agency. Following CDC’s creation of the National Tobacco Control Program in 1999, the network reorganized, with a focus on increasing the importance of tobacco control in state and territorial health agencies and fostering collaboration and communication among state and territorial tobacco control and cessation programs. With the support of ASTHO and funding from CDC’s Office on Smoking and Health, TCN continues to facilitate education, information sharing, and collaboration among state and territorial tobacco control stakeholders across the country. Read More »

State Policy Approaches to Address Healthcare Workforce Shortages

June 12, 2019|3:08 p.m.| ASTHO Staff

Healthcare workforce shortages can reinforce or contribute to health disparities. Rural communities tend to have fewer physicians, nurses, specialists, and other healthcare workers, while also facing higher rates of chronic disease, mental illness, and obesity than their urban counterparts. Retaining adequate healthcare personnel in shortage areas is a contributing factor, especially as healthcare personnel working in shortage areas often experience isolation from their peers and burnout from seeing a greater number of patients and working longer hours than those in non-shortage areas. An essential element to ensuring an adequate healthcare workforce is to improve the reach of provider recruitment programs, which can build a strong and diverse healthcare workforce that represents the population served. Read More »

States Authorize Pharmacists to Prescribe and Dispense Contraceptives

June 06, 2019|12:13 p.m.| ASTHO Staff

An increasing number of states have adopted laws setting out conditions under which pharmacists may prescribe and dispense contraceptives. Allowing pharmacists this role can increase access to contraceptives which, when used properly, can help avoid unintended pregnancies and delay subsequent pregnancies. Research shows that 45 percent of U.S. pregnancies are unintended and almost one-third of U.S. births occur within too short a time period from a previous birth (i.e., 18 months). Both of these circumstances are associated with higher rates of later access to prenatal care, premature birth, and low-birth weight. With women often facing economic, informational, and systematic barriers to contraceptive access, expanding the role of pharmacists in providing such care could be viewed as a way to improve maternal and child well-being and health outcomes. Read More »

Four Strategies to Help New Health Officials Become Successful Leaders

June 06, 2019|11:03 a.m.| ASTHO Staff

Terry Dwelle (alumnus-ND) served as the state health officer for the North Dakota Department of Health from 2001-2016. A North Dakota native, Dwelle worked previously at the University of North Dakota School of Medicine, CDC, and the Indian Health Service. Looking back on these professional experiences and his 15-year tenure as North Dakota’s top health official, Dwelle reflects on four strategies that helped ensure successful leadership, as well as the support ASTHO offers new state health officials as they develop the skills and competencies necessary to run a public health agency. Read More »

A Patchwork Quilt of State Approaches to CHW Training

May 30, 2019|10:25 a.m.| ASTHO Staff

Community health workers (CHWs) are front-line public health workers who have a unique understanding of the communities they serve through shared and lived experience. CHWs provide a wide range of services including advocacy, health education, patient navigation, as well as social-emotional support. According to NIH, some of the key outcomes of CHWs’ services include improved access to and use of healthcare services, better understanding and enhanced communication between community members and the health and social services systems, improved adherence to healthcare provider recommendations, and reduced utilization of emergency and specialty services. Read More »

Emerging Trends in State Lyme Disease Legislation

May 23, 2019|10:51 a.m.| ASTHO Staff

May is Lyme Disease Awareness Month, an opportunity to recognize those impacted by the disease and increase awareness about one of the most common vector-borne diseases in the United States. Lyme disease, caused by the Borrelia burgdorferi bacterium and transmitted through the bite of an infected tick, has been a nationally notifiable disease since 1991, with health agencies reporting approximately 30,000 Lyme disease cases to CDC each year. Reported cases may only be the tip of the iceberg, however, since additional studies of disease diagnoses estimate that approximately 300,000 cases occur annually. Read More »

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