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ASTHO’s guiding principles on Achieving Optimal Health for All remind us that state and territorial health agencies play a critical role in creating and supporting strategies to achieve health equity.Read More »

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Leadership Defines A Legacy: State Approaches to Health Equity

August 16, 2018|10:36 a.m.| ASTHO Staff

On Aug. 6, the world mourned the death of Margaret Heckler, the former HHS secretary under President Ronald Reagan who worked to prioritize health disparities and social determinants of health. In 1985, Heckler commissioned the landmark Report of the Secretary’s Task Force on Black and Minority Health. Now commonly known as the Heckler report, this assessment highlighted the disproportionate burden of death and illness impacting racial and ethnic minorities and initiated a taskforce to improve the health of minorities and eliminate health disparities, the first of its kind by the federal government. Read More »

State Policy Approaches to Incorporating Doula Services into Maternal Care

August 09, 2018|3:59 p.m.| ASTHO Staff

Maternal mortality rates in the United States continue to rise, with ethnic and racial minority populations facing even starker statistics. Policymakers are pursuing a variety of approaches to improve perinatal and postnatal care to support healthy and safe pregnancies, including expanding access to doula services. A doula is a trained professional that provides continuous physical, emotional, and informational support during and shortly after childbirth. Through this continuous support system, doulas positively impact both mothers and babies, as well as help families achieve a healthy and positive birthing experience. For women at-risk for adverse birth outcomes because of racial disparities, doula care can provide positive benefits and improve factors that mediate mortality, including decreasing cesarean births, operative vaginal births, use of analgesics, and duration of labor. Read More »

Affordable Care Act Update

August 02, 2018|5:33 p.m.| ASTHO Staff

While state public health agencies recognize that much of what contributes to health lies outside the doctor’s office, there is evidence demonstrating that stable and ongoing insurance coverage enables consumers to utilize preventive and primary care services that improve outcomes and downstream healthcare spending. Changes to the Affordable Care Act (ACA) that have occurred over the past several years are likely to impact market stability and insurance coverage, as well as actions states are pursuing, given uncertainty around the future of ACA. Read More »

Arkansas Health Official Offers Ideas for Improving Immunization Efforts

August 01, 2018|1:50 p.m.| ASTHO Staff

Every August, the National Public Health Information Coalition and CDC’s National Center for Immunization and Respiratory Diseases sponsor National Immunization Awareness Month to highlight the importance of vaccination in preventing diseases across the lifespan. To kick off this month’s observance, ASTHO spoke with Nathaniel Smith, director and state health officer of the Arkansas Department of Health, about his experience serving on several national advisory committees, how health officials can communicate about the benefits of vaccines, and opportunities for public health and healthcare partners to prioritize HPV vaccination as an effective cancer prevention measure. Read More »

Innovative Approaches to Treating Neonatal Abstinence Syndrome

July 31, 2018|11:43 p.m.| Community Health and Prevention Team

The incidence of neonatal abstinence syndrome (NAS) has increased dramatically over the past decade, placing a significant burden on the healthcare system in terms of the costs associated with extended hospital stays required to care for these newborns. In 2012, annual costs related to NAS admissions in the United States totaled $316 million. Many types of drugs or substances contribute to the severity of an infant’s withdrawal symptoms, but in-utero exposure to opioids is often considered the primary cause of NAS, also referred to as neonatal opioid withdrawal symptom (NOWS). Providing active neonatal care through nonpharmacologic interventions allows for parental bonding, promotes consistent breastfeeding, and results in improved outcomes, such as decreased length of stay, and reduced hospital costs. Read More »

Health Departments are Key to Eliminating Hepatitis in the United States

July 26, 2018|4:07 p.m.| Murray Penner, Executive Director, NASTAD (National Alliance of State and Territorial AIDS Directors)

World Hepatitis Day takes place every year on July 28 to raise awareness around hepatitis and opportunities to eliminate this disease. Despite significant strides in prevention and treatment, hepatitis remains one of the biggest global health threats. Ahead of this year’s observance, Murray Penner, executive director of NASTAD, reflects on what it will take to end this global epidemic and the critical role public health plays in accomplishing this important work. Read More »

2018 Sepsis Legislative Update

July 26, 2018|11:49 a.m.| ASTHO Staff

Sepsis occurs when a body’s immune system overwhelmingly responds to an infection and triggers widespread inflammation. The inflammation leads to blood clots and leaky vessels which can result in organ damage and death. Sepsis can be caused by a wide range of infections, but those most commonly linked to sepsis are infections found in the lungs, kidneys, skin, and gut. Sepsis can also result from a range of pathogens. Most commonly, however, the specific pathogen is not identified in 30 to 70 percent of patients with sepsis. In addition, sepsis occurs in patients across the lifespan, most commonly in those over 65 and under the age of one. Sepsis is a dangerous and often lethal condition, claiming a quarter million American lives annually, as well as a significant driver of healthcare costs. It is the most expensive hospital condition to treat, accounting for more than $23 billion dollars in healthcare costs annually. In addition, with a growing chronic disease burden that places patients at a greater risk of infections that can lead to sepsis, effective and comprehensive strategies to address sepsis are critical. Read More »

Evidence-Based Home Visiting Models Promote Early Brain Development in American Indian and Alaska Native Communities

July 26, 2018|11:35 a.m.| Community Health and Prevention Team

A child’s earliest experiences influence the brain’s developing architecture. Exposure to adversity during the early years can lead to long-term, negative outcomes later in life. Nurturing environments and strong caregiver-child relationships can buffer the consequences of poor early brain development stemming from adverse childhood experiences (ACEs) and toxic stress. Home visiting programs promote early childhood health and development by fostering these positive, interactive relationships which can go a long way toward both preventing child abuse and neglect and supporting early learning and school readiness. Although genetics and the environment are factors in determining a child’s health and developmental outcomes, strengthening the capacity of parents and caregivers to provide appropriate care and support is fundamental to helping children thrive and achieve lifelong health and wellness. Read More »

Using Predictive Analytics for Population Health Management and Public Health Emergencies: Ethical, Legal, and Policy Considerations

July 19, 2018|12:43 p.m.| ASTHO Staff

Predicting the future with data analytics and technology is quickly becoming a reality for making better sense of public health data to inform interventions that will improve the population’s health. As the field of public health informatics continues to evolve its capacity for predictive analytics, ethical and legal challenges remain in terms of maintaining privacy and developing sound policies and infrastructure to support data usage, data sharing, and standardized practices. Read More »

Colorado Looks to Educate Youth About the Public Health Consequences of JUUL

July 19, 2018|11:32 a.m.| ASTHO Staff

Colorado is in the midst of a challenging time addressing the e-cigarette and vaping epidemic among youth. Most popular among these products is the JUUL e-cigarette, a sleek, trendy, USB-shaped device created by JUUL Labs. Recently ranked the top state in the nation for high school vaping by the Youth Risk Behavior Surveillance Survey, Colorado is taking swift and decisive action to reverse these trends. Read More »

California Shares Insights on Preparing for Reaccreditation

July 17, 2018|2:34 p.m.| Performance Improvement, Research, and Evaluation

National public health accreditation enables health departments to provide high-quality public health services to the community. According to the Public Health Accreditation Board (PHAB), accredited health departments play an important role in promoting population health with services that reach over 214 million individuals all across the nation. The accreditation process helps health departments identify strengths and weaknesses and undertake performance management and quality improvement (QI) initiatives. It also provides a framework for health departments to improve external relationships with their governing entities and other stakeholders and their communities. Read More »

State Approaches to Community Health Worker Certification

July 12, 2018|4:57 p.m.| ASTHO Staff

A community health worker (CHW) is defined as “a frontline public health worker who is a trusted member of and/or has an unusually close understanding of the community served.” CHWs typically share the lived experience of members of their communities. With a growing body of evidence supporting the effectiveness of CHWs, policymakers continue to explore ways to leverage the role of CHWs for improving health and wellbeing in the states and other jurisdictions. Some of these policy decisions focus on issues of reimbursement and funding for CHWs, as well as the scope of practice for CHWs. Another key policy issue for CHWs that continues to evolve is certification. Certification programs are often used to standardize the education and training requirements for a profession. However, such programs may also present a barrier if the certification requirements are too costly, time-consuming, or onerous for those seeking to join the profession. Below is a brief summary of how two states, Arizona and Maryland, addressed CHW certification during this past legislative session. Read More »

State Public Health Strategies for Preventing Adverse Childhood Experiences

July 12, 2018|3:43 p.m.| Community Health and Prevention Team

Adverse childhood experiences (ACEs) are stressful or traumatic events during childhood where continual exposure to stressors in the absence of nurturing relationships, known as toxic stress, can damage a child’s developing brain. For this reason, ACEs are a major risk factor for poor early brain development. ACEs not only contribute to suboptimal brain development in children, but they also have lasting effects on overall health and are linked to causes of morbidity and mortality in adults. Read More »

Tips for Using Public Health Accreditation to Orient New Health Department Leaders

July 12, 2018|12:48 p.m.| ASTHO Staff

As of September 2016, the length of time state health officials remained in their positions ranged from two months to nearly 15 years, with an average tenure of 2.7 years. Leadership transitions can be attributed to many factors, but the visibility and political demands associated with the job top the list. Incoming health officials must be familiar with the health department’s internal operations, priorities, partners, stakeholders, and issues impacting the agency early on in their appointments. Read More »

University of Washington’s PEARLS Model Reduces Depression Among Older Adults

July 05, 2018|4:01 p.m.| Community Health and Prevention Team

Depression is the most common mental health problem affecting older adults and the University of Washington Health Promotion Research Center (HPRC) developed and implemented one of the most effective evidence-based programs for older adult depression. The Program to Encourage Active, Rewarding Lives for Seniors (PEARLS) is a home- and community-based program that has been shown to reduce depression symptoms by over 50 percent when delivered by trained professionals over the course of six to eight one-hour sessions. Currently, over 50 agencies offer PEARLS across 18 states and HPRC provides ongoing training and technical support as part of a network of 26 funded CDC academic research centers. ASTHO spoke with HPRC’s research scientist, Lesley Steinman, and the center’s principal investigator, Mark Snowden, to learn more about PEARLS and how the program is being used to confront the stigma associated with depression and mental health. Read More »

A Look at Access to Health Services and the Intersection of Immigration Status with Medicaid and Insurance Eligibility

July 05, 2018|2:39 p.m.| ASTHO Staff

Noncitizens in the United States make up about seven percent of the total U.S. population and are more likely to be low-income and uninsured than citizens. Census data estimates that 71 percent of undocumented adult noncitizens do not have health insurance. Federally Qualified Health Centers (FQHCs) and select public health programs serve immigrants regardless of their immigration status. Medicaid, the publicly funded health insurance program for lower-income Americans, limits eligibility for immigrants to those qualified immigrants with refugee status or those who are veterans and those who have been lawfully present in the United States for five years. States can choose whether to provide coverage to legally present immigrants before their five-year waiting period expires. Read More »

California Department of Public Health Joins the Fight Against Devastating Wildfires

July 05, 2018|12:46 p.m.| ASTHO Staff

Last year’s wildfires in California caused historic levels of damage and destruction. Fires erupted as far north as the Klamath National Forest along the California-Oregon border and as far south as San Diego. Some blazes engulfed areas surrounding major cities including Los Angeles, Santa Barbara, Santa Rosa, and Ventura, burning through mountainsides and neighborhoods. More than 9,000 wildfires roared through California, burning 1.2 million acres of land—an area the size of Delaware—destroying more than 10,800 structures, and causing at least 46 deaths. The Thomas Fire, first reported on December 4, 2017, scorched nearly 300,000 acres across southern California, making it the largest fire ever recorded in California history. Read More »

Member Spotlight: Greg Lakin

June 28, 2018|3:24 a.m.| ASTHO Staff

Greg Lakin, DO, JD, is chief medical officer for the Kansas Department of Health and Environment. In this role, Lakin participates in ASTHO matters on the agency's behalf. Lakin has spent his career working in the field of medicine as a family practitioner, as well as in emergency medicine, skilled nursing, and long-term care. Previously, Lakin was elected to the Kansas House of Representatives. He received a law degree from Northwestern School of Law of Lewis and Clark College, followed by a medical degree from Kirksville College of Osteopathic Medicine. Read More »

New CMS Medicaid-CHIP Scorecard Creates a Pivotal Moment for Public Health Partnership

June 21, 2018|1:18 p.m.| ASTHO Staff

On June 4, 2018, the Centers for Medicare and Medicaid Services (CMS) released a new scorecard that may serve as a new opportunity for state/territorial health agency (S/THA) leadership to collaborate with Medicaid agencies, especially at this early phase of development. The new scorecard combines quality metrics and collectively measures the Children’s Health Insurance Program (CHIP) and state Medicaid programs. CMS intends for the scorecard to be a tool for states to learn from high-achieving peers and contribute to the development of best practices; however, a great deal of uncertainty remains around the scorecard’s use and general reliability. S/THA leadership may consider this as an opportunity to fulfill the role of chief health strategists and partner with their sister Medicaid agencies to jointly improve population health and quality measures, as well as to engage in broader joint strategic planning and priority setting. Read More »

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