President's Challenge


The President's Challenge: A Letter from ASTHO President John Auerbach

John Auerbach, President, ASTHO Board of Directors and Commissioner, Massachusetts Department of Public Health 

Dear Colleagues,


Promoting health equity to reduce disparities is my public health challenge to ASTHO members for the year.  I selected this issue because I believe it is critically important to reduce the disproportionately high burden of illness, injury and premature death that affect certain populations, including people of color and those with the lowest incomes.  Every state is facing financial challenges, yet there are actions we can take to promote equity, such as making data available that highlight disparities, assessing the gaps in prevention and care efforts for target populations, and adopting at least one strategy this year that could lessen the burden of health disparities and health inequities in our home states.


ASTHO will draw on the collective expertise of our Affiliates and other  partners, including the National Association of State Offices of Minority Health and the Office of Minority Health, to help reduce health disparities and make significant moves toward achieving health equity.


The Burden of Health Disparities and Health Inequities


Data clearly show serious health disparities in the United States by race, ethnicity, socioeconomic class, geographical location, education, and other social determinants of health. For instance, infant mortality among African Americans is more than twice the national average of 6.9 deaths per 1,000 live births.


And the cost is enormous. Between 2003 and 2006 the combined costs of health inequalities and premature death were $1.24 trillion in the United States. During the same period, eliminating health inequalities would have reduced indirect costs by more than $1.0 trillion.


Please accept this challenge to consider new ideas, become engaged, and work together to ensure that everyone in this country has equal potential for good health.  Strategies exist across a broad array of topic areas. 

  • Collecting data on social determinants of health by race, ethnicity and language
  • Developing targeted campaigns that feature diverse populations
  • Promoting higher quality, culturally competent services for all populations
  • Partnering with non-health organizations such as the state departments of labor, transportation, education, and housing to change the conditions in people’s lives
  • Developing a special issue report focusing on health disparities in your state
  • Engaging with communities to work on health inequities

What strategy will you take to address these issues in your home state?


John Auerbach 

President, ASTHO Board of Directors

Commissioner, Massachusetts Department of Public Health