Featured Story


With many of the state and territorial legislatures reconvening over the next few weeks, we can look forward to new (and not-so-new) legislation start to crop up that will impact public health. To help navigate the new legislative sessions, ASTHO’s "2021 Legislative Prospectus" series highlights eight priority policy areas jurisdictions will address during this year. Each prospectus in the series provides a brief overview of the issue, the issue’s impact on health, and recent legislative trends aimed at addressing the issue. This year, ASTHO developed prospectuses on COVID-19, e-cigarettes, HIV, influenza, maternal mortality and morbidity, neonatal abstinence syndrome (NAS), polyfluoroalkyl substances (PFAS), and rural health.Read More »

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Public Health Infrastructure Proposals Gain Steam in Congress

April 15, 2021|1:56 p.m.| ASTHO Staff

The COVID-19 pandemic has underscored the consequences of decades of underfunding. To ensure we are better prepared for future pandemics and biological threats, we must consider the long-term investments required to bolster our public health infrastructure and workforce. Read More »

Equity as a Pillar in Our Vaccine Rollout

April 15, 2021|11:28 a.m.| Monica Bharel, MD, MPH | Commissioner of the Massachusetts Department of Public Health

A year ago, it was unthinkable that we would have 600,000 cases and more than 17,000 deaths from COVID-19 in the state of Massachusetts. Many of us know someone who has become ill or has died from COVID-19 and the toll in suffering is immense. I am hopeful that the distribution of COVID-19 vaccine will be a light at the end of this long pandemic tunnel. In Massachusetts, the three pillars of our vaccine effort are to preserve life, preserve our healthcare system, and prioritize equity by focusing on reaching our hardest hit communities. So, equity is at the core of our vaccine allocation work. Read More »

Building Bridges to Better Health the ASTHO Way

April 08, 2021|10:09 a.m.| Michael Fraser, PhD | ASTHO Chief Executive Officer

“Building Bridges to Better Health,” the theme for the 2021 National Public Health Week, resonates with me for two main reasons. First, ASTHO is committed to building and maintaining the partnerships and connections needed to achieve our shared vision of state and territorial health agencies advancing health equity and optimal health for all. These relationships are bridges that connect us to others and to work that amplifies and complements our own. Second, we are deeply rooted in our mission to support, equip, and advocate for state and territorial health officials in their work of bettering health by providing technical assistance and capacity building in areas that advance our collective health and well-being. Read More »

States Work to Support Rural Hospitals Despite Pandemic Challenges

April 07, 2021|11:01 a.m.| ASTHO Staff

When rural hospitals close, it increases the distance people must travel for essential healthcare services. The COVID-19 pandemic has highlighted and magnified the factors leading to rural hospital closures across the country. Many healthcare facilities suspended elective procedures to conserve critically needed personal protective equipment and reduce the risk of exposure to COVID-19 by patients and hospital staff. For many rural hospitals, however, the suspension of elective procedures with the reduced the use of non-urgent services by apprehensive patients meant a loss of revenue and the furloughed healthcare staff. Since the onset of the COVID-19 pandemic, approximately half of all rural hospitals are experiencing negative operating margins due to reduced outpatient revenue. The rate increases in states that have not expanded Medicaid. Unfortunately, these kinds of challenges are not new to rural hospitals. Read More »

Regulating and Remediating PFAS in States

March 31, 2021|3:29 p.m.| ASTHO Staff

A once obscure public health issue that’s gotten more attention in recent years, polyfluoroalkyl substances (PFAS) are a group of synthetic chemicals used in products such as nonstick cookware, water-repellent clothing, stain resistant fabrics, cosmetics, and firefighting products. During production and use, PFAS can migrate into soil, water, air, where they persist. Because they remain in the environment, PFAS can accumulate in humans and animals and can be found at low levels in many food products. Exposure to PFAS can lead to harmful health effects, including an increased risk of kidney and testicular cancer and a decreased vaccine response in children. Read More »

Financing Community Health Workers Through Medicaid

March 23, 2021|3:11 p.m.| ASTHO Staff

As the nation grapples with the ongoing COVID-19 pandemic, community health workers are being recognized for the role they play in improving health outcomes of our most vulnerable communities. In fact, the recently enacted American Rescue Plan Act of 2021 allocates funding for the recruitment, hiring, and training community health workers by public health departments. Read More »

How Can Public Health Data Take a Lead Role? Find Out at the COVID-19 TechXpo

March 17, 2021|3:19 p.m.| J.T. Lane, MPH | ASTHO Chief Population Health and Innovation Officer

While COVID-19 has shown some of the best attributes of the U.S. public health system, it has exposed the weaknesses of our data systems—wrought by chronic underfunding and further exacerbated by siloed, categorical funding and planning. Yet, even with our pandemic weariness and persistent, systemic inequities, this historic event has revealed resiliency across the country. It has also yielded new innovations, along with promising practices and partnerships in how we leverage technology and data to better respond and mitigate public health threats. To build further momentum and support the ongoing modernization efforts of our partners, ASTHO is hosting its first-ever TechXpo. Read More »

Modernizing State HIV Laws: Legislation to Prevent and Decriminalize HIV

March 16, 2021|11:09 a.m.| ASTHO Staff

Though we’ve made progress on the number of HIV cases in the U.S, tens of thousands of Americans are diagnosed with HIV each year—a disproportionate number being people of color. In 2019, the federal government launched the Ending the HIV Epidemic: A Plan for America (EHE) with a goal of ending the HIV epidemic by 2030. EHE leverages four strategies to reduce the prevalence of HIV: diagnosis, treat, prevent, and respond. State efforts to reduce the incidence of HIV align with the federal plan, with many states passing legislation to enhance prevention and harm-risk reduction efforts. Read More »

ASTHO Addresses Insular Areas Health Equity Through Federal Engagement

March 09, 2021|3:46 p.m.| ASTHO Staff

As the Association of State and Territorial Health Officials, ASTHO is committed to the T in our name. The health officials from the territories and freely-associated states are valued members and we are committed to advocating for the unique policy needs and priorities of the Pacific and Atlantic jurisdictions. The insular areas face unique challenges locally but also require a specific strategy here in Washington, D.C. Funding approaches and requirements set for states do not always translate to the unique context of the insular areas. Read More »

What to Know About the American Rescue Plan

March 04, 2021|10:07 a.m.| ASTHO Staff

One of President Biden’s first actions just before being sworn into office was to draft up the American Rescue Plan, a sweeping proposal that ASTHO has committed to working with the Biden Administration on. The proposal offers a national vaccination plan, a promise to address COVID-19 health disparities, and efforts to prioritize the expansion the public health workforce. This post details some of the high-level takeaways, as they relate to public health. Read More »

Maternal Mortality in the U.S.: How States Are Working to Reverse the Rate

March 03, 2021|10:17 a.m.| ASTHO Staff

Two rising health trends are negatively affecting women’s health across the United States: maternal mortality (death from pregnancy or delivery complications) and severe maternal morbidity (mental and physical health consequences from a pregnancy or delivery.) Maternal mortality review committees (MMRCs) are one of the best ways to gather information on why pregnancy-related deaths occur and how to prevent them. Studies show that MMRCs can reduce maternal mortality by 20-50% since they examine the underlying causes of maternal mortality, use data to identify gaps in care, and inform a focused approach to prevent deaths and reduce disparities. Read More »

Reflections on Black History Month: A Q&A with Gail Christopher and Michael Fraser

February 25, 2021|2:11 p.m.| ASTHO Staff

As Black History Month comes to a close, we wanted to reflect on racial equity and how it is intrinsically connected to the work ASTHO does every day in public health. We spoke to our CEO Michael Fraser and Gail Christopher, DN, the executive director of the National Collaborative for Health Equity, to get their thoughts on the month and how we can prioritize diversity and inclusion year-round. . Read More »

Advocacy Over Zoom: A New Frontier for ASTHO’s Hill Day

February 24, 2021|10:58 a.m.| Carolyn Mullen | ASTHO Senior Vice-President of Government Affairs and Public Relations

Every government affairs professional in Washington, D.C. looks forward to the one day each year when their members and stakeholders fly-in to conduct in-person meetings with members of Congress and advocate for top priorities. When the global pandemic struck it completely changed the way hill days are conducted—moving from in-person meetings to virtual platforms, potentially altering this tradition forever. Acknowledging that Zoom meetings are the new frontier for advocacy, the ASTHO team sprung into action, researching best practices, talking to other non-profit organizations and Congressional staff. After an abundance of research and thoughtfulness, we decided to completely flip the script and chart our own path for ASTHO’s Hill Day this year. Read More »

How States Are Addressing the Public Health Crisis of Racism

February 23, 2021|10:45 a.m.| ASTHO Staff

An increasing body of research finds racism can have a significant impact across one’s lifespan. Research shows that persistent exposure to racial discrimination may result in premature aging, poor health outcomes, and increased prevalence of certain chronic diseases. At every level of government, policymakers are seeking to acknowledge the systemic oppression of people of color that persists and to elevate racism as an urgent public health crisis comparable to other public health emergencies. Read More »

More States Consider Restricting Sale of Flavored Tobacco Products

February 16, 2021|12:01 p.m.| ASTHO Staff

A pressing public health issue before the COVID-19 pandemic hit, the need for public health interventions to reduce tobacco use is heightened with a strong association between tobacco use, in all forms, with severe COVID-19 outcomes. Additionally, tobacco use remains the leading cause of preventable death in the U.S., claiming approximately 480,000 deaths each year. Evidence-based policies to reduce tobacco use like raising the age of sale to 21, increasing tobacco pricing, and prohibiting the sale of flavored tobacco products are common public health strategies enacted through state legislation. As anticipated in ASTHO’s 2021 Legislative Prospectus on E-Cigarettes, states are considering many of these evidenced-based tobacco reduction strategies during the 2021 legislative sessions. Read More »

Community Health Workers and the Heart of Public Health

February 11, 2021|12:13 p.m.| Marcus Plescia MD, MPH | ASTHO Chief Medical Officer

Over the years evidence has expanded on community health workers (CHWs) improving outcomes and even reducing disparities in heart disease and many other public health priority areas. However, their presence in state and local public health workforce is still modest. A number of efforts have sought to expand the role of CHWs in medical care settings by developing reimbursement through third party payers, along with including them in managed care contracts and incorporating them in state Medicaid plans. The experience and lessons of the COVID-19 pandemic could substantially change the way we practice public health in the future, and provides opportunities to expand the role and presence of CHWs in the state and local public health workforce. Read More »

How State and Territorial Health Departments Can Navigate Recent Executive Actions

February 10, 2021|12:33 p.m.| ASTHO Staff

One of tools presidents have to implement and drive their strategy—particularly as they settle into the job—are executive actions. However, not all executive actions are the same and may or may not change how the federal government operates. Executive orders (E.O.) and presidential memorandums carry the force of law and allow presidents to move quickly, deliver a clear message, organize the functioning of the executive branch, and spotlight critical issues with declarations of commemorative observances. Read More »

Building a More Equitable Economy Post-Pandemic

February 08, 2021|2:54 p.m.| Ann Flagg | Senior Director, Policy and Practice, American Public Human Services Association (APHSA)

Economic security and well-being, job stability, access to safe and affordable housing, access to healthy and nutritious foods, and access to resources to manage mental and physical health—all of these things impact individual, family, and community health. The COVID-19 pandemic has fundamentally impacted each of these social determinants of health for many Americans. Furthermore, some communities and industries have faced harder economic impacts than others, including households with low incomes, non-white households, and households with children. Human services and public health leaders can collaborate to make sure we are rebuilding systems and programs in a way that creates healthier, more resilient families and communities. Read More »

New Executive Orders Shine Spotlight on Health and Racial Equity

February 04, 2021|3:25 p.m.| Mary Ann Cooney, RN  |  ASTHO Vice-President for Health Equity

COVID-19 has revealed the stark reality of racial and ethnic health disparities that exist nationally. Black and Hispanic Americans were nearly three times more likely to die from COVID-19 than white Americans. Black and Hispanic Americans experience a greater prevalence of underlying risk factors such chronic disease and co-morbidities, access to health care, lower socioeconomic status, and others. The root causes of these disparities can be attributed to structural racism and the legacy of policies that perpetuates health inequities. As we commemorate Black History Month throughout the month of February, it is imperative that we work to correct the wrongs of the past and address structural racism and health inequities to build a healthier future. Read More »

Neonatal Abstinence Syndrome: State Considerations for 2021

February 03, 2021|11:07 a.m.| ASTHO Staff

Neonatal Abstinence Syndrome (NAS) has become more prevalent in the United States, with the hospitalization rate increasing from 2.9 to 7.3 hospitalizations per 1,000 newborn births between 2009 and 2017. NAS occurs in newborns who experience withdrawal from substances they were exposed to during pregnancy. While NAS is most often associated with exposure to opioids (e.g., Neonatal Opioid Withdrawal Syndrome), it can also be caused by exposure to other drugs such as cocaine, amphetamines, or barbiturates. Infants with NAS experience withdrawal symptoms including tremors, irritability, poor feeding, vomiting, dehydration, and increased sweating. These symptoms usually appear within 72 hours of birth. Read More »

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