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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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 »

How States are Preparing for Opioid Settlement Funds

January 27, 2021|12:32 p.m.| ASTHO Staff

The opioid crisis continues to claim the lives of thousands across the United States and has cost the economy billions in health care, mortality, and criminal justice costs. In 2018, it’s estimated that 67,367 people died of overdose, with opioids (prescription opioids, heroin, and other synthetic opioids other than methadone) made up almost 70% of overdose deaths. Provisional data for the twelve-month period ending December 2019 shows that there were 71,130 overdose deaths, with 50,178 overdose deaths attributed to opioids. The COVID-19 pandemic has also exacerbated the drug overdose crisis. Data shows that in the time of continued lockdowns and social distancing that overdose rates have increased, indicating a sustained need to support people with substance use disorder (SUD). Read More »

Lessons Learned from the U.S. Affiliated Pacific Islands COVID-19 Response

January 25, 2021|1:11 p.m.| Karl Ensign, MPP | ASTHO Vice-President of Territorial Support

As COVID spread throughout the country and infection rates rose in every state, the U.S. Affiliated Pacific Islands (USAPI) received media attention as remaining relatively COVID-free, apart from Guam. And most recently, the USAPI received renewed attention as they led the nation in vaccination rates. The USAPI’s unified response in the face of a global pandemic is a history-making tale of collaboration, communication, and partnership. The successes of public health leaders provide important lessons for preventing, preparing for, and responding to future public health emergencies. Read More »

A Wondrous World: A Week of Unity, Reflection and Renewal

January 21, 2021|3:37 p.m.| Michael Fraser, PhD | ASTHO Chief Executive Officer

This week has been both exhilarating and poignant. Almost surreal. We started the week by pausing to celebrate and reflect on the life and legacy of one of America’s greatest sons, Dr. Martin Luther King, Jr. On Tuesday, ASTHO participated in the National Day of Healing, which provided opportunities for our staff to engage in conversations with one another, seeing one another’s humanity, as well for individual mediation, reflection and learning. On Wednesday, we were honored to witness the inauguration of President Joe Biden and Vice President Kamala Harris—the first woman, first Black and first Asian American to serve in this role. This week also marked one year since we learned of the first known case of COVID-19. Despite these challenges, I am more optimistic now than ever that our collective impact and commonsense recovery response will help guide our successful return to safety and normalcy. Read More »

States Consider Expanding Scope of Flu Vaccine Policies

January 19, 2021|11:43 a.m.| ASTHO Staff

The 2019-2020 flu season had approximately 5 million fewer illnesses than the previous year. Thanks to COVID-19 mitigation efforts like social distancing and increased handwashing—coupled with a higher rate of flu vaccinations among the public this year—this all likely led to a milder end to the 2019-2020 flu season and start of the 2020-2021 flu season. Although there were fewer flu illnesses overall last year, the rates of infection, hospitalization, and death were more severe for children aged 0-4. There were 80 deaths of children under the age of 5 last season, however due to underreporting the CDC estimates that as many as 254 children under age 5 died over the course of the 2019-2020 season. Read More »

What ASTHO Expects from the Incoming Biden Administration

January 14, 2021|11:13 a.m.| ASTHO Staff

As the country prepares for the inauguration of President-elect Joseph R. Biden, Jr. on Wednesday, the incoming administration has highlighted several priorities over the next four years. Below is a summary of priorities that are closely aligned with the work and interests of state and territorial public health, including continued COVID-19 recovery and response, racial equity, and climate change. Read More »

ASTHO’s Public Health Resolutions for 2021

January 13, 2021|4:39 p.m.| ASTHO Staff

Every year, ASTHO performs an annual environmental scan to identify these policy and programmatic priorities. The most recent scan occurred from June 2019 to May 2020. Through ongoing collection of data from a variety of sources—including state and territorial health improvement plans and strategic plans, documentation of discussion topics from ASTHO’s weekly calls with state and territorial health officials (S/THOs), requests for technical assistance that ASTHO receives from S/THOs and agency staff, and subject matter expert input on trends and issues emerging in the field—ASTHO accumulated a catalogue of issues facing S/THAs and identified those most commonly experienced among jurisdictions over the year. These priorities will be ASTHO’s “2021 resolutions” as we enter a new year. Read more about these priorities below. Read More »

2021 CEO Look Ahead: What is Our Next Normal?

January 06, 2021|1:09 p.m.| Michael Fraser, PhD | ASTHO Chief Executive Officer

I think we all welcomed 2021 with open arms as we look to put the worst of 2020 behind us. I know I sighed a huge sigh of relief at 12:01am and embraced this new year with more anticipation than many others. We have all been through a lot—we have lost family members and friends to COVID-19, we have seen public health officials harassed and maligned, we sheltered-in-place, stayed home, and radically altered our day-to-day schedules, we have witnessed protests over police brutality and racial discrimination, and we have lived through (and still are living through it) a presidential transition unlike any other. Despite all the challenges, turmoil, and changes wrought by 2020, the work of state and territorial public health continues. What is on our ASTHO horizon as we greet this new year and the opportunities and challenges it presents? Here are a few things on my mind as I look toward the future. Read More »

A Public Health Milestone: COVID-19 Vaccine Q&A With Meredith Allen, ASTHO’s Vice President for Health Security

December 17, 2020|2:47 p.m.| ASTHO Staff

The delivery of the first shipments of COVID-19 vaccines to hospitals across the country this week is a major moment in United States public health history. We sat down with Meredith Allen, ASTHO’s vice president for health security, to contextualize the significance of this achievement and what it means for the pandemic response moving forward. Read More »

The Legal Framework for Administering COVID-19 Vaccines

December 17, 2020|11:11 a.m.| ASTHO Staff

After a deadly year, a vaccine to prevent COVID-19 infections is finally here. Earlier this month, the FDA issued an Emergency Use Authorization (EUA) for a COVID-19 vaccine developed by Pfizer/BioNTech and will be considering a similar authorization for a vaccine developed by Moderna later this week. Anticipating a rapid deployment of COVID-19 vaccines as they are authorized, the CDC developed COVID-19 Vaccination Program Operational Guidance in collaboration with state and local jurisdictions to outline how each jurisdiction will make an authorized vaccine widely available. In addition to the operational plans, there is a legal framework of federal and state laws supporting the distribution and administration of the FDA-authorized vaccines. Read More »

Ending the HIV Epidemic Through Community Engagement

December 16, 2020|10:24 a.m.| ASTHO Staff

As the federally-funded “Ending the HIV Epidemic: A Plan for America” enters its second year, it is apparent that community engagement is paramount in reaching those that are out of care and making sure resources are available to the communities who need them most. Community engagement involves meaningful participation of non-traditional partners, elevating their voices and empowering communities to improve their own health. The federal government is affirming its commitment to community engagement and keeping a health equity lens front and center, and states are following suit in their own HIV planning. Read More »

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