2026 Environmental Scan: Early Insights on Current and Emerging Public Health Priorities

Table of Contents

• Background
  • About the Scan
  • Approach Moving Forward
  • Data Sources
  • Methods
• Preliminary Results: Current and Emerging Themes
  • Chronic Disease Prevention and Management
  • Maternal, Child, and Family Health
  • Substance Use and Mental Health
  • Food and Nutrition Security
  • Infectious Disease and Outbreak Response
  • Tobacco Control and Emerging Products
  • Suicide and Violence Prevention, Intervention, and Community Safety
  • Environmental Health and Climate
  • Emergency Preparedness and Supply Chain
  • Aging, Dementia, and Long-Term Care
  • Variance in Community Health Outcomes
  • Oral Health and Preventive Dental Care
  • Disability, Accessibility, and Technology Support
• Looking Ahead: Next Steps and Ongoing Development

Background

About the Scan

ASTHO's annual Environmental Scan of Current and Emerging Public Health Priorities (Scan) is an ongoing study that tracks public health concerns and trends across U.S. states, territories, and freely associated states. 

Approach Moving Forward

In alignment with current public health trends, ASTHO is investing in infrastructure to enable a more agile horizon scanning approach. 2026 marks the start of this transition, which lays the foundation for our iterative scanning approach. In addition to analyzing health agency materials like state health improvement plans and strategic plans, we expanded our approach to include:

• ASTHO's internal technical assistance (TA) request and response data.
• Notes from calls ASTHO held for its members, state and territorial health officials (S/THOs).

Data Sources

In all, the foundational data corpus consisted of:

• 53 agency Strategic Planning documents.
• 52 agency Health Assessments.
• 49 agency Health Improvement plans.
• Notes from 65 S/THO calls.
• 1,972 documented TA requests. 
• 1,741 documented TA responses.

The included health agency planning documents were all either active within a defined time period (e.g., 2024-2030) or were created in or after 2020 by the jurisdictional health agency. The ASTHO data sources represent S/THO calls conducted between January 2025 and May 2026 and TA documentation generated between May 2022 and May 2026, both of which represent the most complete available data for each source.

Methods

The preliminary 2026 Scan themes were derived through a mixed-methods approach combining:

• Multiple topic modeling methods to identify both strong and weak signals of public health priority areas.
• Qualitative analyses of the topic modeling results.

Preliminary Results: Current and Emerging Themes

ASTHO’s 2026 Scan identified 13 themes of current and emerging priority signals in the public landscape. The themes capture both current signals that represent well-established priorities that are widely recognized and consistently present across the data, and secondary signals that indicate areas that are beginning to coalesce or that may warrant continued monitoring. Together, these themes provide a snapshot of where the field stands today and where it may be heading. 

Chronic Disease Prevention and Management

Current Priority: Diabetes, heart disease, and cancer screening are well-established priorities, with clinical management and risk factor control as the dominant framing.

Secondary Signal: Strengthening capacity to support population-level strategies and community-based approaches (e.g., cross-sector partnerships, community focus groups, and community asset mapping) appeared as a secondary signal in the data, suggesting broader consideration of community-informed assessment and surveillance strategies alongside clinical prevention approaches.

Maternal, Child, and Family Health

Current Priority: Prenatal care, birth outcomes, and infant health are deeply embedded in public health conversations.

Secondary Signals: 

• Postpartum support, breastfeeding, and child development surfaced as signals in the data, suggesting a broader framing of maternal health conversations that extends beyond pregnancy.
• Child and family topics appear separately from maternal health, suggesting limited integration across the life course. The data also indicated interest in fortifying infrastructure capacity for intervention strategies that support lifelong health beyond infancy. 

Substance Use and Mental Health

Current Priority: Opioid use and overdose prevention are established priorities in substance use discussions, with treatment and recovery frameworks dominating the conversation. Substance use and overdose prevention strategies receive less emphasis than treatment and recovery in substance use discussions, suggesting a focus on downstream interventions.

Secondary Signal: The co-occurrence of substance use and mental health conditions was identified as a secondary signal, suggesting attention to strengthening capacity for integrated behavioral health approaches.

Food and Nutrition Security

Current Priority: Food access and assistance program participation are dominant themes in nutrition-related public health work.

Secondary Signal: 

• Nutrition quality and healthy food access are highlighted in the data.
• The coexistence of program and nutrition terms suggests emerging prioritization of nutrition security alongside the more established framing of food security.

Infectious Disease and Outbreak Response

Current Priority: Pandemic response and immunization efforts are established priorities in infectious disease work and related surveillance capabilities.

Secondary Signal: Foodborne illness, outbreak surveillance, and laboratory capacity surfaced as secondary signals, highlighting complementary infectious disease detection and response capabilities beyond pandemic response and immunization.

Tobacco Control and Emerging Products

Current Priority: Well-stablished tobacco control priorities center around combustible tobacco products and youth prevention, with cessation and secondhand exposure as accompanying topics.

Secondary Signals: 

• Secondary signals are expanding beyond traditional tobacco to include novel products and delivery systems, suggesting an evolving prevention landscape that may require new approaches.
• Youth prevention and adult cessation appear as separate topics, suggesting age-specific rather than life-course approaches.

Suicide and Violence Prevention, Intervention, and Community Safety

Current Priority: Health agencies continue to prioritize comprehensive approaches to prevent both suicide and firearm violence, with growing attention to community-level intervention and postvention.

Secondary Signal: The data shows health agencies focus beyond traditional prevention to include multisector and comprehensive approaches, including improved crisis services, access to care, violence intervention, postvention response, and community-driven healing.

Environmental Health and Climate

Current Priority: Drinking water quality and environmental regulation are established priorities in environmental health.

Secondary Signals: 

• Climate adaptation surfaces as a priority, with specific attention to extreme heat, air quality, and wildfire events.
• Regulatory and infrastructure language appears prominently in the data, suggesting a policy and systems focus.

Emergency Preparedness and Supply Chain

Current Priority: Fortifying response capacity and systems readiness are established emergency preparedness priorities.

Secondary Signal: Pharmaceutical supply chain vulnerabilities and drug shortages emerged as additional priority topics related to public health infrastructure and systems resilience.

Aging, Dementia, and Long-Term Care

Current Priority: Falls and injury prevention are established priority areas, with aging-related issues appearing across multiple topics, suggesting broad relevance within other public health conversations.

Secondary Signals: 

• Dementia, fall prevention, and caregiver support are appearing across multiple topics, suggesting aging-related issues may be coalescing into a distinct priority area.
• This topic focuses more on individual health risks associated with aging rather than long-term care system capacity.

Variance in Community Health Outcomes

Current Priority: Documenting and measuring differences in health outcomes between communities is a well-established priority area.

Secondary Signals: 

• Community experience, opportunity access, and cross-sector collaboration are secondary signals, suggesting consideration of broader systems-level drivers of variance in health outcomes.
• Increasing foundational capacity for approaches that document and address within-community variance (e.g., experiences of people with disabilities within rural communities) in health outcomes also surfaced as a secondary signal.

Oral Health and Preventive Dental Care

Current Priority: Routine preventive care and dental provider availability are established priorities in oral health.

Secondary Signals:

• The integration of oral health with primary care and broader health care delivery is becoming more visible, with attention to workforce capacity and cross-disciplinary care.
• Discussions about the connection between oral health and overall health outcomes appeared in the data, suggesting interest in advancing more integrated approaches to dental care.

Disability, Accessibility, and Technology Support

Current Priority: Disability services and developmental disabilities are more established themes that appear in the data, primarily focused on service provision and support systems.

Secondary Signals: 

• Technology accessibility, telehealth access for people with disabilities, and inclusive design are appearing across multiple topics within the data, suggesting a focus on ensuring access to services and technology for people with disabilities.
• There is interest in the potential applications of emerging technologies to support disability inclusion, independent living, and accessibility more broadly including for people in rural communities.
• Enhancing disability preparedness and emergency planning for people with disabilities and access/functional needs also emerged in the data.

Looking Ahead: Next Steps and Ongoing Development

Building on this foundational work, ASTHO will continue to strengthen and expand our horizon scanning capabilities through:

• The implementation of a panel of subject matter experts to iteratively validate and refine the preliminary findings.
• Continued exploration and refinement of our topic modeling methods.
• Integration of additional data sources over time to deepen our scanning capabilities.