ASTHO works with states and territories, funders, and other national partners to align resources and improve public health infrastructure. This collaborative effort means there is a mix of frameworks, tools, and evolving needs to consider—and these needs do not always align with how health agencies are organized. ASTHO is committed to recognizing this complexity and offering cross-cutting resources to help.

To improve the state and territorial public health agencies’ performance, ASTHO works to improve public health infrastructure by:

  • Advancing participation in national accreditation.
  • Facilitating performance management and quality improvement.
  • Increasing systems assessments.
  • Increasing competencies in financial and grant management.
  • Enabling states and territories to strengthen their ability to deliver the essential public health services.


2022 Environmental Scan

ASTHO's annual Environmental Scan tracks current public health priorities and trends in the U.S. state and island jurisdictions. Recognizing that the states and island jurisdictions have different needs, capacities, and opportunities available to them, ASTHO conducted two separate scans.

View the Scan

View the Executive Summary

Financing the Future of Public Health

On this podcast, Steven Stack (commissioner, Kentucky Department for Public Health) and Janet Hamilton (executive director, CSTE) speak on what’s needed to fund the public health systems of the future.

Listen to the Podcast

State and Territorial Health Department Strategic Planning Module

The strengthening public health systems and infrastructure learning modules are designed to help public health agencies make systems-level decisions that improve their services.

Explore the Module

What Territorial Health Officials Need to Know about Grants Management

These introductory materials provide territorial health officials and their leadership teams with an overview of grants management—an essential health department function.

Explore the Module
Descarga la Versión Completa de la Guía en Español miniatura

Guide on Conducting an Administrative Policy Assessment and Gap Analysis

This resource is for state and territorial health agencies interested in improving administrative and operational policies and processes.

Get the Policy Guide in English

Descarga la Versión Completa de la Guía en Español

Latest Public Health Infrastructure Resources

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Summary of FY24 Labor, Health and Human Services, Education, and Related Agencies Appropriations Bill

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Technical Assistance Offerings

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Alabama’s Positive Transformation Through Cross-Cutting PHIG Workplans

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ASTHO engages state and territorial health agency leaders through peer networks for senior deputies and chief financial officers. These networks support mentorship, professional development, and technical assistance.

ASTHO collaborates with public health improvement partners including CDC, NACCHO, the National Indian Health Board, the Public Health Foundation, the National Network of Public Health Institutes, the Public Health National Center for Innovations, and the Public Health Accreditation Board. Through this work, partners convene performance improvement staff, advise on workforce development needs, and identify emerging needs.