ASTHO supports public health leaders across the U.S. territories and freely associated states — including the chief health officials (ASTHO members) — in their efforts to improve the health and well-being of their communities.
The territories are under the jurisdiction of the U.S. government, while the freely associated states are independent nations that have entered into Compacts of Free Association with the United States.
Note: ASTHO collectively refers to these eight jurisdictions as the territories and freely associated states, T/FAS, island areas, or island jurisdictions.
U.S. Freely Associated States
Public health needs in the island jurisdictions are complex and often substantially different than those of the states. This is due to nuances in services configuration, population health dynamics, susceptibility to certain public health threats (e.g., severe weather events), and eligibility for federal funding and programs. Given this, ASTHO works to champion each jurisdiction’s unique needs across partnerships and in advocacy efforts.
In addition, the team partners with health officials from the territories and freely associated states to provide direct technical assistance and share tools that support their priorities. Explore these capacity building resources today.
Featured
Leveraging the NIH Bookshelf to Showcase Health Agency Research
This free, searchable collection feeds into the PubMed database and accepts “gray literature,” or research produced outside of traditional commercial or academic publications. It is a great opportunity for public health agencies to expand their reach.
Best Practices for Productive Island Grantor/Grantee Relationships
Explore practical tips to strengthen collaboration between federal grant officers and health agency teams in U.S. territories and freely associated states. Learn strategies to improve grant spenddown, enhance existing relationships with funders, and build new partnerships for sustainable public health funding.
Braiding & Layering Funding to Sustain Cross-Cutting Efforts that Benefit Multiple Programs and Funding Streams
This four-part online course, housed in ASTHO's e-Learning Center, is designed for local, state, and island area health agencies. Users will explore key components and tools for braiding and layering funding.
Island Areas Health Equity Framework
The framework builds on current health equity frameworks to reflect the culture, experiences, and strengths of island communities more authentically.
Including Island Areas in Federal Public Health Datasets
Public health datasets inform effective decision-making. This report and addendum identify where the island areas are missing in U.S. public health datasets and share recommendations to address barriers.
Improving Indirect Cost Rate Use in Island Jurisdictions
Indirect cost rates are a critical component of effective financial management for public health agencies. This report and guide outline how island jurisdictions can improve their indirect cost rates use and maximize federal funding.
Latest Island Areas Resources
Island Areas Pursue Policies That Advance Health Outcomes
