Public Health Challenges in States

Major challenges are facing the Association of State and Territorial Health Officials (ASTHO) including limited resources but also by emerging health threats and the availability of a skilled workforce. This is reported in the ASTHO “2018-2021 Strategic Plan”,

ASTHO recently released the “Building a Healthier Nation: The State of State and Territorial Public Health” report for 2018, which provides an overview of priorities and how ASTHO can help public health organizations meet these challenges.

The first of five challenges listed in the ASTHO “Building a Healthier Nation” report seeks solutions as how to address the opioid crisis State public health leaders have responded to the crisis by implementing monitoring programs to track opioid prescriptions, providing public health campaigns to provide information on opioid misuse, and have expanded access to treatment, recovery and other prevention programs.

Secondly, state and territorial public health agencies support public health initiatives to reduce chronic disease risk factors which can include cancer, heart disease, stroke, diabetes, and substance misuse. These public health agencies require support to reduce chronic diseases which means developing public health programs, policies, and partnerships in different settings such as in communities, schools, and workplaces.

Thirdly, public health agencies are taking major efforts to prevent infectious disease outbreaks. The agencies are working hard to fight infections through immunizations, risk reduction and prevention education, and linking people to care. However, state and territorial budget cuts are affecting these programs.

Next, public health agencies have to deal with many health threats which means that these agencies have to sustain a strong public and medical preparedness system to use as both a frontline defense and safety net.

Lastly, public health agencies have oversight of public water supplies and are responsible to implement measures to reduce chemicals in the water supply and then communicate these risks to the media and public.

ASTHO has initiated a “Center for Population Health Strategies” as a resource to help State and Territorial Health Officials build clinical to community connections, address health equity and the social determinants of health, and the best way to capitalize on health data analytics and public health informatics.

In the informatics area, ASTHO’s Public Health Informatics Policy Committee leads ASTHO’s work on informatics and health IT policy issues. ASTHO provides technical assistance to state and territorial health agencies on policy questions. In addition, ASTHO through the Informatics Directors Peer Network addresses workforce issues

ASTHO is also leading a community-driven initiative funded by the CDC to develop the “Public Health Community Platform” (PSCP) to provide a public health technology platform with interoperable shared solutions to common public health informatics challenges.

ASTHO is also supporting CDC’s syndromic surveillance strategy, is engaged in CDC’s National Syndromic Surveillance Program, participating in BioSense, and is involved in CDC’s Behavioral Risk Factor Surveillance System.

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