Public Health Review

There are many considerations when forming and managing an office of health equity or minority health. The National Association of State Offices of Minority Health shares how agencies across the United States have overcome common challenges and benefited from having a dedicated health equity office. In addition, the United States Virgin Islands Department of Health discusses initial successes and challenges experienced while establishing their office. Finally, the California Department of Public Health, with a well-established office of health equity, shares how their office utilized health equity liaisons and supported rural/tribal communities. This podcast episode complements the recently published ASTHOReport “Establishing an Office of Health Equity or Minority Health,” which examines different approaches to sustainability.

 Guests

·       Rohan Radhakrishna, MD, MPH, MS, Deputy Director and Chief Equity Officer, California Department of Public Health

·       Justa Encarnacion, RN, MBA, HCM, Health Commissioner and Chief Public Health Officer, United States Virgin Islands Department of Health

·       Veronica Halloway, Executive Director, National Association of State Offices of Minority Health

Resources

·       Establishing an Office of Health Equity or Minority Health | ASTHO

·       Islands Health Equity Framework | ASTHO

·       Office of Health Equity | California Department of Public Health 

·       United States Virgin Islands Department of Health

·       National Association of State Offices of Minority Health

·       Public Health Review Morning Edition

Community health workers (CHWs) are frontline, public health professionals who share life experience, compassion, and cultural and value alignment with the communities they serve. They work in a range of settings under different titles, but what makes them unique is their ability to build deep trust with the people they serve based on their lived experience.  

Despite robust evidence demonstrating the value of CHWs, sustainability of CHW positions and funding remains a perpetual challenge. In this episode, two industry experts with direct state public health experience discuss why it is so critical to invest in the CHW workforce as part of a health equity strategy, and share resources available to help recruit, retain, and sustain the workforce.

Guests:

·       Joneigh Khaldun, MD, MPH, FACEP: Chief Health Equity Officer, CVS Health, alum–MI

·       Sherri Ohly: Co-Director, Development, Envision

Resources:

·       ASTHO: CHW resources

·       Center for Community Health Alignment: CHW Model Best Practice Toolkits

·       Community-Based Workforce Alliance: Advancing CHW Engagement in COVID-19 Response Strategies

·       CVS Health:

o   ASTHO-CVS Health: High-Impact Community Investments by Health  Plans

o   Health Equity

·       Envision:

o   Community Health Worker (CHW) Training and Technical Assistance Center 

o   Online community

o   Newsletter

o   Trainings

o   CHW Sustainability Summit Journal (English or Spanish)

·       National Association of Community Health Workers:

o   Community Health Worker Pay Equity

o   Sustainable Financing of Community Health Workers Employment

·       Northern Arizona University, Center for Health Equity Research: Community Health Representative Integration Tools for Vaccine Deployment and Emergency Response

·       Public Health Review Morning Edition

The landscape of public health data is changing. This episode dives into the importance of modernizing data exchange for a more efficient and effective public health system. We explore a framework that utilizes cloud services, open-source software, and open data standards to revolutionize how public health data is collected, shared, and analyzed.

This innovative approach outlines tools to reduce manual effort and streamline data flow across various sources, ultimately empowering state, tribal, local, and territorial health agencies (STLTs) to improve public health outcomes.

Join us as we hear national and state perspectives on data modernization initiatives, including valuable insights, experiences, and recommendations on workforce, policy, and funding to prepare for a future of cloud-based data sharing. This episode is a must-listen for public health professionals looking to harness the power of modern technologies to improve public health data exchange and ultimately, the well-being of their communities.

Speakers:

·       Rachelle Boulton, MSPH: Health Informatics Program Manager, Division of Population Health, Utah Department of Health and Human Services

·       Tabatha Offutt-Powell, DrPH, MPH: Vice President, Public Health Data Modernization and Informatics, Association of State and Territorial Health Officials

Resources:

·       The North Star Architecture framework is one way CDC has been talking about improving data exchange and leveraging cloud technologies. The themes and tools described as part of North Star Architecture are also connected to other opportunities and initiatives at CDC and with public health partners. We expect this to continue to evolve.

·       CDC Data Modernization Initiative provides a comprehensive overview of national efforts to modernize public health data collection, sharing, and analysis.

·       CDC Public Health Data Strategy details a comprehensive strategy and goal-oriented plan for leveraging data to improve public health outcomes across the nation.

·       Data Pipeline Pilot Project is a CDC and United States Digital Service (USDS) initiative co-piloted with the Virginia Department of Health that led to the creation of a prototype cloud-based data processing pipeline that validates, ingests, and links data across multiple data streams.

·       Trusted Exchange Framework and Common Agreement (TEFCA) outlines a national vision for public health data and the data, technology, policy, and administrative actions essential to exchange core data efficiently and securely across healthcare and public health.

·       CDC Data Enterprise Exchange (DEX) is a cloud-based service that streamlines data exchange between STLTs and CDC through a centralized entry point, accepts data in various formats from public health partners, and utilizes modern Application Programming Interface (APIs) for secure and efficient data exchange.

·       CDC is working closely with partners through a number of initiatives to advance interoperability. This page covers several of these with access to additional resources and information.

Summary:

The FDA Food Code provides an evidence-based set of best practices for retail food safety that can reduce the risk of foodborne illnesses from retail food establishments. It offers a wide array of benefits that can help establish uniformity in retail food across the country, but some jurisdictions may face challenges in adopting it. There are different ways to adopt the Food Code, showcased in this podcast episode, with examples from Connecticut and the Mashantucket Pequot Tribal Nation.

Speakers:

·       Manisha Juthani, MD: Commissioner, Connecticut Department of Public Health

·       Cynthia Costa: Supervisor, Food Protection Program, Environmental Health Drinking Water Branch/Environmental Health Section, Connecticut Department of Public Health

·       Maryam Hosseini, RS/REHS: Environmental Health Manager, Mashantucket Pequot Tribal Nation

Resources:

·       The Importance of the FDA Food Code | ASTHO

·       Helping Healthy Agencies Adopt the FDA’s Updated Food Code | Journal of Public Health Management and Practice (lww.com)

·       Our History | Mashantucket Pequot Tribal Nation

·       Environmental Health Program | Mashantucket Land Use Commission

·       Sec. 19a-36j. Food inspectors. Certification. Inspections. | Chapter 368a – Department of Public Health

·       Sec. 19a-36h. Adoption by reference of United States Food and Drug Administration’s Food Code. Regulations. | Chapter 368a – Department of Public Health

·       ASTHO Daily Newscast: Public Health Review Morning Edition

The Government of Guam (GovGuam)— along with many other states, territories, and freely associated states — experience s challenges with procurement, which were illuminated by the COVID-19 pandemic response. To improve their small purchase procurement process, GovGuam invested time and resources into business process improvement (BPI), forming cross-agency leadership and project teams with key staff from the Guam Department of Public Health and Social Services (DPHSS), the Office of the Governor of Guam, and other government agencies to inform decisions. Learn about the benefits and challenges of their efforts, and listen to their hopes for the future.

Guests

·       Arthur San Agustin: Special Assistant of Health to the Governor of Guam, Former Director of Guam DPHSS, ASTHO Alum

·       Bertha Taijeron: Program Coordinator, Guam DPHSS

·       Jon Junior Calvo: Chief of Staff, Office of the Governor of Guam

Resources

The social determinants of health (SDOH)—the social, economic, and built environments in which people live, learn, work, and play—have significant impacts on health outcomes. Yet, sustainably funding initiatives that address SDOH is an ongoing challenge. In this episode, Admiral Rachel Levine, MD, assistant secretary for health at HHS, and Danielle Nelson, Senior Program Analyst at the Federal Transit Administration, discuss the federal government’s commitment to aligning investments and resources across agencies. In addition, Elizabeth Hertel, director of the Michigan Department of Health and Human Services, provides a practical example of how Michigan’s state health agency works collaboratively with the housing authority to ensure access to stable housing.

Guests:

Admiral Rachel Levine, MD: Assistant Secretary for Health, HHS

Elizabeth Hertel: Director, Michigan Department of Health and Human Services

Danielle Nelson: Senior Program Analyst, Federal Transit Administration

Resources:

Braiding and Layering Funding to Address the Social Determinants of Health

Public Health Review Morning Edition

In 2016, Mike Fraser joined ASTHO as CEO. Throughout the seven subsequent years, he served as an indispensable leader, visionary, mentor, and friend—steering the organization through unprecedented challenges in public health, including the global COVID-19 pandemic. Now, the time has come to bid Mike a bittersweet farewell. In this episode of Public Health Review, we speak with Mike about his profound legacy, celebrate ASTHO’s extraordinary achievements under his tenure, and wish him well in his new position as CEO at the College of American Pathologists.

Behind the Scenes: What it Takes to do COVID Testing

Public Health Review Morning Edition

The One Health approach recognizes the interconnection between human and animal health and their shared environment. There is an urgent need for a One Health approach now, especially in the prevention of outbreaks, not just response. Public health agencies and the animal agriculture industry play crucial roles in One Health, along with other stakeholders. In this episode, our guests tell us how they put One Health into practice in a state health department, how health departments can connect across agencies to address One Health issues, and what falls under the One Health umbrella.  

Guests 

Dr. Karen Smith, MD, MPH: Founding Partner, Healthy Community Partners, Inc 

J.J. Jones: Executive Director of the National Institute for Animal Agriculture 

Dr. Megin Nichols DVM, MPH, DACVPM: Deputy Division Director, Division of Foodborne, Waterborne, and Environmental Diseases, CDC 

Resources 

ASTHO One Health Case Studies 

ASTHO One Health Webinars 

ASTHO Responding to Emerging Food Safety Threats Policy Statement 

CDC Division of Foodborne, Waterborne, and Environmental Diseases 

CDC One Health Office 

National Institute for Animal Agriculture

Public Health Review Morning Edition

Public health has a workforce problem: the demand for a new generation of public health practitioners is higher than ever, but health agencies are having a hard time filling positions, either due to funding or lack of visibility. Luckily, there are solutions to bridge fresh graduates to public health careers. In this episode of Public Health Review, Dr. JP Leider from the University of Minnesota and Dr. Heather Krasna of Columbia University spoke with ASTHO about solutions to recruit new public health professionals and the partnerships forming around that endeavor.

Guests:

JP Leider, PhD: Director, Center for Public Health Systems, University of Minnesota School of Public Health

Heather Krasna, PhD: Associate Dean, Career and Professional Development, Columbia University School of Public Health

Resources:

Public Health Careers

Consortium for Workforce Research in Public Health

Successful overdose prevention efforts require support from public health, public safety, and community harm reduction programs. These partnerships are key to promoting sustainable and effective overdose prevention.

On this episode of Public Health Review, we speak with representatives from each of these fields to discuss their perspectives, experiences, and the importance of maintaining strong relationships while also negotiating differing strategies and approaches: Brandon del Pozo, a former police officer and current assistant professor of medicine and public health at Brown University; Joy Rucker of the Black Harm Reduction Network; and Dr. Cathy Slemp, former state health commissioner of West Virginia and current vice chair of the West Virginia Hope in Action Alliance.

Guests:

Brandon del Pozo, PhD: Assistant Professor of Medicine and Health Services, Policy, and Practice, Brown University

Joy Rucker: National Harm Reduction Consultant, JR Harm Reduction Consulting

Cathy Slemp, MD, MPH (alumni-WV): Co-Founder and Vice Chair, West Virginia Hope in Action Alliance

Resources:

https://www.astho.org/globalassets/brief/od2a-public-health-public-safety-partnerships.pdf

ASTHO’s Essentials of Leadership and Management (ELM) training gives public health experts the skills they need to better perform their supervisory positions and support their teams. On this episode, we check in with ELM graduates in Kentucky: Shannon Rome at the Franklin County Health Department, and Elizabeth Anderson-Hoagland with the Kentucky Department of Public Health. They share how the program has improved their work and helped them grow as leaders. We also hear from ASTHO’s Avia Mason about ELM, its impact on public health practitioners, and how programs like ELM can improve organizational culture and workplace wellbeing.

Guests:

Shannan Rome, Health Access Nurturing Development Services (HANDS) Manager, Franklin County Health Department

Elizabeth Anderson-Hoagland, Cabinet for Health and Family Services, Kentucky Department of Public Health Division of Prevention and Quality Improvement

Avia Mason, Vice President of Leadership and Organizational Performance, ASTHO

American Indian and Alaska Native (AI/AN) populations experience profound health disparities in part due to significant social and economic barriers. Having solid data helps inform policies that can improve the systems that serve these populations and mitigate stigmas impacting the health of AI/AN mothers and infants. Centering community voices can produce more effective and equitable healthcare, reducing the disparities impacting AI/AN communities.

In this episode, three experts—Ed Ehlinger (alumni-MN), a previous past president of ASTHO; Janelle Palacios, a nurse midwife and researcher; and Katelyn Strasser, administrator of the Office of Child and Family Services with the South Dakota Department of Health—discuss the Federal Advisory Committee on Infant and Maternal Mortality’s most recent report on AI/AN health outcomes and the data-focused recommendations for states and territories.

Guests:

·       Edward P. Ehlinger, MD, MSP: former Minnesota Health Commissioner and past president of ASTHO

·       Janelle Palacios, PhD: Salish & Kootenai, originally from the Flathead Indian Reservation in Montana; Nurse Midwife, Researcher, and Storyteller

·       Katelyn Strasser, MPH: Administrator of the Office of Child and Family Services, South Dakota Department of Health

Resources:

·       Making Amends: Recommended Strategies and Actions to Improve the Health and Safety of American Indian and Alaska Native Mothers and Infants

·       Strengthening Risk-Appropriate Care in American Indian and Alaska Native Communities

ASTHO thanks the CDC for its support of this episode of Public Health Review.

Maternal mortality rates are disproportionally high in the United States and still increasing. The majority of maternal deaths are preventable, indicating the need for system improvements. Equitable access to risk appropriate care improves maternal health outcomes and can be achieved by engaging providers in the process of developing and implementing risk appropriate care strategies at a state systems level. In this episode, two maternal healthcare veterans share approaches for bringing providers into the process, as well as how state health officials can promote risk appropriate care strategies and address challenges in achieving equitable risk appropriate care. 

Show Notes

Guests

·       Eugene C. Toy, MD, FACOG, FABFM, Obstetrics & Gynecology, Medical Director of ACOG Texas Levels of Maternal Care Verification Program

·       Lily Lou (alumni-AK), MD, FAAP, Neonatal-Perinatal Medicine

Resources

·       Risk Appropriate Care Stakeholder Convenings

·       Strengthening Risk-Appropriate Care in American Indian and Alaska Native Communities

·       CDC Levels of Care Assessment ToolSM (CDC LOCATeSM)

·       Levels of Maternal Care (ACOG)

STIs are on the rise. Now more than ever, it is imperative to raise awareness of the current state of STIs, especially their disproportionate impact on marginalized populations. Whole person care and status-neutral approaches to STI treatment and prevention empower people to access resources and services, as well as increase engagement, outreach, and education, all of which are key components of these care models. Hear from Leandro Mena of CDC and Thomas Dobbs (alumni-MS) on the benefits of these approaches.

Guests

Resources

·       Innovative STD Prevention and Treatment Strategies Microlearnings

·       Blog on the rise of STIs

·       ASTHO and NCSD Joint Statement on Rise of Syphilis in the U.S.

·       Sexually Transmitted Infections: Strategies for Your State

Like other vulnerable populations, American Indian and Alaskan Native (AI/AN) communities faced greater risk for complications during the COVID-19 pandemic. One such complication was ensuring that AI/AN populations had access to the vaccine. Listen to three public health experts share how they prioritized vaccine equity for AI/AN communities on the local, state, and national levels during the pandemic.

Guests

Anne Zink, MD, FACEP, Chief Medical Officer for Alaska Department of Health, ASTHO President   

Gary Lankford, Program Director for the Advances in Indian Health Care, Association of American Indian

Physicians 

Johnny Delgado, Project Director, Bakersfield American Indian Health Project 

Resources

New ASTHO Program Aims to Increase Equity in Adult Immunization 

Partnering with Community Action Agencies Can Improve Trust in Vaccines 

Public Health and Healthcare Partner to Promote Influenza Vaccination 

10 KEY ACTIONS to Improve Immunization Uptake and Advance Health Equity: Community Engagement 

This podcast focuses on the Washington State Department of Health’s (WA DOH) approach to understanding and addressing climate and equity concerns. Guests discuss the need to continuously make connections between climate change and public health, the role of community engagement and partnerships in advancing these efforts, the use of existing networks to reach at-risk populations, and how to stay grounded in the public health messaging on climate change. WA DOH discusses some of its recent initiatives for engaging environmental justice communities, shares its approach for training and coordinating resiliency planning, and highlights ways the department raises awareness of the climate’s impact on health.  

Resources:

• WA DOH Climate and Health Web Page • WA State Environmental Justice Task Force Final Report • ASTHOReport: Climate Change and Environmental Justice: A Snapshot of Jurisdiction Activities

Guests: 

Umair A. Shah, MD, MPH, Secretary of Health, Washington State Department of Health

Rad Cunningham, MPH, MPA, Senior Epidemiologist, Washington State Department of Health

The Association of State and Territorial Health Officials was incorporated on March 23, 1942. For 80 years, ASTHO has worked to advance public health and create a healthier nation. What has that looked like in the past, and we where are we going in the years ahead? Join ASTHO’s leadership panel—including CEO Mike Fraser, President Anne Zink, Past President Nirav Shah, and Idaho Commissioner of Health Elke Shaw-Tulloch - for a discussion on the unique role ASTHO plays in the public health landscape, and how we can seize historic investments in health to create a more equitable future.

Guests

Mike Fraser, PhD, MS, CAE, FCPP, ASTHO CEO

Anne Zink, MD, FACEP, Chief Medical Officer, Alaska Department of Health and Social Services, Division of Public Health

Nirav Shah, MD, JD, ASTHO Past President, Director of the Maine Center for Disease Control and Prevention

Elke Shaw-Tulloch, MHS, Public Health Administrator, Idaho Department of Health & Welfare

Resources

About Us | ASTHO

Anne Zink, MD, Chief Medical Officer for Alaska Department of Health, Announced as ASTHO’s 80th President

Thanking Our Public Health Workforce

Public health agencies had to rapidly innovate during COVID-19, and one of those innovations was virtual restaurant inspections. Beginning in March 2020, COVID-19 social distancing and stay-at-home orders required many food establishments to adopt takeout and/or food delivery models. To ensure that establishments were abiding by food safety rules and to protect the health of professionals who inspect these facilities, some state health agencies implemented virtual inspection protocols. This podcast showcases how one state health department pivoted during the pandemic and how they are continuing to use this innovation now and in the future.

Guests

Resources

As Ebola cases grow in Uganda, state and island area health officials are preparing for the possibility of a case in the United States. While there are no U.S. cases currently, there was an outbreak of Ebola in Dallas in 2014 when Dr. David Lakey was Commissioner of the Texas Department of State Health Services. He joins this episode of Public Health Review to discuss his experience managing the outbreak and what lessons and advice he has as health officials prepare for potential cases of Ebola in the United States.

Guests:

Resources:

Building a comprehensive workforce response to the youth mental health crisis requires educators, traditional school behavioral health workers, and public health professionals to work collaboratively. A public health approach is needed to address youth mental health by supporting frontline staff through a “helping the helpers” model. Public health and education sectors can work in tandem to train frontline school staff and create systems of support for staff well-being. This episode highlights strategies for addressing youth mental health through the workforce and promising state practices for cross-sector collaborations.

Guests:

Resources:

Health equity is a top priority for many health agencies. In an ideal implementation, public health leaders can use performance management systems to advance health equity goals. These systems ensure that progress is being made toward department goals by systematically collecting and monitoring data to track results and identify opportunities for improvement.

Our latest episode highlights how the current equity efforts can integrate with established performance management practices. It also discusses how health agencies can use planning documents to integrate equity in health assessments, health improvement plans, strategic plans, and performance management systems.

Guests:

Resources:

The Senior Leader Reserve Corps connects former government public health leaders with current state health officials in need of leadership-level technical assistance and support. ASTHO developed this program with CDC to support state health officials as they face their biggest professional challenges.

In this episode, Dr. Greg Holzman (alum-MT), Paula Tran (SHO-WI), and Meredith Alexander (ASTHO) discuss this innovative program and highlight the work that Paula and Greg have done in Wisconsin to strengthen the statewide public health infrastructure.

To request support for your health agency, or for more information on volunteering with the Senior Leader Reserve Corps, please reach out to the Performance Excellence team, at pe@astho.org. 

Guests

Resources

Opioid use disorder (OUD) during pregnancy contributes to maternal death and poor birth outcomes. Although prenatal care can reduce these effects, pregnant individuals may delay care due to concerns about stereotyping and stigmatizing by providers. The relationship between a physician and their patient may also be strained by mandated reporting of substance use to law enforcement or social services, and related fears of parent-child separation and criminalization. Such fears may present additional barriers to receiving prenatal care.

In this episode, Dr. Joseph Kanter, the current state health official of Louisiana, and Dr. Amy Ladley, Program Manager for the Louisiana Perinatal Quality Collaborative, discuss Louisiana’s approach to reducing stigma and fears of criminalization around opioid use in pregnant and postpartum individuals. They also highlight the importance of partnerships in these efforts.

Resources:

Stigma Reinforces Barriers to Care for Pregnant and Postpartum Women with Substance Use Disorder

Supporting Pregnant and Postpartum Women with Opioid Use Disorder: An Infographic Series

Opioid Use Disorder Toolkit: Supporting the Public Health Response in Maternal, Child and Adolescent Health

Since 2000, rates of suicide and substance overdose mortality have steadily increased in the United States. A prevailing theory within public health is that substance use disorder and suicide are both “deaths of despair” and a way to cope with socioeconomic infrastructure challenges, such as poverty, lack of social connection, housing instability, and discrimination—issues which have only been exacerbated by the COVID-19 pandemic.

As a method of preventing suicide and substance use disorder, states turn to addressing upstream factors like creating healthy communities where individuals feel they matter. In this podcast episode, Sheila Nelson, a program manager for adolescent health and injury prevention at the Maine Center for Disease Control and Prevention, and Kini-Ana Tinkham, the executive director of the Maine Resilience Building Network, discuss how they are working in their communities to set youth up to thrive. Using behavioral health data from the Maine Integrated Youth Health Survey (MIYHS), they are collaborating on a Cultivating Mattering for Maine Youth Initiative where they build resilience, incorporate youth voices, and support communities in their suicide and substance use prevention efforts.

Guests:

Resources:

COVID-19 has impacted the ways in which we prevent, detect, and treat tuberculosis (TB) infections. The pandemic presented challenges to public health and healthcare systems which may have caused delayed diagnoses, and increased new infections, however some COVID-19 mitigation measures may have positively impacted TB disease burden.

What do the data tell us? What can public health do to improve TB prevention and treatment efforts?

In this episode, Dr. José Romero (SHO-AR) and Dr. Philip LoBue (Director of the Division of Tuberculosis Elimination at CDC) discuss the current state of TB, and the challenges and areas of opportunity posed by the COVID-19 pandemic. Dr. LoBue also shares information about the latest CDC TB Campaign: Think. Test. Treat TB, which aims to raise awareness for TB among patients, providers, and partners.

Older-adult health has been increasingly on the radar of public health agencies over the course of the COVID-19 pandemic. For many, it prompted new or enhanced partnerships with their sibling agencies. As the population of older adults continues to grow, it is crucial for public health agencies to join partners in the aging network to create systems that support healthy aging.

In this podcast episode, Jewel Mullen (alumni-CT) offers perspectives on the value of cultivating partnerships between state public health agencies and state units on aging. In addition, Elizabeth Head (Deputy Director, Injury Prevention Section, Georgia Department of Public Health) and Aline Stone (Georgia Alzheimer’s and Related Dementias Coordinator, Division of Aging Services, Georgia Department of Human Services) describe their collaboration to improve the health of older adults in Georgia. They share their experience participating in a pilot project with ASTHO and Trust for America’s Health to cross reference their state health improvement and aging plans.

Guests

Resources

The expansion of federal and state telehealth flexibilities throughout the COVID-19 pandemic loosened policy restrictions and improved access to telehealth for millions of people, although challenges remain for certain under resourced populations. As telehealth continues to take off, there are questions around how public health agencies are engaging in telehealth activities. Each public health department operates differently and offers a varying perspective on how they implement and support telehealth to increase access to care for communities.

In this podcast episode, Scott Harris (SHO-AL) and Mei Kwong (executive director, Center for Connected Health Policy) explore the current state of telehealth during COVID-19 and how it’s being used as a tool to access care, spotlighting examples from public health.

Guests:

Resources:

State, Federal Policies Increase Virtual Access to Behavioral Health Care

States Leverage Telehealth to Respond to COVID-19

What’s Next for Telehealth: States Try to Make COVID-19 Telehealth Options Permanent

Telehealth: An Opportunity for State and Territorial Health Agencies to Improve Access to Needed Health Services

Public health agencies work around the clock to prepare for and respond to public health threats, including infectious diseases, natural disasters, clinical care emergencies, and more. While advanced preparedness planning is invaluable, past and current emergencies also serve as critical learning opportunities to inform future public health responses.

In this episode, Haley Cash (Pacific Island Health Officers Association) and Secretary Jack Niedenthal (Republic of the Marshall Islands) share insights into the unique strategies and successes of COVID-19 responses in the U.S.-Affiliated Pacific Islands. How have these jurisdictions—with unique needs and oftentimes limited supplies—managed to protect their populations over the last two years? Our experts dive into key lessons and share broader takeaways for future public health crises.

Resources:

Adults with disabilities are reported to experience more mental distress than those without disabilities. Mental distress in this population is associated with poorer health behaviors, an increase in health services use, mental and behavioral health disorders, and reduced quality of life. In particular, the pandemic has spotlighted a need for improved healthcare delivery systems and public health response strategies as COVID-19 has exacerbated health disparities in people with intellectual and developmental disabilities (IDD).

In this podcast episode, Alison Beam (alumni-PA) and Kristin Ahrens (deputy secretary, Pennsylvania Department of Health) offer cross-agency perspectives on the challenges and experiences they faced addressing the complex needs of people with IDD during the COVID-19 pandemic. They also share strategies to leverage state Medicaid data to better understand the impact of COVID-19 on the health of people with IDD, along with how cross-agency data-sharing can provide a more comprehensive look at statewide trends and inform decision-making in current and future pandemic response efforts.

Guests:

Resources:

Centers for Disease Control and Prevention - The Mental Health of People with Disabilities

Cross-Agency Partnerships for Health Equity: Understanding Opportunities Across Medicaid and Public Health Agencies (ASTHO)

How COVID-19 impacts people with disabilities

Embedded: When Disaster Strikes for People Living With Disabilities (ASTHO)

Embedded: One Year Review of Disability and Preparedness Specialists Project

As Omicron leads to nation-wide COVID-19 surges, many jurisdictions face the decision to activate crisis standards of care, a decision-making guide that helps healthcare providers give the best care during situations where resources are scarce. These guidelines focus on care for groups of people rather than individuals and are steered by ethical principles to avoid discrimination. Crisis standards of care can be especially impactful for people living with disabilities who may require access to certain resources, such as ventilators, as part of their routine medical care.

In this episode, Katey Redmond (former Disability and Preparedness Specialist, Alaska Department of Health and Social Services) and Dr. Alexis Travis (State Health Officer, Michigan Department of Health & Human Services) speak about disability inclusion in crisis standards of care and share advice on how to build partnerships with the disability community.

Guests

Resources

Public Health leaders know that location matters and has a significant impact on an individual’s health—and initiatives that have the highest impact focus on localized conditions and speak directly to community needs. Nicole Alexander-Scott (director, Rhode Island Department of Health) and Katie Lamansky (health program manager, Idaho Department of Health and Welfare) discuss why place-based interventions are a key strategy for health agencies to advance health equity. We examine the Health Equity Zone model and share what states can borrow from it to reimagine how they engage with communities.   

Guests

Resources

A strong public health infrastructure is required at the national, state, territorial, and local levels to carry out critical programs and respond to emergencies. How can states move from a reactive approach of ad hoc crisis funding to a proactive investment in nimble, cross-cutting systems? How are states that are undergoing public health transformations positioned to leverage new funding for core priorities like data modernization?

In our latest episode, Dr. Steven Stack (Commissioner, Kentucky Department for Public Health) and Janet Hamilton (Executive Director, CSTE) share the latest insights from the field. They address short and long-term needs that public health departments must consider as they create the next generation of public health infrastructure—from laboratories to workforce development, to community partnerships, data systems, administrative readiness, and more. Together, building this infrastructure can be the rising tide that lifts all services across the public health system.

Guests:

Resources:

This episode highlights COVID-19’s impact on overdose-related deaths during the postpartum period, also known as the fourth trimester. There has been a significant increase in postpartum overdose-related deaths in recent years—a problem that has only been exacerbated by the COVID-19 pandemic.  

In this episode, Dr. Kristina Box (Indiana state health commissioner) discusses the topic from a state-level perspective. Dr. Mishka Terplan (medical director, Friends Research Institute) then shares an overview of the stigma this population faces, and what can be done to improve health outcomes for people with substance use disorder during the postpartum period.  

Guests:  

Resources: 

The COVID-19 pandemic has brought challenges to communities nationwide, but there is reason for hope: In the face of these struggles, health agencies are seeing real progress that will provide benefits long after the pandemic passes.

In our latest episode, Anne Zink (Chief Medical Officer, Alaska Department of Health and Social Services) and Larry Lewis (licensed psychologist and executive coach) speak on the importance of celebrating “small wins”—tangible stories of progress that can sustain the public health workforce in an otherwise trying time. Listen in to hear what these wins look like and learn how leaders can apply this motivational practice in their own daily work.

Speakers:

Anne Zink, MD, FACEP, Chief Medical Officer, Alaska Department of Health and Social Services, Division of Public Health

Larry Lewis, PhD, Licensed Psychologist and Independent Executive Coach

Resources:

As states continue to respond to the COVID-19 pandemic, the role of crisis communications is vital. How can states provide the public with relevant, timely information? What are the essential elements of a crisis communications response?   

In our latest episode, Umair Shah (Director, Washington State Department of Health) and Khalilah LeGrand (Director of Communications, Nebraska Department of Health and Human Services) share the latest insights from the field. Hear them discuss lessons learned during the pandemic, strategies public health communications departments can use to connect audiences with resources, and best practices of media relations.

Guests:

Umair Shah, MD, MPH, Secretary of Health, Washington State Department of Health

Khalilah LeGrand, EdD, Director of Communications, Nebraska Department of Health and Human Services

Resources:

On this episode, we dissect concerns at the southwest United States border, where health and governmental officials find themselves managing an extraordinarily complex situation, handling an increase in migration activity during a global pandemic.

Pritesh Gandhi, MD, Chief Medical Officer, U.S. Department of Homeland Security, and Erica Pan, MD, State Epidemiologist and Deputy Director, Center for Infectious Diseases at the California Department of Public Health, share how community-based partnerships are vital to managing an issue with both public health and national security implications.

Our speakers discuss how leaders at all levels of government ultimately lean on partners at the local level to carry out their missions and what that looks like at the border right now.

Guests:

Erica Pan, MD, MPH, FAAP, California State Epidemiologist and Deputy Director, Center for Infectious Diseases at the California Department of Public Health

Pritesh Gandhi, MD, MPH, Chief Medical Officer, U.S. Department of Homeland Security

Resources:

As the COVID-19 vaccination campaign continues, countering misinformation has become a core public health goal. What approaches are showing promise, and who can public health agencies bring to the table to advance clear and accurate information about vaccines?

In this episode, Nirav D. Shah, MD, JD, ASTHO President and Director, Maine Center for Disease Control and Prevention, and Joe Smyser, PhD, CEO, The Public Good Projects, share the latest insights from the field.

Tune in to hear about Maine CDC’s social media strategy, learn about existing expertise health agencies can leverage to counter misinformation, and stay up to date with challenges at the intersection of traditional media, social media, and health information.

Speakers:

Nirav D. Shah, MD, JD, ASTHO President and Director, Maine Center for Disease Control and Prevention

Joe Smyser, PhD, CEO, The Public Good Projects

Resources:

With the pandemic upending social interaction, youth mental health is an increasingly important issue. State and territorial health agencies and community partners play a role in advancing prevention at the intersection of adverse childhood experiences (ACEs)s, overdose, and suicide--strengthening equity in these efforts by addressing root causes and shared risk and protective factors.

Today’s guests discuss why understanding the intersection of suicide, overdose, and ACEs is critical to helping individuals live happy and healthy lives. It also focuses on the importance of connecting community needs, implementing awareness campaigns, and addressing stigma to reduce health disparities.

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In this bonus episode, we hear from three leading state public health officials about the latest national and state response to the COVID-19 pandemic. Their comments are taken from a virtual news conference with national journalists held Thursday, July 29, 2021.

During the event hosted by the Association of State and Territorial Health Officials (ASTHO), Dr. Nirav Shah (Maine), Dr. Karyl Rattay (Delaware), and Dr. Joseph Kanter (Louisiana), discuss the latest issues related to the COVID-19 pandemic – mask guidance, back to school issues, and the surging Delta variant.

Listen to the full briefing here.

Speakers:

Medicaid plays a critical role in providing access to health services for low-income U.S. citizens in the five U.S. territories. However, Medicaid financing in the territories has been underfunded when compared to states.

While Congress has provided a patchwork of short-term, enhanced funding solutions through recent appropriation bills, they are set to expire at the end of September, which could trigger a “Medicaid cliff” and result in drastic cuts to territorial Medicaid programs.

Today’s guests discuss the urgent need for a permanent Medicaid solution, drawing attention on the need for equitable health financing for the U.S territories. This funding is necessary to support comprehensive public health and healthcare within these jurisdictions that includes expanded prevention, testing, and treatment programs and capabilities.  

Speakers:

Karl Ensign, MPP, Vice President, Territorial Support, Association of State and Territorial Health Officials  

Justa Encarnacion, RN, BSN, MBA,  Commissioner of Health, U.S. Virgin Islands Department of Health

Jorge Galva, JD, MHA, Executive Director, Puerto Rico Health Insurance Administration

Resources:

Permanent, Sustainable Medicaid Financing for U.S. Territories Policy Statement (ASTHO)

Medicaid Financing for the Territories (Congressional Research Service)

Medicaid and CHIP in the Territories (Medicaid and CHIP Payment and Access Commission)

The COVID-19 pandemic was an important lesson for public health officials that their surveillance needs can evolve and change quickly - from ramping up testing, to building up a contact tracing workforce, to creating a database for vaccinations.

On this bonus episode, Jim Ivey, chief operating officer at Chexout - a company that helps public health organizations digitize their clinics and operations - discusses the importance of interoperability.

Ivey makes the case that public health organizations need to invest in software that will adapt to their changing needs in both ongoing disease outbreaks and emerging infections, adding a robust, up-to-date data dashboard can make the difference between an economy closing down or staying open.

Forensic pathologists investigate deaths to serve the living, but what are the implications for public health when we do not have a viable forensic pathology workforce? State medicolegal death investigation systems currently lack a capacity to respond to major public health crises, and the surge of overdose deaths over the past decade have only exacerbated this workforce shortage.

Today’s guests discuss the critical need to find new recruits in forensic pathology and urge state health officials to consider reforms that could help bring reinforcement to a vital yet often neglected profession with a huge impact on public health.

 Guests:

Tracie Collins, MD, MPH, Secretary, New Mexico Department of Health

Kurt Nolte, MD, Professor of Pathology and Radiology, University of New Mexico, Former Chief Medical Investigator for the New Mexico Office of the Medical Investigator

Resources:

Forensic Pathologist Shortages: Context and Considerations for State Public Health Agencies (ASTHO)

Increasing the Number, Retention, and Quality of Board-Certified Forensic Pathologists (The National Institute of Standards and Technology)

Reclaiming the Autopsy as the Practice of Medicine (National Association of Medical Examiners)

Needs Assessment of Forensic Laboratories and Medical Examiner/Coroner Offices (The National Institute of Justice)

The idea of “vaccine passports” is starting to become a divisive issue, but the reality is many businesses likely will begin to require patrons to show some kind of proof of vaccination against COVID-19. The good news is businesses and governments have options for how they might want to implement this requirement.

On this bonus episode of Public Health Review, Kevin Richardson, Outside Counsel on Global Government Affairs for Zebra Technologies Corporation, discusses how a business or government can create vaccine credentials that are more sophisticated than CDC’s paper cards, but also protect a holder’s personal information.

Richardson explains digital vaccine credential options, outlines their security features, and considers the policy outcomes for entities looking to confirm that people are protected against COVID-19.

Vaccines that protect against COVID-19 are now readily available for most Americans. Almost half of the adult population is fully inoculated. This is a huge step in the right direction in order to put COVID-19 behind us.

However, there remains a significant number of people who are vaccine hesitant - enough to possibly prevent the United States from reaching herd immunity. On this bonus episode we talk with Jens Dakin, Managing Director of Information Operations and Strategic Communications with AM Trace, to discuss how to best to communicate to these populations. 

AM Trace is currently working with a handful of states to create community-specific messaging for vaccine hesitant people, and Dakin discusses what they’ve learned in this process so far.

People living with disabilities have borne disproportionate burden in past emergency situations due to inequities in preparedness and response. To address and prevent inequities in the COVID-19 response, ASTHO placed 14 disability and preparedness specialists into health agencies around the country to promote inclusivity of people living with disabilities.

On today’s episode, we explore how two of these disability and preparedness specialists have worked to address the needs of people living with disabilities in their jurisdictions. Our experts share their drive for this work and what their states are doing to promote equity for people living with disabilities.

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Resources

As public health leaders race to vaccinate the nation against COVID-19, it’s critically important for public health data to move faster than disease.

On this bonus episode of Public Health Review, we chat with an expert in artificial intelligence who knows how to leverage data in the fight against disease.

Stanley Campbell, CEO and CTO of EagleForce, discusses its proprietary telehealth platform (“myVax™”) and how the company has developed a platform for a digital passport for COVID-19 Testing and Vaccination results.

He also explains how a centralized database for all personal health information--yes, even to track vaccinations-- can help us transition into a post-pandemic world.

This conversation was first published in May 2020, but we thought the lessons and takeaways are still very relevant as the nation finally begins to emerge from the COVID-19 pandemic.

May is Mental Health Month, and this year, health officials are tasked with navigating the impact of COVID-19 on the behavioral health system. The rates of depression, suicide, and substance use are expected to surge as communities continue to struggle with COVID-19 cases — along with the fear, isolation and unemployment that comes with the pandemic. It’s essential that policymakers ensure that communities have continued access to mental health and substance use disorder services not only during, but also in the aftermath of this pandemic.

During this episode, public health leaders discuss gearing up for a surge of mental health needs, and strategies states could take to mitigate the impacts. Experts also discuss why it is especially critical to examine the behavioral health infrastructure for rural communities and the impact of historical trauma exacerbated by the pandemic.  

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COVID-19 has not only stressed the U.S. healthcare and public health systems, but also highlighted racial and ethnic disparities in pre-existing conditions and health outcomes. These inequities are in part the result of differential access to quality and affordable healthcare, including access to health insurance. And individuals in rural and underserved areas face additional barriers to care, including limited access to healthcare providers, insufficient high-speed broadband connectivity, and less access to critical care because of high rates of rural hospital closures. In this episode, our guests discuss how health officials can serve as chief health strategists to work across sectors and ensure that all people have access to the services and resources that allow them to be well. This episode also details how states and territories can transform service delivery, ensure equitable access to prevention and healthcare services, and ultimately build stronger, more resilient communities. Guests: • Esther Muña, CEO, Commonwealth Healthcare Corporation, Commonwealth of the Northern Mariana Islands • The Honorable Lance Robertson, Director, Healthcare Practice, Guidehouse Resource: • ASTHO Bounce Forward Resources: https://astho.org/COVID-19/Bounce-Forward/

People with chronic diseases have suffered the most during the pandemic both in rates of COVID-19 mortality and morbidity, and in how they experience the social determinants of health (things like food insecurity, poverty, etc.) The health disparities that exist in those with chronic disease and poor social determinants of health are stark, and the pandemic clearly demonstrates the link between health equity and the social determinants of health. On today’s episode, we speak to chronic disease experts and public health leaders on how to address this growing divide.

Our guests discuss how public health can reduce disparities in communities of color and rural parts of the country where rates of chronic disease are highest--often by starting with the social determinants of health and putting racial equity at the forefront.

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One of the many lessons learned from the COVID-19 pandemic is the needed investment in a robust public health workforce that can respond to crises when they arise. Yet, a well-funded public health workforce isn’t enough--there also needs to be a fundamental commitment to health equity.

Unfortunately, years of disinvestment in governmental public health led to a system that wasn’t as prepared as it could have been for a pandemic, and COVID-19 demonstrated disproportionate impacts across racial and ethnic groups.

It is critical now more than ever to have a strong public health workforce that can address evolving challenges and needs, and build confidence in public health in communities disproportionately disenfranchised and negatively impacted by COVID-19.

The experts on this episode make the case for how a robust public health workforce could have changed the trajectory of our pandemic response, but also explain why we should reimagine what a strong public health workforce requires as we enter into pandemic recovery.

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The COVID-19 pandemic has affected children’s and families’ social, emotional, and mental wellbeing, and demand for social services has increased due to COVID-19-related and economic factors.

Programs that place foster children, prevent domestic violence, and provide temporary assistance to families experiencing job loss – among other human services programs – are as important now as they have ever been.

However, these services may have shifted from in-person visits to digital operations, eligibility requirements may have shifted, and states may soon be facing budget cuts affecting the delivery of safety net programs.

The speakers on this episode explain how states can build relationships with the human and social services sector and ensure that children and families can access critical social supports during and after this period of increased need.

This episode also leverages new resources and flexibilities created during the COVID-19 response to rebuild systems to be community-centered, prevention-focused, and equitable.

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As COVID-19 spread across the country, public health officials became key spokespeople for simple prevention measures such as hand washing, mask-wearing, and social distancing. However, these actions were met with resistance from those who felt their individual freedoms and liberties were being challenged. Misinformation and conspiracy theories led to beliefs that the virus was a hoax and prevention measures were unnecessary. Efforts to limit public health authority resulted in reduced confidence from the public and an inability for public health officials to lead.

Our experts on this podcast episode explore what public health officials can do to build back public confidence in our public health infrastructure and offer lessons that work. Our experts will discuss how and why this has happened, and how we can remedy this as we enter into COVID-19 recovery and the largest vaccination campaign in decades.

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It’s been a long and draining year in the year since the first confirmed case of COVID-19 in the United States. But help is on the way with two FDA-authorized vaccines, and more likely to get approved in the months to come. Now begins the challenge of getting Americans vaccinated from the virus that has killed more than 400,000 Americans and sickened even more. Our guests today discuss where we are now in the rollout, what we can expect in the weeks to come, and making sure that the vaccines are distributed equitably in populations disproportionately impacted by COVID-19.

Our experts on this episode also discuss that while there have been perceived challenges in the initial rollout, the overall effort of getting vaccines into the arms of a virus that barely existed one year ago is nothing short of miraculous.

Speakers:

Claire Hannan, MPH

Executive director, Association of Immunization Managers

Thomas Dobbs, MD, MPH

State health officer, Mississippi State Department of Health

Resources:

COVID-19 Resource Library (Association of Immunization Managers)

ASTHO’s COVID-19 Resource Page

COVID-19 vaccine information page (CDC)

In medical schools and public health programs across the country, 2020 will be worth its own textbook chapter in the years to come. But today we’re still in the thick of our response to the COVID-19 pandemic, though there is light at the end of the tunnel with the end of the year and an impending vaccine.

On this episode, we ask public health experts to zoom out a bit and reflect on a truly remarkable year. These public health leaders discuss the politicization of public health mitigation efforts, becoming the target of hateful attacks, and being at the forefront of the biggest health crisis in a century. Our experts also reflect on what they hope people have learned about our public health infrastructure and lessons learned for future disease outbreaks. 

Guests:

Rachel Levine, MD, Secretary, Pennsylvania Department of Health, and President, ASTHO

Tom Frieden, MD, MPH, President and CEO, Resolve to Save Lives, and former Director of the Centers for Disease Control and Prevention, 2009-2017

Resources:

COVID-19 resource page (ASTHO)

COVID-19: Simple Answers to Top Questions (ASTHO)

About Resolve to Save Lives

Economic insecurity has been on the rise in the U.S. as COVID-19 continues to spread across the country. Millions of Americans have filed for unemployment while others risk losing their income because of illness or businesses closing temporarily. The pandemic is also exacerbating the housing crisis with many facing evictions and foreclosures. There have been numerous efforts at the national and state level to address these issues.

This episode highlights ongoing efforts and provides consideration for health officials to not only limit the impact of the pandemic on the economic security and housing needs of Americans but also to rebuild systems that create a healthier, more equitable post-COVID-19 world. This podcast is the first in a series that challenges state/territorial health officials to “Bounce Forward” instead of simply bouncing back to the way things were before.

Guests:

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If there’s one major lesson we can learn from the COVID-19 pandemic, it’s the stark structural inequities among communities of color and low-income families. Though public health and human services organizations have similar goals to close these gaps, there are lots of opportunities to improve collaboration in order to eliminate some of the root causes of disparities across the country. However, that is beginning to change as investments in prevention-based work continue to get buy-in from policymakers. 

ASTHO and the American Public Human Services Association (APHSA) are now in partnership to support the transformation of the child welfare system through a prevention first model. In this episode, ASTHO’s CEO Michael Fraser, along with ASPHSA’s CEO Tracy Wareing Evans, discuss the intersection of public health and human services and why it’s so important for these two sectors to work together to achieve a shared vision of thriving families. 

Guests: 

Michael Fraser, PhD, CEO, ASTHO

Tracy Wareing Evans, President, CEO, APHSA

Resources:

Creating a 21st Century Legacy Toward Thriving Families (ASTHO and APHSA)

Policy and Practice Magazine (APHSA)

Adverse Childhood Experiences (ACEs) (CDC)

Cyanotoxins can be a major summertime public health concern for freshwater bodies. The rapid growth of blue-green algae in these waters can be harmful to humans and animals, particularly children, and it is difficult to decide if an algal bloom is toxic just by looking at it. Officials from the Oregon Health Authority (OHA) had to handle this the hard way when there was an outbreak of cyanotoxins found in the drinking water supply of the state’s capital city, Salem, in 2018.

This podcast will focus on lessons learned from the OHA’s cyanotoxin education and outreach efforts, and how a water contamination emergency caused by cyanotoxins can quickly become a public information emergency. Three guests from OHA will share how they used science-based health messaging as part of their risk communication strategy, and how important partnerships are in tackling cyanotoxins. In addition, OHA staff will discuss tools on the horizon to help conduct surveillance for cyanotoxins and prepare for future events.

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In 2017, nearly 64,000 children under six had elevated blood levels as defined by the CDC. There is no safe blood lead level in children, and even low levels of lead have been shown to affect IQ, ability to pay attention, and academic achievement. To decrease maternal and child morbidity and mortality associated with lead exposure, families need access to systems of coordinated care in order to address their needs related to lead exposure.

This episode will discuss how Louisiana and Iowa have used quality improvement strategies and innovative partnerships to improve systems of care related to maternal and child lead exposure. Our guests also discuss the racial disparities that exist in populations with high lead exposure, and how addressing this is critical to achieving overall health equity.

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Related Resources:

Initially started after the 1979 Surgeon General’s Report, Healthy People began as a way achieve health improvement through a national commitment to disease prevention and health promotion.

Now in its fifth iteration, which kicked off last week, Healthy People 2030 charts the course for public health over the next decade. In this episode, public health leaders share their perspectives about where state and territorial health agencies intersect with Healthy People 2030 and why it should be treated as a ‘North Star’ in public health.

Guests:

Paul Halverson, DrPH, Founding Dean and Professor at Indiana University Richard M. Fairbanks School of Public Health Former Secretary, Arkansas Department of Health

Jill Hunsaker Ryan, MPH, Executive Director of Colorado Department of Public Health and Environment 

Resources:

Preparing for Healthy People 2030 (ASTHO)

Healthy People 2020 and 2030: Conversation and Cup of Joe ASTHOConnects webinar (ASTHO)

From Healthy People 2020 to Healthy People 2030 ASTHOBrief  (ASTHO)

Healthypeople.gov  (ODPHP)

In the past decade, 120 rural hospitals have closed—leaving many vulnerable Americans without care. As communities age, medical care is becoming harder to find due to the shortage of physicians in rural areas. On top of that, the COVID-19 pandemic is shining even more of a light on the growing health disparities faced by rural communities and the emerging needs of the rural health workforce.

On this episode, speakers will discuss the impact of COVID-19 on rural health infrastructure and workforce, and how to improve these conditions in rural communities. We hear from three leaders who work in states with high rural healthcare needs and vast provider shortages to learn how to increase access to quality healthcare in rural areas, barriers that exist, and innovative strategies for rural health workforce recruitment and retention.

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COVID-19 is amplifying why systemic racism in America is a public health issue. Communities of color are being disproportionately burdened by this pandemic due to persistent inequities that increase their risk to more severe bouts of COVID-19 and death. America is currently engaged in dual crises to stop the spread of COVID-19 and to advance racial justice.

On this episode, speakers will address both issues and highlight the importance of public health agencies leading with and integrating equity in their COVID-19 response. We hear from three leaders managing their COVID-19 response by prioritizing areas with the greatest need and supporting community-led decision-making to ensure the most socially vulnerable populations have increased access to treatment, testing, isolation options, and resources.

Speakers:

Resources:

How to Address COVID-19 in Communities of Color [ASTHO]

Promoting Health Equity through State Orders for COVID-19 Testing [ASTHO]

Health Equity During COVID-19: Top Strategies for an Equity-Focused Recovery Strategy [ASTHO]

Why We Need Race and Ethnicity Data to Beat COVID-19 [ASTHO]

COVID-19 Response Health Equity Strategy: Accelerating Progress Towards Reducing COVID-19 Disparities and Achieving Health Equity [CDC]

CDC Health Equity Considerations and Racial and Ethnic Minority Groups [CDC]

The House Ways and Means Committee Hearing on The Disproportionate Impact of COVID-19 on Communities of Color [United States House of Representatives]

The COVID Racial Data Tracker [The Atlantic]

Increasing and maintaining vaccine coverage is an important way to prevent the spread of disease and keep communities healthy.  Efforts to reduce COVID-19 transmission, such as social distancing, led to fewer people seeking non-urgent medical care and receiving routine vaccinations.  Recent studies demonstrate that childhood vaccine uptake has decreased since the onset of COVID-19, leaving many children under or unvaccinated.  Ensuring routine vaccination services during the COVID-19 pandemic is an important way to prevent the spread of serious illness, hospitalizations, and further strain on the healthcare system. 

This fall it will be vital for individuals to get vaccinated for the flu to reduce the overall burden of respiratory illness, protect vulnerable populations, and decrease the burden on the healthcare system. In this episode, our guests give the national and state-level perspective of what to expect this upcoming flu season, and why it’s so important to adhere to a vaccination schedule.

Speakers:

Nancy Messonnier, MD, Director of the Center for the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention

Jose Romero, MD, Interim State Health Official, Arkansas Department of Health; Chair, Advisory Committee for Immunization Practices; Section Chief of Pediatric Infectious Disease, Arkansas Children’s Hospital Research Institute.

Resources:

Vaccination Guidance During a Pandemic (CDC)

Why Routine Immunizations are a Must—Even During a Pandemic (ASTHO)

Leading a governmental health department is a complex job during the best of times, but particularly so during a pandemic when leaders must navigate every step carefully.  In this episode, our guests introduce and discuss a concept called ‘polarity thinking,’ which invites leaders to embrace situations or problems from the opposing perspectives, or ‘poles.’

As public health leaders have to communicate messaging that many people may not want to hear – like wearing a mask in public or urging the public to get a flu shot this fall – embracing ‘polarity thinking’ can strengthen their arguments and earn them more credibility with the people they serve. Learn more about this leadership strategy in the episode.

PROGRAMMING NOTE: At several points in the interview, the host and guests refer to the word ‘STHO,’ which stands for “state (territorial) health officials.”

Guests:

Abigail Dunne-Moses, Senior Faculty, Center for Creative Leadership

Paul Halverson, DrPH, Founding Dean and Professor at Indiana University Richard M. Fairbanks School of Public Health and former Secretary, Arkansas Department of Health

Resources:

Communicating Crucial Messages: 5 Tips to Improve Public Speaking (ASTHO)

Are You Facing a Problem? Or a Polarity? (Center for Creative Leadership)

Lessons from the Trenches: Leading During a Public Health Crisis (ASTHO)

Navigating Complexity: Managing Polarities (Harvard Business)

For people with substance use disorders or those who rely on opioids to manage chronic pain, the COVID-19 pandemic has highlighted gaps in these systems of care. Access to services has been severely impacted in areas around the country, and some states and territories are experiencing increases of fatal and nonfatal overdose. In some places, overdose deaths have outpaced COVID-19 deaths.  

State and territorial health leaders are thinking long-term about how policy changes made as a response to the pandemic might be continued to support vulnerable populations. During this episode, public health experts discuss how states and territories can better support communities by addressing barriers to pain management and substance use treatment services, along with establishing wraparound services to mitigate the societal and economic impacts of COVID-19.

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May is Mental Health Month, and this year, health officials are tasked with navigating the impact of COVID-19 on the behavioral health system. The rates of depression, suicide, and substance use are expected to surge as communities continue to struggle with COVID-19 cases — along with the fear, isolation and unemployment that comes with the pandemic. It’s essential that policymakers ensure that communities have continued access to mental health and substance use disorder services not only during, but also in the aftermath of this pandemic.

During this episode, public health leaders discuss gearing up for a surge of mental health needs, and strategies states could take to mitigate the impacts. Experts also discuss why it is especially critical to examine the behavioral health infrastructure for rural communities and the impact of historical trauma exacerbated by the pandemic.  

Guests:

Resources:

The current COVID-19 pandemic serves as a case example that highlights the fundamental need to more aggressively use the Shared Risk and Protective Factors (SRPF) Framework to address Adverse Childhood Experiences (ACEs), suicide, and opioid misuse. This episode explains what the SRPF framework is, and how states and territories can collaborate with a broader range of partners to implement research-based programs, policies, practices, and strategies that will improve the existing fractured and unstable systems. This framework ultimately works to nurture the safe and stable communities that youth and families need to thrive.

During this episode, two public health practitioners join us to discuss their unique perspectives on the SRPF Framework through a state/federal government and academic lens. Our guests explain how leveraging the SRPF Framework ultimately achieves better outcomes more efficiently—and how the pandemic underscores the urgency of using more upstream approaches.

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If there’s anyone who has spent their career preparing for a global pandemic, it’s Anne Schuchat, MD. Currently, she serves as the principal deputy director of the Centers for Disease Control and Prevention (CDC). She served as acting CDC director from January-July 2017 and February-March 2018. 

In the past 15 years, Dr. Schuchat worked on CDC emergency responses for the 2009 H1N1 pandemic influenza response, the 2003 SARS outbreak in Beijing, and the 2001 bioterrorist anthrax response. She’s worked at the CDC since 1988 on immunization, respiratory and infectious disease. Kate Winslet’s character in the 2011 film ‘Contagion’ was even modeled after Schuchat.

She sat down with ASTHO for a 1-on-1 to discuss her reaction to the COVID-19 response, what policymakers should be thinking about next, and what keeps her up at night.

“The virus hasn’t gone through the entire population. We don’t know whether the months ahead will bring a much worse illness, but I think we need to be ready for that. We need to have our systems even stronger than they’ve been in the past few months,” Schuchat says.

Guest:

Anne Schuchat, MD (RADM, USPHS, RET), Principal Deputy Director, Centers for Disease Control and Prevention (CDC)

Resources:

COVID-19 Resource Page (ASTHO)

Coronavirus (COVID-19) Page (CDC)

In just a matter of weeks, the situation around COVID-19 in the United States altered dramatically. Now, dozens of states have called for non-essential businesses to close and for residents to stay at home. It’s an evolving situation that’s testing many aspects of American life.

On this episode, we speak with two public health veterans who led state health departments during times of public health uncertainty--like H1N1 and Ebola. Our guests discuss the lessons they learned during trying times, the advice they’d give the public health workforce, and their thoughts on the situation surrounding COVID-19.

Guests:

Josh Sharfstein, MD, Vice Dean for Public Health Practice and Community Engagement at Johns Hopkins University, former state health official of Maryland

Leah Devlin, DDS, MPH, Professor of Health Policy and Management at the University of North Carolina, former state health official of North Carolina

Resources:

State, territorial, and local governments continue to grapple with substance misuse and addictions. Today’s episode discusses why there needs to be a comprehensive response in public health surveillance, in particular around the opioid epidemic. After all, without thorough data, it’s tough for lawmakers to drive action that will reduce the prevalence and incidence of drug overdoses.

This episode also explores states that are considering novel initiatives to address non-fatal drug overdoses. Today, we highlight Rhode Island and Vermont, where officials are looking at the substance misuse epidemic through a global lens to hold themselves accountable.

Guests:

Ewa King, Ph.D., Associate Director of Health, Rhode Island Department of Health Mark A. Levine, M.D., Commissioner, Vermont Department of Health

Resources:

Every year, state and territorial health officials descend on the Nation's capital to educate lawmakers on the importance of increased funding for public health. This year is no different, though there is a shadow hanging over this year's events: COVID-19, an infectious disease that's been spreading across the globe.

On the first day of ASTHO's "Washington Week," the organization formally requested emergency supplemental money with the National Association of County and City Health Officials (NACCHO), Council of State and Territorial Epidemiologists (CSTE), and Association of Public Health Laboratories (APHL) in order to adequately respond to COVID-19.

Though the risk to Americans remains low, this episode highlights why it's important for Congress and the Trump administration to support state, territorial, tribal, and local public health workforces as they respond to this possible pandemic.

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Blink and you might have missed it: In December, the federal government passed a bill that raises the legal age to buy tobacco to 21, now in effect. On top of that, the federal government also issued enforcement guidance that will remove some flavored e-cigarette products from the shelves. These laws are in response to the epidemic of youth e-cigarette use, with 27.5 percent of high schoolers reportedly using them. This podcast investigates what these federal policies might mean for youth e-cigarette use and discusses what states can do on their own to make tobacco products less available and attractive to youth and young adult consumers.

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Since 2016, 30 states have experienced hepatitis A outbreaks, primarily among individuals experiencing homelessness and/or those struggling with substance abuse. State health departments, with support from the CDC, have mounted a robust public health response, with vaccination as a cornerstone for prevention. Hear from our experts about the national perspective and on-the-ground action to stop the spread of hepatitis A—as well as challenges that remain with these complex populations.

Guests:

Cathy Slemp, MD, MPH, Commissioner and State Health Officer, West Virginia Bureau for Public Health

Neil Gupta, MD, MPH, Chief of the Epidemiology and Surveillance Branch in the Division of Viral Hepatitis, Centers for Disease Control and Prevention

Resources:

Sepsis is a life-threatening condition caused by the body’s extreme response to an infection and can rapidly lead to tissue damage, organ failure, and death. Sepsis can be caused by a wide range of infections but is most commonly linked to infections of the lungs, kidneys, skin, and gut. Based on CDC estimates, at least 1.7 million American adults developed sepsis in 2014 and nearly 270,000 died as a result of sepsis. CDC investigations showed that sepsis begins outside of the hospital for four out of every five patients. While preventing infections and illness is critical to reduce the risk of sepsis, early detection and immediate treatment is often the difference between life and death. Many opportunities exist to improve sepsis prevention, detection, and treatment and improve patient outcomes. Our experts discuss the national burden and epidemiology of sepsis, the importance of raising awareness among healthcare personnel and the community, and case examples of state efforts to promote policy changes relating to sepsis, including options for state-level policy to identify and/or prevent sepsis.

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Pregnant women are particularly vulnerable to behavioral health issues, including depression and substance misuse. According to American Congress of Obstetricians and Gynecologists (ACOG), depression is the most common mental health disorder experienced during pregnancy, with estimates that 14% to 23% of women experience perinatal depression. Leaders in Louisiana discuss how they’re providing more support for women across the span of their reproductive life, and the challenges they still face on this episode. The National Council for Behavioral Health also outlines how states can provide integrated systems of care for pregnant women.

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It’s that time of year again…flu season. Each year, the United States battles seasonal influenza, leaving thousands of people sick, hospitalized, or worse. Public health professionals across the nation are on the front lines, doing their best to prepare for and respond to seasonal flu in the hopes of reducing the likelihood of a pandemic event. This episode will focus on the burden of seasonal and pandemic flu, and highlight key planning activities and strategies that federal, state, and local public health agencies are doing to combat flu and keep communities healthy.

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In the United States, three main types of fungi—coccidioidomycosis, histoplasmosis, and blastomycosis—can cause lung infections like pneumonia when people breathe in fungal spores from the air. Depending on where you live, you may be more likely to come in contact with one of these fungi. Some fungal diseases go undiagnosed and cause serious infections in people in the United States and around the world, leading to illness and death. Increased awareness about fungal diseases is one of the most important ways we can improve early recognition and reduce delays in diagnosis and treatment. In this episode, in honor of Fungal Disease Awareness Week, Tom Chiller from CDC’s Mycotic Diseases Branch, and Kristen Ehresmann, director at the Minnesota Department of Health’s Infectious Disease Epidemiology department, talk about the risks of endemic fungal diseases.

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Nearly 34 million U.S. adults smoke cigarettes. About two out of every three of them want to quit and more than half will try to quit each year. Quitting can be difficult, but if we come together and double down on our efforts, we can help people who smoke make 2019 the year they quit—and quit for good. CDC’s Office on Smoking and Health (OSH) has designated 2019 the Year of Cessation, providing a coordinated opportunity across state and territory public health agencies to enhance their capacity to address tobacco cessation efforts. In this episode, hear about the policy implications and implementation efforts from the Tobacco Control Network and state public health executive leadership.

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Medicaid and public health partnerships play an important role in advancing a statewide approach to addressing chronic disease and population health. Collaboration and shared priorities between agencies play a significant role in addressing health conditions. In this episode, Deborah Fournier, senior director of Clinical to Community Connections at ASTHO, and Mark Larson, vice president of policy at the Center for Health Care Strategies, share some of the common misconceptions about each agency’s understanding of one another. They also discuss leveraging the respective roles and resources of Medicaid and public health through the CDC’s 6|18 Initiative. J.T. Lane (ASTHO Alumni-LA), director of value transformation at Navigant, also shares lessons learned on Medicaid and public health partnerships through the 6|18 Initiative and beyond in Louisiana.

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ASTHO

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This resource was supported by Cooperative Agreement Number, NU38OT000161, funded by the Centers for Disease Control and Prevention. The findings and conclusions in this resource are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Adverse childhood experiences (ACEs) are stressful events, including child abuse and other household challenges, that can have a negative impact on early brain development and lifelong health. In this episode, Judy Cameron, a psychiatry professor at the University of Pittsburgh, discusses her research on how early life experiences shape brain development and brain plasticity. John Hellerstedt, commissioner of the Texas Department of State Health Services and a pediatrician by training, describes how his agency is taking action to address the challenges that ACEs pose to children and families across the state. Finally, David Lakey, chief medical officer at The University of Texas System, gives an overview of an integrated data system that maps infant maltreatment in Texas, as well as a predictive model that uses geomapping and hotspots to target prevention efforts.

Guests

Resources

ASTHO:

Early Brain Development Library

Adverse Childhood Experiences: Primary Prevention

Screening for Adverse Childhood Experiences in Delaware

Other:

CDC: Adverse Childhood Experiences 

University of Pittsburgh: Working for Kids: Building Skills

University of Texas at Austin: Texas Institute for Child and Family Wellbeing

Each year, nearly 700 women in the United States die from complications related to pregnancy or delivery, with black women 3 to 4 times more likely than white women to die from a pregnancy-related cause. Three in five of these deaths can be prevented, but it involves a collaborative approach, including consistent care and cross-sector partnerships. In this episode, ASTHO’s president and leadership from CDC and HRSA discuss efforts to prevent maternal mortality and the role states and communities play to reduce racial disparities.

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Resources:

Evaluation Link: http://astho.az1.qualtrics.com/jfe/form/SV_3n2oJU8B3us5j9P

The opioid epidemic is the biggest public health crisis we currently face, with an average of 130 Americans dying every day from an opioid overdose. Medication Assisted Treatment (MAT) is an evidence-based treatment for substance use disorder that combines FDA-approved medication with counseling and behavioral health therapy but is often associated with stigma therefore limiting access and availability. In this episode, we explore Pennsylvania’s multi-pronged approach to addressing the opioid epidemic in the state and efforts to expand access to MAT. Dr. Rachel Levine, current Secretary of Health in Pennsylvania, has made opioid use a key focus of her work and will discuss how state health leadership is critical to advancing policy. Steve Seitchik, MAT Coordinator for the PA Department of Corrections, will provide a unique perspective on the importance of MAT access and provision for incarcerated populations. 

Guests:

Overview: In March 2018, Robert R. Redfield became the 18th director of CDC, bringing to the role more than 30 years of experience as a public health leader engaged in the clinical research and care of viral infections and infectious diseases, especially HIV. Since then, HHS and President Trump have announced an ambitious plan to end HIV in America, a cause which Redfield considers a prominent part of his life’s work. But public health challenges remain, including the opioid epidemic and anti-vaccine movement. In this wide-ranging conversation, Redfield shares insights into how his own personal experiences have shaped his priorities as CDC director, the importance of improved communication around vaccine education, CDC’s strategy to end HIV transmission, and how the agency plans to support states and territories as they address the opioid epidemic and other public health challenges. 

Guest: Robert R. Redfield, MD, Director, Centers for Disease Control and Prevention and Administrator of the Agency for Toxic Substances and Disease Registry 

Resources:

CDC Strategic Framework

Ending the HIV Epidemic: A Plan for America

Overview: Advocating on Capitol Hill for strong public health systems is critical to advancing the work of state and territorial health agencies. Earlier this month, the nation’s top health officials came to Washington, D.C., to meet with members of Congress and raise awareness around key issues, including raising the caps on non-defense discretionary spending, supporting the 22x22 campaign to increase the CDC’s budget 22% by FY22, and prioritizing funding for public health programs. “Washington Week” came and went, but the work is far from over, according to ASTHO CEO Michael Fraser and Carolyn Mullen, ASTHO’s chief of government affairs and public relations. Tune in as they recap the week’s events and share their outlook on the wins and challenges that lie ahead for public health funding.

Guests:

Michael Fraser, PhD, MS, CAE, FCPP

Chief Executive Officer, ASTHO

Carolyn Mullen

Chief, Government Affairs and Public Relations, ASTHO

Resources:

ASTHO’s Public Health Advocacy Materials

In recognition of American Heart Month, this episode focuses on the important role that community health workers (CHWs) play in Virginia’s statewide approach to addressing health disparities and heart disease, in particular. Across the nation, CHWs serve as linkages between patients and the healthcare system to address health disparities and provide social support. These individuals have a deep understanding of their communities and share personal, cultural, linguistic, and other characteristics with those they serve. With the support of CHWs, the Virginia Department of Health improved its capacity statewide to identify and monitor individuals with hypertension.

Guests:

 ASTHO Resources:

This episode emphasizes the importance of addressing heart disease and stroke prevention through approaches that center on health equity, including systems-level changes, quality improvement, and community development. CDC’s Division for Heart Disease and Stroke Prevention is partnering with ASTHO to support jurisdictions in successfully integrating efforts with healthcare and community partners and implementing best practices and evidence-based policies to identify, control, and improve blood pressure. Esther Muña, CEO for the Commonwealth Healthcare Corporation, the health agency for the Commonwealth of the Northern Mariana Islands, joins CDC’s Michael Sells and Chip Allen, director of health equity programs in Ohio, to explain how state and territorial health departments can improve health by being more intentional about enhancing community-clinical linkages, budgeting, and policymaking.

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The midterm elections may be behind us, but how will our nation’s political dynamics impact the public health agenda? On this episode, we examine opportunities for bipartisanship and forecast what the public health landscape may look like in the next Congress. Emily Holubowich joins us from the Coalition for Health Funding to point out key issues to watch as the federal budget process unfolds. Former Alaska health commissioner Jay Butler also explains why it’s important for health officials to build relationships with their Congressional delegations and remain agile as we prepare for both new and ongoing public health challenges.

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Overview: This episode introduces the new 2018-2023 Healthy Brain Initiative Road Map, which offers strategies for public health agencies to promote cognitive health and support people living with dementia and their caregivers. Co-authors from CDC and the Alzheimer’s Association provide details about this initiative and a forthcoming companion guide for Indian Country. Jewel Mullen, former president of ASTHO, explains how state and territorial health departments can advance healthy aging efforts through partnerships and policy, programs, and systems change.

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This episode highlights the nation’s childhood obesity epidemic and discusses ways to reduce climbing obesity rates by increasing access to healthy foods and promoting physical activity through community planning and changes to the built environment. Tennessee shares how policies and programs at the local level are working to combat obesity, and CDC examines the landscape of childhood obesity research in America and describes the Active People, Healthy Nation initiative designed to help 27 million Americans become more physically active by 2027.

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This episode highlights ASTHO’s President’s Challenge, “Building Health and Resilient Communities,” which is a multi-year campaign that calls on state, territorial, local, and tribal health officials to align strategic investments and promote community-driven, place-based solutions to empower communities to be as healthy as possible, reduce health disparities, and stimulate economic development. The challenge is aligned with the National Association of County and City Health Officials (NACCHO) and the U.S. Surgeon General’s focus on community health and economic prosperity.

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This episode explores the rise of suicide rates across the United States and the need for a comprehensive public health approach to suicide prevention. Propelled by the recent CDC Vital Signs report on state suicide rates, the episode features a federal overview of the current landscape, Colorado’s comprehensive suicide prevention strategy, and Utah’s use of technology to improve crisis responses.

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Resources:

Medicaid is a publicly-funded health insurance program that currently covers 74 million people in the US. Medicaid covers low-income people who are children, expectant mothers, people with disabilities, senior citizens, and some adults.

Opportunities exist through Medicaid to address the social determinants of health through a variety of vehicles. ASTHO’s senior director for clinical to community connections in the Center for Population Health Strategies, and a former Medicaid Director, discusses Medicaid approaches to addressing the social determinants of health and improving health outcomes for Medicaid beneficiaries.

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Antimicrobial resistance is a growing threat in the United States and containing its spread through action when even a single case of an antimicrobial resistant bacteria is identified is a priority public health strategy. In this episode, we will hear national and state perspectives on the prevention and containment of unusually resistant bacteria. The co-author of the April 2018 CDC Vital Signs report on containing unusual resistance provides an overview of the CDC strategy and Nebraska state health leadership discusses policy approaches to preventing and containing antimicrobial resistance.

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RESOURCES:

Healthy brain development in early childhood is the foundation for lifelong learning and optimal physical and behavioral health. This podcast traces early brain development science and practice, from cutting-edge research to implications for population health and implementation at the state level. In this episode, Ami Klin discusses early detection of developmental disabilities as a strategy to improve access to early care and treatment. John Wiesman shares Washington state’s success story in supporting healthy early brain development through collective impact and cross-sector collaboration.

 GUESTS:

Telehealth plays a unique role in addressing access to care issues in rural and remote areas. This podcast explores successful programs developed by the Eastern Aleutian Tribes and Alaska Department of Health and Human Services that serve both residents and migrant workers out of eight remote access clinics. In this episode, Marcus Plescia discusses how to apply telehealth strategies to existing health department activities to improve health outcomes, and Susan Highley Bailey, Janice Gray, and Tara Ferguson-Gould share success stories and models for implementing telehealth programs.

GUESTS:

This podcast, the second in a two-part series, continues to explore the concept of "Chief Health Strategist" as a way to address the most pressing public health issues and advance population health activities. This discussion continues the conversation on moving from concept into practice, as well as how to apply ASTHO’s three pillars for population health improvement to support clinical to community connections, improve health equity and the social determinants of health, and utilize public health informatics. Mary Ann Cooney offers examples of this model already at work and tells you where you can get help if you want to move forward in your state.

GUEST:

Mary Ann Cooney, Chief, Center for Population Health Strategies, ASTHO

RESOURCES:

The High Achieving Governmental Health Department in 2020 as the Community Chief Health Strategist - http://www.resolv.org/site-healthleadershipforum/files/2014/05/The-High-Achieving-Governmental-Health-Department-as-the-Chief-Health-Strategist-by-2020-Final1.pdf

ASTHO Center for Population Health Strategies - http://www.astho.org/Programs/Clinical-to-Community-Connections/ASTHO-CPHS-Overview_FINAL/

Trust for America’s Health – www.tfah.org

The concept of "Chief Health Strategist" allows public health leaders to serve as a chief architect across their jurisdiction and align health systems transformation and population health activities. Chief health strategists ensure that population health activities are targeting community health needs and build effective working relationships with healthcare partners and other sectors that affect the social determinants of health. This podcast is the first in a two-part series, and it will explore how the concept is defined, how it works, and how public health leaders can rethink their approach to be effective in their communities.

GUEST:

John Auerbach, President and CEO, Trust for America’s Health

RESOURCES:

The High Achieving Governmental Health Department in 2020 as the Community Chief Health Strategist - http://www.resolv.org/site-healthleadershipforum/files/2014/05/The-High-Achieving-Governmental-Health-Department-as-the-Chief-Health-Strategist-by-2020-Final1.pdf

ASTHO Center for Population Health Strategies - http://www.astho.org/Programs/Clinical-to-Community-Connections/ASTHO-CPHS-Overview_FINAL/

Trust for America’s Health – www.tfah.org

STDs are at a record high in the United States, and while they can impact anyone, vulnerable groups—including young people, pregnant women, and men who have sex with men—are hit hardest. In this episode, we hear state and national perspectives from leaders in the fight against STDs, discussing the resurgence and health impacts of STDs, proven prevention strategies, and the critical role of disease intervention specialists.

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The opioid epidemic has been called the worst public health crisis in America, affecting people from all walks of life, even our youngest. The second half of our story on the opioid epidemic explores how coalitions in Kentucky are driving prevention efforts, what public health practitioners in West Virginia are doing to identify and care for newborns who have been exposed prenatally to addictive drugs, and how one federal agency is working to ensure that rural communities get access substance abuse and mental health services.

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NEWS CLIPS:

For more information on the grants and programs mentioned on this program, visit: https://www.hhs.gov/about/news/2017/09/14/hrsa-awards-200-million-to-health-centers-nationwide.html.

The link above includes information about

The Access Increases in Mental Health and Substance Abuse Services (AIMS) awards (the $200 million to 1,178 health centers and 13 rural health organizations in every U.S. state, the District of Columbia, Puerto Rico, the Virgin Islands, and the Pacific Basin to increase access to substance abuse and mental health services). The new Rural Health Opioid Program (RHOP) (provides approximately $2.5 million for 10 rural health organizations in Arizona, Arkansas, Indiana, Kentucky, Maine, Maryland, Montana, Ohio, and Virginia to help community members struggling with opioid abuse find locally available treatment options and support services through partnerships with local health care providers and other community-based groups).

As the opioid epidemic continues to plague communities across the nation, health officials face growing concern over a number of related threats to our health, such as increasing rates of HIV, hepatitis C, and neonatal abstinence syndrome (NAS). In this episode, public health leaders from Alaska, Kentucky, and West Virginia discuss the evolution of the opioid epidemic and explain why health departments are so integral to the response.

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