Public Health Review

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 Edward Simmer, MD, MPH, DFAPA, Agency Director, South Carolina Department of Health and Environmental Control. Susan Best, Program Manager, Division of Food and Lead Risk Assessment, South Carolina Department of Health and Environmental Control. Resources ASTHOBrief: Virtual Food Safety Inspections During the COVID-19 Pandemic South Carolina Resource: DHEC COVID-

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: David Lakey, MD, Vice Chancellor for Health Affairs and Chief Medical Officer, The University of Texas System, Alumni-TX Resources: ASTHO Podcast: Lessons From the Trenches: Leading During a Public Health Crisis CDC Webpage: Ebola (Ebola Virus Disease)

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: Sharon Hoover, PhD, Co-Director, National Center for School Mental Health Director, NCTSN Center for Safe Supportive Schools, University of Maryland School of Medicine Allison Budzinski, MSW, CAPSW, Trauma and Resilience Coordinator Wisconsin Department of Health Services Jessica Frain, MSW, School Mental Health Consultant, Student Services/Prevention and Wellness, Wisconsin Departm

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: Nicole Alexander Scott, MD, Former Director, Rhode Island Department of Health Harry Chen, MD, Former Commissioner, Vermont Department for Health Anna Bradley, MS, CHES, State Health Improvement Coordinator, Montana Department of Public Health and Human Services Resources: Data Visualization for Performance Improvement Learning Series

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 Greg Holzman: Alum-Montana, SLRC Member Paula Tran: SHO-WI Meredith Alexander: Senior Analyst, Performance Excellence and Engagement, ASTHO Resources Senior Leader Reserve Corps Wisconsin Department of Health Services      

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

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

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. MMWR: Tuberculosis — United States, 2021 CDC Webpage: Tuberculosis Data and Statistics CDC Communications Campaign: Think. Test. Treat TB

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 im

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: Scott Harris, MD, MPH, State Health Officer, Alabama Department of Public Health Mei Kwong, JD, Executive Director, Center for Connected Health Policy Resources: State, Federal Policies Increase

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: USAPI COVID-19 Response Hub ASTHO JPHMP Article: US-Affiliated Pacific Islands Response to COVID-19: Keys to Success and Important Lessons ASTHO Newscast Clip: Fighti

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 lo

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 Alexis Travis, PhD, State Health Officer, Michigan Department of Health &am

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 Nicole Alexander-Scott, MD, MPH, Director, Rhode Island Department of Health Katie Lamansky, CHES, Health Program Manager, Get Healthy Idaho, Office of Policy, Performance and Strategy, Division of Public Health, Idaho Department of Health & Welfare Resources Episode Transcript Health Equity Zones: A Toolkit for Building Healthy and Resilient Communities Rhode Island’s Health Equity Zones: Addressing

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: Stev

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:   Kristina Box, MD, FACOG, Indiana State Health Commissioner  Mishka Terplan, MD, MPH, FACOG, DFASAM, Friends Research Institute Resources:  Preventing Fatal Overdoses in Postpartum Populations Postpartum Depression: Expanding Screening Practices to Improve Outcomes Stigma Reinforces Barriers to Care for Pregnant and Postpartum Women with Substan

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: Resiliency Guide: The Alaska Department of Health and Social Services CDC: Practicing Gratitude Works

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: Washington Department of Health COVID-19 Resources Nebraska Department of Health and Human Services COVID-19 Resources CDC Crisis and Emergency Risk Communication

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

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: Maine CDC’s #VaccineAnswersforMe video campaign The Public Good Projects Project VCTR First Draft News Stanford Int