Public Health Review

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. Show Notes: Rachael Banks, Oregon Health Authority in the Division of Public Health, Director Jessica Kroeker, Trauma Matters Omaha, Initiative Coordinator Resources: Maternal and Child Health Public Health Nurse Home Visiting Programs (Oregon Health Authority) Maternal and Child Health Title V Block Grant (Oregon Health Au

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: Nirav Shah, MD, JD, Director, Maine Center for Disease Control and Prevention, and ASTHO President. Karyl Rattay, MD, MS, Director, Delaware Department of Health and Social Services, Division of Public Health Joseph Kanter, MD, MPH, State Health Officer, Louisiana Department of Health

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

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,

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. Speakers: Sara Hart Weir, MS, Special Advisor, Missouri Department of Health & Senior Services Kara Nett Hinkley, MPP; Special Advisor for COVID-19, Louisiana Department of Health Joseph Kanter, MD, MPH, State Health Officer, Louisiana Department of Health Resources Examining the Americans with Disabilities Act in Emergency Responses (ASTHO) W

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

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

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. Guests: Karen Hacker, MD, MPH, Director of CDC's National Center for Chronic Disease Prevention and Health Promotion M. Norman Oliver, MD, MA, State Health Commissioner, Virginia Department o

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 re

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,

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. Guests: Ngozi Ezike, MD, Director, Illinois Department of Public Health David Sundwall, MD, Executive Direc

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 Libr

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

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: Karyl Thomas Rattay (MD, MS), Director, Delaware Division of Public Health Nan Roman, President and CEO, National Alliance to En

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, Presid

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. Speakers: Cu