Public Health Review

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. Guests: J.T. Lane (Alumni-LA), Director, Value Transformation, Navigant Deborah Fournier, Senior Director, Clinical to Community Connections, ASTHO Mark Larson, V

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 Judy Cameron, PhD, Professor of Psychiatry, University of Pittsburgh John Hellerstedt, MD, Commissioner, Texas Department of State Health

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.   Guests: Nicole Alexander-Scott, MD, MPH, ASTHO President and Director, Rhode Island Department of Health Wanda Barfield, MD, MPH, RADM USPHS, Director of the Division of Reproductive Health, CDC Michael D. Warren, MD, MPH, FAAP, Associate Administrator, Maternal and Child Health, HRSA   Resources: CDC Vital Signs Report on Pregnancy-Related Deaths (May 2019) CDC Levels of Care Assessment Tool (CDC LOCATe) HRSA – Maternal Morbidity and Mortality Resources HRSA’s Alliance for

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: Rachel Levine, MD; Secretary of Health for the Commonwealth of Pennsylvania Steven Seitch

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 Toxi

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: Norman Oliver, MD, MA, State Health Commissioner, Virginia Department of Health Patrick Wiggins, Health Systems Intervention, Coordinator, Virginia Department of Health Keandra Holloway, Community Health Worker, Richmond City Health District    ASTHO Resources: Tools for Change Resource Library Community Health Workers: An Overview AST

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. Guests: Michael L. Sells, MSPH, CHES, Project Officer, Advancing Population Health Team, Division for Heart Disease and

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. Guests: Jay Butler, past president of ASTHO and former commissioner of the Alaska Department of Health and Social Services Emily Holubowich, executive director of the Coalition for Health Funding  Resources: ASTHO Government Affairs Coalition for Health Funding

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. Guests: Molly French, MS, Public Health Director, Alzheimer’s Association Lisa McGuire, PhD, Alzheimer’s Disease and Healthy Aging Program Lead, Centers for Disease Control and Prevention (CDC) Jewel Mullen, MD, MPH, MPA, 2014-2015 ASTHO President and Associate Dean for Health Equity at The University of Texas at Austin Dell Medical School Resources: State and Local Public Health Partnerships to Address Dementia, The 2018-2023 Road Map CDC’s Alzheimer

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. Guests: Terry O’Toole, PhD, Chief, Program Development and Evaluation Branch, CDC Division of Nutrition, Physical Activity, and Obesity John Dreyzehner, MD, MPH, FACOEM, Commissioner of Health, Tennessee Department of Health John Vick, PhD, Evaluation and Assessment Director, Office of Primary Prevention, Tennessee Department of Health Resources: CDC’s Active People, Healthy Nation Initiative CDC Public Health Grand Rounds: Preventing Childhood Obesity TN Depart

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. Guests: Nicole Alexander-Scott, MD, MPH, ASTHO president and director of the Rhode Island Department of Health VADM Jerome Adams, MD, MPH, 20th Surgeon General of the United States Kevin Sumner, MPH, NACCHO president and health officer for the Middle-Brook Regional Health Commission in New Jersey Resources: ASTHO President’s Challenge Web Page Rhode Island Health Equity Zones Brochure  

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.   Guests: Deborah Stone, ScD, MSW, MPH, Behavioral Scientist, Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention (CDC) Jarrod Hindman, MS, Deputy Chief, Violence and Injury Prevention-Mental Health Promotion, Colorado Department of Public Health and Environment Joseph Miner, MD, MSPH, Executive Director, Utah Department of Health   Resources: CDC Vital Signs Report on Suicide Rates Colorado’s Suicide Prevention Resources Utah Suicide Prevention Plan: 2017-2021  

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. GUEST: Deborah Fournier, Senior Director, Clinical to Community Connections, ASTHO RESOURCES: ASTHO Medicaid and Public Health Partnerships ASTHO Resources on Cross-Sector Partnerships to Address Social Determinants of Health Georgetown University Health Policy Institute, Center for Children and Families Report on Leveraging Medicaid to Address Social Determinants and Improve Child and P

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. GUESTS: Arjun Srinivasan, Associate Director, Healthcare-Associated Infection Prevention Program, National Center for Emerging and Zoonotic Infectious Diseases, CDC Thomas Williams, Chief Medical Officer and Director, Office of Public Health, Nebraska Department of Public Health. Maureen Tierney, Director, Healthcare Associated Infections/Antimicrobial Resistance Program, Nebraska Department of Public Health 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: Ami Klin, PhD, Director, Marcus Autism Center, Children's Healthcare of Atlanta, and Georgia Research Alliance Eminent Scholar Professor and Chief, Division of Autism and Related Disorders, Department of Pediatrics at Emory University School of Medicine John Wiesman, DrPH, MPH, Secretary of Health, Washington State Department of Health, President, ASTHO

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: Marcus Plescia, MD, Chief Medical Officer, ASTHO. Susan Highley Bailey, RN Case Manager, Eastern Aleutian Tribes. Janice Gray, Nurse Consultant II, the Alaska Department of Health and Human Services. Tara Ferguson-Gould, Quality Improvement Coordinator, the Alaska Primary Care Association.

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 C

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 S

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. GUESTS: Gail Bolan, Director, CDC’s Division of Sexually Transmitted Disease Prevention Nathaniel Smith, Director and State Health Officer, Arkansas Department of Health Jeff Stover, Operations Director for Population Health, Virginia Department of Health RESOURCES: STD Awareness Month https://www.cdc.gov/std/sam/index.htm STD Treatment Guidelines https://www.cdc.gov/std/tg2015/default.htm Syphilis Call to Action https://www.cdc.gov/std/syphilis/resources.htm