Download - Issue BrIef State Health Agency Activities
State health agencies protect and promote the health, well-being, and safety of their citizens. To fulfill this responsibility, they perform a wide range of activities and functions. The ASTHO Profile of State Public Health, Volume Three, provides the most current data on state health agency services and activities.
Collaboration and TrainingState health agencies enjoy a high level of collaboration with local health departments, the healthcare sector, other state health agencies, and other partners. State health agencies often provide technical assistance to their partners on different topics. The greatest percentage of states provide technical assistance on quality improvement, performance, and accreditation.
State health agencies also provide training to local health department personnel, on topics including disease prevention and control (94% of state health agencies), tobacco (92%), preparedness (89%), and maternal and child health (89%).
Federal InitiativesState health agencies have primary programmatic and fiscal responsibility for a variety of federal initiatives. When they do not have sole responsibility for an initiative, they typically share it with another state health agency, a local governmental agency, or a nonprofit organization. The five federal initiatives for which the most state health agencies report having responsibility are the Public Health Emergency Preparedness cooperative agreement (100%), Maternal and Child Health/Title V (98%), vital statistics (98%), Preventive Health and Health Services Block Grant (96%), and the Hospital Preparedness Program cooperative agreement (Assistant Secretary for Preparedness and Response) (96%).
Access to CareEnsuring access to high quality, affordable healthcare is a key responsibility for state health agencies. The majority of state health agencies engage in activities to promote access to healthcare within their jurisdictions, particularly health disparities and minority health initiatives (94%) and rural health (72%). Additionally, the majority of state health agencies report providing financial support to primary care providers through state-sponsored loan repayment programs. These programs are intended to increase the supply of providers within a state’s jurisdiction.
I s s u e B r I e f
State Health Agency Activities
State-Sponsored Loan Repayment Programs to Increase the Supply of Providers, 2012 (n=47)
Phys
icia
ns
Den
tists
Mid
-leve
l pr
ovid
ers
Nur
ses
Oth
er p
rimar
y ca
re p
rovi
ders
70%
55%
38% 36%
23%
Primary Prevention, Treatment, and ScreeningState health agencies provide a number of services related to population-based primary prevention, screening, and treatment of diseases and conditions.
Population-Based Primary Prevention ServicesThe primary prevention services provided by the most state health agencies are tobacco (87%), HIV (85%), sexually transmitted disease counseling and partner notifi-cation (85%), nutrition (79%), and physical activity (77%).
ImmunizationsMore than 90 percent of state health agencies directly perform vaccine order management and inventory distribution for childhood immunizations, and more than 80 percent are responsible for vaccine order management and inventory distribution for adult immunizations. In contrast, only approximately one-quarter perform order management for interna-tional travel immunizations directly. Less than half of state health agencies directly administer childhood and adult vaccines, and less than one-quarter directly administer international travel vaccines.
Screening and TreatmentIn addition to population-based primary prevention services, state health agencies perform screening and treatment for a variety of diseases and conditions. The three diseases and conditions screened for directly by the most state health agencies are STDs other than HIV/AIDS (65%), HIV/AIDS (63%), and newborn screening (63%).
The greatest percentage of state health agencies provide treatment services for tuberculosis (54%), STDs other than HIV/AIDS (50%), and HIV/AIDS (30%).
Surveillance, Data Collection, and Laboratory ActivitiesState health agencies perform a variety of surveillance, data collection, and laboratory activities. The three laboratory services provided by the greatest number of state health agencies are bioterror agent testing (96%), foodborne illness testing (94%), and influenza typing (94%).
Most state health agencies perform the majority of data collection, epidemiology, and surveillance activities listed in the Profile Survey, with 100 percent directly performing reportable disease data collection,
2010 2012
Screenings for Diseases and Conditions Performed by State Health Agences, 2010-2012 (n=48)
17%25%
17%
Col
on/re
ctum
can
cer
46%
25%
Brea
st a
nd
cerv
ical
can
cer
23%17%
Car
diov
ascu
lar
dise
ase
Pred
iabe
tes
13% 15%
Ast
hma
8%13%
Oth
er c
ance
rs
21% 23%
Oth
er
56%
65%
Oth
er S
TDs
New
born
scr
eeni
ngs
69%63%
Tub
ercu
losi
s
58%56%
Bloo
d le
ad
31%
42%
Body
mas
s in
dex
29% 27%
Hig
h bl
ood
pres
sure
23%
Perc
enta
ge o
f sta
tes
Note: Body mass index and prediabetes only appeared on the 2012 Profile Survey.
Dia
bete
s
29% 27%
HIV
/AID
S
60%63%
epidemiology, and surveillance activities and 98 percent performing communicable/infectious disease, foodborne illness, and vital statistics activities in 2012, as indicated in the corresponding figure.
Regulation, Inspection, and LicensingState health agencies serve an important role in enforcing laws and regulations that protect and promote health and ensure safety. The five regulatory activities performed by the greatest percentage of state health agencies in 2012 were regulation, inspection, and licensing of laboratories (89%), food service (81%), hospitals (81%), trauma systems (81%), and emergency medical services (79%). The 15 regulatory activities performed by the most state health agencies are displayed in the related figure.
State health agencies are also involved in the oversight of professional licensure for a variety of different healthcare providers. Just under one-quarter of state health agencies are involved in the licensure of dentists, nurses, physicians, physician assistants, and pharmacists.
Environmental HealthHuman health is inextricably linked to the environments in which we live. As such, state health agencies serve as key players in environmental health. The five environ-mental health activities performed by the greatest percentage of state health agencies are environmental epidemiology (94%), food safety training and education (83%), radiation control (69%), toxicology (69%), and indoor air quality (65%).
Other Public Health ActivitiesState health agencies also perform a range of services not typically considered traditional public health activities. The six such activities performed by the most state health agencies are trauma system coordination (88%), veterinarian services (81%), state health planning and development (77%), healthcare consultations for childcare environments (69%), institutional review boards (63%), and nonclinical services in correctional facilities (63%).
Health Insurance ExchangesState health agencies were asked whether or not their state was currently establishing a health insurance exchange. Of the 48 states that responded to this question, more than half indicated that they are. Among the 28 states that are establishing exchanges, 20 (71%) of state health agencies report being engaged in the process of establishing the health insurance exchange in their state.
Additional InformationFor additional information on state health agency activities, including maternal and child health services, other clinical services provided by state health agencies, and registry maintenance, as well as a variety of other data, please refer to the ASTHO Profile of State Public Health, Volume Three, available at www.astho.org/profile. The Profile is the only comprehensive source of information about state public health agency activities, structure, and resources. Launched in 2007 and fielded every two to three years, the Profile Survey aims to define the scope of state public health services, identify variations in practice among state health agencies, and contribute to the development of best practices in governmental public health.
Recommended citation: Association of State and Territorial Health Officials. ASTHO Profile of State Public Health, Volume Three. Washington, DC: Association of State and Territorial Health Officials. 2014.
Establishment of Health Insurance Exchanges by States in 2012 (n=48)
Yes 58% No 42%
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Top 15 Regulation, Inspection, and Licensing Activities Performed Directly by State Health Agencies, 2010-2012 (n=47)
Data Collection, Epidemiology, and Surveillance Activities Performed Directly by State Health Agencies, 2010-2012 (n=48)
Perc
enta
ge o
f sta
tes
2010 2012
89%
75%
83%79%
70%66%
62%
72%75%
64%70%
49%53%
62% 64%
89%
81% 81% 81% 79% 77%72% 70% 70%
64% 62% 60% 60%57% 55%
Labo
rato
ries
Food
ser
vice
est
ablis
hmen
ts
Hos
pita
ls
Trau
ma
syst
em
Emer
genc
y m
edic
al s
ervi
ces
Lead
insp
ectio
n
Publ
ic s
wim
min
g po
ols
Long
-ter
m-c
are
faci
litie
s
Nur
sing
hom
es
Body
pie
rcei
ng
and
tatt
ooin
g
Hos
pice
Cam
pgro
unds
/RV
s
Food
pro
cess
ing
Ass
iste
d liv
ing
Smok
e-fr
ee o
rdin
ance
s
Perc
enta
ge o
f sta
tes
2010 2012
Repo
rtab
le d
isea
ses
Com
mun
icab
le/
infe
ctio
us d
isea
ses
Food
born
e ill
ness
Vita
l sta
tistic
s
Mor
bidi
ty d
ata
Perin
atal
eve
nts
or
risk
fact
ors
Beha
vior
al r
isk
fact
ors
Chr
onic
dis
ease
s
Synd
rom
ic s
urve
illan
ce
Envi
ronm
enta
l hea
lth
Inju
ry
Can
cer
inci
denc
e
Ado
lesc
ent
beha
vior
Uni
nsur
ed, o
utre
ach,
an
d en
rollm
ent
for
med
ical
insu
ranc
e
96%100%
96% 98%92%
98% 96% 98%92% 94% 94% 94% 96% 94% 94% 94%
79%
94%88% 88%
92% 92% 94%90%
77% 77%
52%
44%