ABSTRACT
The Association of State and Territorial Health Officials Increasing Access to Contraception Learning Community project, conducted in collaboration with the Centers for Disease Control and Prevention's Division of Reproductive Health, implemented a series of learning communities with 27 multidisciplinary teams (from 26 states and one territory) between 2014 and 2018 to improve access to the full range of contraceptive methods. The Association of State and Territorial Health Officials, the National Association for County and City Health Officials, and the National Association of Community Health Workers will partner to build the community health workforce through collaboration with community-based organizations.8 In this next phase of "life with COVID," the expanded community workforce has an opportunity to pivot to addressing other public health priorities such as contraception access with trusted frontline workers in communities serving as a link between health and social services. During the COVID-19 pandemic, public health, clinical, and community organizations have been leading data collection activities to better understand the digital literacy and telehealth experiences of patients and providers and have been working closely with providers to expand services and the capacity of communities to deliver them.9 Examples include public health efforts to accomplish digital inclusion and telehealth equity assessments, the creation of "heat maps" identifying barriers and access points for unavailable specialty services,10 and training and employment of community members in places such as libraries as digital navigators to support telehealth services.11 Early in 2020, the Office of Population Affairs of the US Department of Health and Human Services authorized telehealth as an option for Title X family planning clinics across the country and announced $35 million in grants for the Title X program to support telehealth as a means of sustaining access to contraceptive health services.12 Including contraception access within such endeavors can enhance access to services, support clinical reach, and build capacity within communities.
ABSTRACT
Local and state public health officials, who before the pandemic mainly worked behind the scenes to protect the public's health, were quickly thrust into the spotlight alongside their governors, mayors, and county commissioners to explain public health mitigation efforts such as business and school closures, mandatory mask orders, and social distancing recommendations. Before COVID-19, state and territorial health officials faced opposition from members of the public for supporting efforts to ban youth vaping and the sale of flavored e-cigarettes, for failing to support (and in some states for supporting) the use of cannabis for medical or recreational use, for enforcing vaccination requirements for school entry, or for supporting taxes on sugar-sweetened beverages. A VIEW FROM THE FIELD As the executive director of the Association of State and Territorial Health Officials (ASTHO), I have seen firsthand the stress, strain, and cognitive dissonance that results from the denigration and defamation of our public health leaders. By November 2021, almost every state legislature has seen the introduction of a bill to weaken or remove the emergency powers of governors and/or local or state health officials.11 Successful efforts to reduce the power of public health authorities are a Pyrrhic victory: knee-jerk reactions that incite one's political base but with potentially deadly consequences for all of us when health officials' hands are tied in new outbreaks.