ASTHO works with states and territories, funders, and other national partners to align resources and improve public health infrastructure. This collaborative effort means there is a mix of frameworks, tools, and evolving needs to consider—and these needs do not always align with how health agencies are organized. ASTHO is committed to recognizing this complexity and offering cross-cutting resources to help.
To improve the state and territorial public health agencies’ performance, ASTHO works to improve public health infrastructure by:
- Advancing participation in national accreditation.
- Facilitating performance management and quality improvement.
- Increasing systems assessments.
- Increasing competencies in financial and grant management.
- Enabling states and territories to strengthen their ability to deliver the essential public health services.
ASTHO also conducts a census of state and territorial public health agencies through the ASTHO Profile, which is fielded every two years. This survey aims to define the scope of state and territorial public health services, identify variations in practice among state and territorial public health agencies, and contribute to the development of best practices in governmental public health. For more information on the survey and its findings, visit the ASTHO Profile website.
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A Guide for Sustainable Public Health Accreditation
This sustainability guide is a planning document that health departments can use to support accreditation and reaccreditation efforts, including organizational and business process improvements. It provides guidance, examples, and templates.
Environmental Scan
ASTHO's annual Environmental Scan tracks current public health priorities and trends in the U.S. state and island jurisdictions. The scan allows ASTHO and its members to continually and proactively address the evolving public health landscape and better serve their communities.
Financing the Future of Public Health
On this podcast episode, Steven Stack (SHO-KY) and Janet Hamilton (executive director, CSTE) discuss what’s needed to fund the public health systems of the future.
State and Territorial Health Department Strategic Planning Module
The strengthening public health systems and infrastructure learning modules are designed to help public health agencies make systems-level decisions that improve their services.
What Territorial Health Officials Need to Know About Grants Management
These introductory materials provide territorial health officials and their leadership teams with an overview of grants management — an essential health department function.
Administrative Policy Assessment and Gap Analysis
This resource is for state and territorial health agencies interested in improving administrative and operational policies and processes. It includes a guide (available in both English and Spanish), as well as an instructional webinar.
Latest Public Health Infrastructure Resources
Government Shutdown Effects on Public Health: Lessons from the 2025 and 2018-2019 Closures
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Best Practices for Productive Island Grantor/Grantee Relationships
Learn MoreCollaborations
ASTHO engages state and territorial health agency leaders through peer networks for senior deputies and chief financial officers. These networks support mentorship, professional development, and technical assistance.
ASTHO collaborates with public health improvement partners including CDC, NACCHO, the National Indian Health Board, the Public Health Foundation, the National Network of Public Health Institutes, the Public Health National Center for Innovations, and the Public Health Accreditation Board. Through this work, partners convene performance improvement staff, advise on workforce development needs, and identify emerging needs.