Join CSTE   |   Career Center   |   Print Page   |   Contact Us   |   Report Abuse   |   Sign In
CSTE Features
Blog Home All Blogs

Design and Implementation of the Minnesota Drug Overdose and Substance Abuse Pilot Surveillance System (MNDOSA)

Posted By Terra Wiens, MPH, CSTE AEF Class XV Fellow, Friday, March 9, 2018
Updated: Thursday, March 8, 2018

The recreational use of drugs and other substances is an emerging and important public health threat. In Minnesota, there was a 16% increase in fatal drug overdoses between 2015 and 2016. Similarly, non-fatal emergency department (ED) visits for opioid overdoses have been increasing steadily over the past 10 years. Since 2010, there have been at least four clusters of synthetic drug use in various communities in Minnesota. The burden that drug overdoses impose on health care systems is difficult to quantify. Many ED visits attributed to recreational drug use do not have a diagnosis of drug overdose, but have diagnoses of symptoms and signs related to substance abuse (e.g., altered mental status, acute respiratory failure, etc.). As such, these visits are not readily identified from typical data sources.

During the epidemiologic investigation of one of the aforementioned clusters, epidemiologists from the Minnesota Department of Health (MDH) discovered that identifying cases through chart review was impossible, as a wide variety of ICD codes were used. This cluster highlighted the need for a surveillance system to identify patients who present to the ED and/or are hospitalized for drug use or substance abuse.

In collaboration with key partners, MDH designed the Minnesota Drug Overdose and Substance Abuse Pilot Surveillance System (MNDOSA). This innovative surveillance system aims to: (1) determine the burden of overdose and substance abuse in Minnesota hospitals, (2) identify clusters of drug overdoses in near real time to provide situational awareness to stakeholders, (3) identify substances causing atypical clinical presentations, clusters, and severe illness and/or death, and (4) describe at-risk populations in order to focus and guide prevention efforts. MNDOSA is unique and novel as it collects real-time data rather than relying on data sources that have long delays in reporting, allowing for a near real-time response and notification of stakeholders.

This surveillance system combines reporting of drug overdose cases at three pilot hospitals, enhanced toxicology testing of clinical specimens, medical record reviews for a subset of patients, and the utilization of public health codes in medical records to monitor trends in drug and substance abuse and overdose in Minnesota. Active reporting includes real-time reporting to MDH of ED and in-patient admissions at the participating hospitals where the principal diagnosis is attributed to the recreational use of one or more of the following: Schedule I drugs, opioids (including prescription opioids, fentanyl or fentanyl analogs), synthetic, non-prescription drugs, prescription drugs, drug combinations, natural substances for recreational purposes, and other substances, including inhalants. ED visits and/or hospitalizations attributed to alcohol use alone are excluded from surveillance. Comprehensive data is abstracted from medical records for a subset of patients.

Clinical specimens for a small number of patients are submitted to the MDH Public Health Laboratory for enhanced toxicological testing. This testing is necessary because clinical specimens are often not obtained from non-fatal drug overdose patients in the ED. Additionally, hospital laboratory panels do not detect many of the new, synthetic drugs. The MDH Laboratory has the capacity to detect a vast array of prescription, illicit, and designer drugs. Laboratory results are used for surveillance purposes only, and the results will enhance understanding of the drugs/substances circulating in Minnesota.

In addition to active reporting, this surveillance incorporates an informatics-based, passive approach. Public health codes will be assigned to patients’ medical record for ED visits and hospitalizations attributed to the recreational use of the aforementioned drugs/substances, allowing MDH to monitor trends and patterns in drug/substance use and overdose in Minnesota.

Surveillance started in November of 2017 with plans to continue until December 2020, at which time the feasibility of continued surveillance will be assessed. MNDOSA is supported in part by funding from CSTE. The lessons learned thus far include:

  • Capacity to report patients varies by ED – this pilot explores multiple methods of both active and passive reporting to assess feasibility and determine the best method of reporting
  • Ability to utilize the electronic medical records to flag clinical specimens for submission to the MDH laboratory or assign public health codes to the chart also varies by site
  • Some ED staff have concerns about reporting identifiable data on patients likely engaged in criminal activity (i.e. illicit drug use), which we addressed by agreeing to eliminate identifying information from the data as soon as possible
As the burden of recreational drug and substance use and abuse continues to increase nationwide, advancing our understanding of this epidemic is imperative. The Minnesota Drug Overdose and Substance Abuse Pilot Surveillance System will track drug overdoses and substance abuse resulting in ED visits at participating hospitals and ultimately give public health officials a better understanding of the rapidly-changing landscape of recreational drug overdose and substance abuse in the state.

(Image: Poster created by Elly Pretzel at MDH with input from Poison Center in response to the investigation of synthetic drug use in 2013).

Terra Wiens is a CSTE Class XV AEF Fellow at the Minnesota Department of Health. Her fellowship focus area is Behavioral Health. The fellowship is supported by CDC Cooperative Agreement Number 5U38OT000143.

This post has not been tagged.

Share |
PermalinkComments (0)

A CSTE Fellow’s American Samoa EpiAid Response Experience

Posted By Stephanie Johnson, MPH, Class XV CSTE Applied Epidemiology Fellow, Friday, February 16, 2018
Updated: Friday, February 16, 2018

Each year, CSTE’s Applied Epidemiology Fellowship (AEF) offers recent epidemiology graduates the opportunity to experience applied epidemiology in a real-world setting. This is a powerful way for a young epidemiologist to get real-life experience and gain valuable exposure to many facets of the job. Following the completion of my MPH in epidemiology at the University of Pittsburgh, my passion to learn more and investigate mosquito-borne infectious diseases led me to apply and accept a two-year Applied Epidemiology Fellowship. I was placed at the Centers for Disease Control and Prevention-Dengue Branch (CDC-DB) and the Puerto Rico Department of Health (PRDH) in San Juan, Puerto Rico.

A month into my fellowship, CDC-DB received a call from the territory of American Samoa requesting assistance with a dengue outbreak. The outbreak started in November of 2016 when a fisherman introduced a dengue virus strain that had not been seen in American Samoa since the 1970s. In September 2017, I deployed with an EpiAid team from Puerto Rico to work with our counterparts in American Samoa. Being part of the American Samoa team, and participating in this outbreak investigation has been a highlight of my fellowship experience so far and has opened my eyes to the reality of applied epidemiology.

Pictured: American Samoa Department of Health staff drawing blood and interviewing a person during household-cluster investigations. (Photo credit: Caitlin Cotter)

In American Samoa, I assisted in a household cluster investigation to identify people with recent dengue virus infection and identify behavioral or environmental factors associated with infection. We conducted household and individual interviews of houses within 50 meters of a confirmed dengue case. The interviewers asked about demographics, history of recent illness, use of insect-repellent, and collected blood samples of willing household members. Within two weeks, the team obtained 250 blood samples and performed interviews in six different districts on the main island of Tutuila. My work varied from organizing and maintaining field materials to managing the different interviewer and phlebotomist teams. The interviews were usually conducted in Samoan.

Pictured: The entomology team doing outdoor aspiration collecting mosquitoes. (Photo Credit: Tyler Sharp)

An additional aim of this EpiAid response was to review medical records to evaluate clinical management of hospitalized dengue patients. This information will be used to see how dengue illness might be affected by co-morbidities, timing of when care was sought, previous infection with Zika (American Samoa had a Zika outbreak in 2016), and other variables that could possibly influence severity of disease. My work involved going to the central health clinic to collect the information, and attending doctor rounds to hear their first-hand experience with dengue patients’ stories, and alert us to current patients in the ward.

My deployment took me from the familiarity of crunching numbers behind a desk to front and center fieldwork. It cemented that I love fieldwork with all that comes with it – insect repellent, unexplained delays, outdated maps, miscommunication, and the unexpected. This opportunity also showed me more of American Samoa than most people who come here as tourists get to see.

Pictured: Stephanie surveying potential mosquito breeding sites. (Photo Credit: Tyler Sharp)

As an epidemiologist, we are sometimes on the front lines of disease epidemics. My deployment to American Samoa with the EpiAid team began the Monday before Hurricane Maria hit Puerto Rico. Our originally planned team of six flew out as a team of three, with one of us leaving early due to family concerns, leaving us a team of two. I am so thankful to the American Samoa Department of Health (ASDOH) for all their help and support. The employees of both ASDOH and the field teams were fantastic. They helped my EIS officer colleague and I get to know American Samoan culture, were always available to lend a helping hand, and taught us a few words of Samoan! They also taught us about the two different types of coconut, the one you drink, and the one you cook with, as well as some of the tales and legends of the ancient Samoans.

Pictured: The EpiAid team on a hike in American Samoa (Credit: Tyler Sharp)

As a CSTE/CDC Applied Epidemiology Fellow, my deployment to American Samoa further expanded my capacity as an epidemiologist. It demonstrated to me both the interesting and exciting aspects of being on the front lines during an outbreak response, as well as the importance of time-consuming medical chart review to learn exactly how a disease can manifest. This opportunity enriched my field knowledge and allowed me to learn how to work with different cultures, different health departments, and how to bring together a lot of different people to work on an outbreak response.
Stephanie Johnson is a CSTE Class XV AEF Fellow in the Minnesota Department of Health Zoonotic Disease Unit. This publication was supported by Cooperative Agreement Number 5U38OT000143 from CDC. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC.

This post has not been tagged.

Share |
PermalinkComments (0)

CDC and CSTE Collaborate, Train Future MMWR Authors

Posted By Sonja A. Rasmussen, MD, MS, Editor-in-Chief, Morbidity and Mortality Weekly Report (MMWR), Friday, October 27, 2017
Updated: Friday, October 20, 2017

This past spring, CDC and the Council of State and Territorial Epidemiologists (CSTE) joined forces to co-host an intensive writing training series for the Morbidity and Mortality Weekly Report (MMWR). Led by MMWR Executive Editor Charlotte Kent, PhD, MPH and CSTE Senior Program Analyst Jessica Arrazola, DrPh, MPH, CHES, the workshop was designed to increase the number of quality submissions from state, territorial, local, and tribal (STLT) health agencies and to train junior authors, strengthening their capacity to write reports appropriate for publication in MMWR.

CSTE was a natural partner for this initiative, as CSTE outlined the need for scientific writing training specific to MMWR in a special report. It was this report that also prompted the development of a toolkit of scientific writing resources for public health practitioners.

Dr. Kent and our MMWR team conducted three webinars, which were open to the public. The webinars provided an overview of MMWR and focused on cross-cutting skills and strategies for writing for scientific publications. The recorded webinars were well-attended, attracting 200 participants per webinar session. The success of this effort confirmed that there’s broad interest in writing for MMWR as well as the need for scientific writing guidance among STLT staff.

In addition to the webinars, MMWR and CSTE identified 21 junior STLT authors, selected through a competitive application process, to attend a two day in-person training. These novice authors were paired with an experienced author for mentorship and assistance in the development of an MMWR submission. In addition to Dr. Kent and myself, workshop mentors included: Paul Etkind, DrPH, MPH; John S. Moran, MD, MPH; Paul Z. Siegel, MD, MPH; and Rich Vogt, MD. The in-person training allowed for peer-to-peer feedback about their draft manuscripts and covered important topics such as engaging the media, social media outreach, and legal and ethical implications of publishing public health data.

I had the privilege of serving as mentor to Maureen Leeds, MPH, an epidemiologist for the Minnesota Department of Health. Today, MMWR is pleased to publish the first of the novice STLT authors’ manuscripts titled, “Timeliness of Receipt of Early Childhood Vaccinations Among Children of Immigrants — Minnesota, 2016,” which was written by Maureen.

"It was an honor to be accepted into this first training group, and I'm grateful for the support provided by CSTE and my CDC mentor. It's exciting to be published for the first time, especially in MMWR," shared Maureen.

Congratulations, Maureen! We look forward to publishing the work of all of our MMWR and CSTE trainees.

Photo caption: Maureen Leeds, MPH, (second from the left) and other workshop participants discuss opportunities for publishing in MMWR.

Photo caption: Dr. Charlotte Kent, MMWR Executive Editor, leads discussion of a case study about publishing in MMWR.

This post has not been tagged.

Share |
PermalinkComments (0)

2017 CSTE Student Scholar Carrie Clippinger – Highlights from the 2017 Annual Conference

Posted By Stephen Clay, Friday, October 20, 2017
Updated: Wednesday, October 18, 2017
CSTE President Joe McLaughlin, 2017 Student Scholarship winner Carrie Clippinger and Executive Director Jeff Engel.
Pictured: CSTE Vice President Joe McLaughlin, 2017 Student Scholarship winner Carrie Clippinger and Executive Director Jeff Engel.

Editor’s note: In spring 2017, CSTE awarded the second student scholarship to Carrie Clippinger, MPH of Pennsylvania. Carrie is a recent Penn State College of Medicine graduate looking to begin her career in epidemiology with a focus on substance use, mental health and suicide prevention. Carrie has written a blog on her experience as the 2017 CSTE Student Scholar.

I am honored to have been chosen as the 2017 recipient of the CSTE Student Scholarship. Attendance at the 2017 Annual Conference was especially exciting, as it was the largest gathering of applied epidemiologists in U.S. history. It was my first time visiting the host city Boise, Idaho, and I enjoyed exploring the friendly mountain desert city, known for its scenic trails and Basque culture.

Participating in such a large event has given me valuable perspective into the work of public health professionals. As a recent graduate, it was refreshing to see real world and cutting-edge application of epidemiological principles. Although insightful work was presented in every track, I was most drawn to discussions of mental health and substance use, which align with my professional work. The topic of the hour was opioids, and it was fascinating to learn how government epidemiologists across the nation – with vastly different authority and resources at their disposal – are tracking this epidemic with the tools available. Despite huge differences in how each agency tackled this problem, most presenters agreed that strong community cooperation was an integral component of their opioid epi work.

I was also particularly interested in discussions of suicide surveillance, a topic which I am heavily involved in rural Pennsylvania. Again, I was struck by the diverse range in epidemiologists’ ability to monitor suicides, the variance in relationships with community partners and coroners or medical examiners, and the creativity with which public health professionals across the nation are collecting and analyzing data on suicides and suicidality. There was a particular emphasis on the sensitive nature of the research, the need for flexibility to address localized concerns, and ethical considerations.

Idaho’s public health efforts were well-represented during a standout plenary on the state’s work with its refugee populations – the largest per capita of any state in the nation. I also enjoyed attending breakout sessions on public health law – a timely and impactful topic that inspired reflection on epidemiology’s role in protecting public health. Engaging presentations on climate change, tickborne disease, water supply infrastructure, and maternal and child health were also eye opening. On the whole, successful projects at the conference included novel research methods such as geomapping, the use of real-time data gathered through new technologies, and the use of syndromic data – demonstrating that epidemiology is not a static discipline. Across the board, projects showcased the power of epidemiology to adapt and innovate.

Networking with CSTE fellows and attendees was truly invaluable. Seeing and learning from the practical, meaningful work of epidemiologists from a wide diversity of career paths was a unique opportunity that holds great importance for me as a recent graduate. Thank you to everyone who contributed to the scholarship for making my attendance at the CSTE Annual Conference possible. The Student Scholarship will undoubtedly continue to be an influential experience for future recipients.

To donate to the CSTE Student Scholarship, visit

Tags:  workforce development 

Share |
PermalinkComments (0)

CSTE Welcomes 15th Class of Applied Epidemiology Fellows

Posted By Kiara Maddox, MPH, CSTE Workforce & Fellowship Coordinator, Thursday, October 5, 2017
Updated: Friday, September 29, 2017
CSTE is excited to welcome the 15th class of the Applied Epidemiology Fellowship (AEF) program with 25 new fellows.

Pictured: Class 15 AEF Fellows at Orientation in Atlanta (Photo credit: Robin Gaucher)

CSTE recently hosted the new fellows in Atlanta for a week-long orientation. The agenda featured faculty from CDC, CSTE, as well as current and former Applied Epidemiology Fellows. Topics included public health surveillance, outbreak investigations, use of data visualization, public health law, scientific writing, and hot topic sessions in HAI and opioids/substance use. Fellows also had the opportunity to network with their peers, fellow alumni, as well as CSTE and CDC staff working in their subject area.

Pictured: John Anderton, CDC Acting Associate Director for Communications Science, presents on Health Communications (photo credit: Matt Cone).

Fellows’ subject areas of placement this year include behavioral health, chronic disease, environmental health, infectious diseases, healthcare-associated infections, maternal and child health, infectious disease-quarantine, substance use, and a new area of infectious diseases with a Zika focus. At their host sites, fellows will work on surveillance systems and tools, conduct case investigations, build their communication skills, and participate in training, research and field activities designed to build their epidemiologic capacity.

Some expected projects of the fellows include:

  • Evaluation of the current surveillance system for coccidioidomycosis (Valley Fever) in Washington State, Mackenzie Fuller, MPH
  • Evaluating the identification and reporting of migrant workers among New York City’s TB population, Carley Perez, MPH
  • Critical evaluation of CJD (Creutzfeldt-Jakob Disease) surveillance program in Pennsylvania, Christina Butler, DVM, MPH
  • STD surveillance data for descriptive and analytical epidemiology, Kiara Diggins-Parker, MPH
  • Enhanced surveillance for Zika virus vectors, Stephanie McCracken, MPH
  • Evaluate the potential usefulness and validity of data from the National Survey on Drug Use and Health (NSDUH), Abby Hagemeyer, PhD, MPH
  • National Healthcare Safety Network catheter-associated urinary tract infection data validation, Lee Hundley, MPH
  • Evaluation of school- and home-based asthma programs, Grace Christensen, MPH

Since 2003, the CSTE AEF program’s mission has been to provide training and real-world experience to epidemiologists early in their careers. Since its beginning, 295 fellows have completed the program, and CSTE has placed fellows in 41 states and 19 local jurisdictions.

Congratulations to the new fellows!

If you are interested in hosting an AEF fellow at your agency in 2018 visit for more information or email The deadline to apply is October 20, 2017.

This post has not been tagged.

Share |
PermalinkComments (0)

California Tribal Epis Visit New Orleans for a Peer to Peer Technical Assistance Consultation supported by CSTE’s Vector-Borne Diseases Subcommittee

Posted By Stephen Clay, Friday, September 29, 2017
Updated: Tuesday, September 26, 2017

One of CSTE’s primary objectives is to increase epidemiology and surveillance capacity in state, local, tribal and territorial jurisdictions through various programmatic and workforce capacity building initiatives. The CSTE Vector-Borne Diseases Subcommittee facilitates peer to peer technical assistance consultations to support new and less established vector-borne disease surveillance coordinators and staff. These consultations may include an orientation to the surveillance system, guidance and program requirements and day-to-day systems management.

Michael Mudgett and Zoilyn Gomez, epidemiologists at the California Tribal Epidemiology Center (CTEC), recently participating in a peer to peer technical assistance consultation supported by CSTE with staff at the Louisiana Department of Health (LDH). CTEC is one of 12 Tribal Epidemiology Centers that provide epidemiological support to each Indian Health Service region and work directly with both tribes and Indian Health Programs. CTEC monitors the health status of American Indian/Alaska Natives (AIAN) in California to develop effective public health services for their respective AIAN populations.

To begin building a foundation for vector-borne disease (VBD) surveillance capacity, Michael and Zoilyn traveled to Louisiana to work with the Infectious Disease Epidemiology Section (IDEpi) within the LDH Office of Public Health in New Orleans. CTEC’s main goal was to gain a better overall understanding of VBD surveillance in order to increase surveillance capacity within tribal jurisdictions in California. Chrissie Scott-Waldron (Public Health Epidemiologist Supervisor), Julius Tonzel (Public Health Epidemiologist) and Sean Simonson (Public Health Epidemiologist) coordinated the technical consultation visit at LDH and they were all very gracious, accommodating and helpful in answering questions throughout the consultation.

Much of the consultation consisted of engaging on various aspects of VBD disease surveillance, ranging from orientations of databases and surveillance systems, demonstrations of integrated mosquito management including various traps, mosquito species identification, rearing rooms, biological control and adulticiding/larviciding equipment, touring laboratories for human and ecologic testing and other sites vital to the VBD program.

Pictured: A shot of downtown New Orleans. Photo credit: CTEC

Day 1

We were quickly brought up to speed about IDEpi through introductions and key personnel presentations. Throughout our first day, we reviewed the various types of databases and surveillance systems utilized for VBD and visited the New Orleans Mosquito and Termite Control Board. At NOMTCB, we learned about the actual controlling and surveilling of the mosquito population, especially with the amount of standing water and high humidity in the area. Dr. Sarah Michaels demonstrated the various types of mosquito traps used around the city. Interestingly, we learned just how much Zika-virus potential is in the area since the mosquito Aedes aegypti is prevalent.

One of the biggest issues in the area with mosquitos breeding and standing water is that of disposed car tires. Many tires were simply dumped in areas like New Orleans East, which causes interesting problems for public health to handle. It was surprising that there were so many tires that needed to be disposed of in the area, and how the people contracted to dispose of the tires are finding it increasingly difficult to keep up with the demand.

The presentations given by the great staff at IDEpi provided a unique opportunity to see how VBD surveillance works behind the scenes with electronic lab reporting, database management, lab testing, interaction with providers and the Zika Pregnancy Registry.


Day 2

Pictured (L-R): Randy Vaeth, Sean Simonson, Chrissie Scott-Waldron, Kyle Moppert, Zoilyn Gomez, Julius Tonzel and Mike Mudgett. Photo credit: Louisiana Department of Health.

The second day had no shortage of VBD-related sites to see. The day began with a trip to Baton Rouge to meet State Medical Entomologist Kyle Moppert. We toured the East Baton Rouge Mosquito Abatement and Rodent Control District with Randy Vaeth, Assistant Director.

One interesting conversation on Day 2 was the public perception of public health services. In recent years, the public has been debating whether they believe the risk of spraying is worth the reward of having a mosquito population controlled. We found this intriguing since the general public in California is no stranger to debating public health services and whether certain services are perceived to be more harmful than good. However, it was clear to see the vital role these entities play in controlling the mosquito populations.

Following the Mosquito Control facility tour, the group headed to the ecologic arboviral testing lab at the Louisiana Animal Disease Diagnostic Laboratory, where Dr. Alma Roy gave a tour of their facility and shared information on the comparable lab in California. She described in detail how they tested mosquitoes for endemic and important arboviral diseases via PCR, in addition to testing various animal reservoirs for these diseases.

Next, we visited the West Baton Rouge Mosquito Control District, a small yet impressive two-person operation, before rounding out the day at the Louisiana Office of Public Health State Laboratory. We toured the facility and saw how the lab conducts molecular and serologic testing to report out human results to IDEpi. It was inspiring to see the great relationships IDEpi had with all of these sites.


Day 3

On our final day, we met with the CDC Epidemic Intelligence Service (EIS) Officer, Dr. Alean Frawley, where she provided insight on her role. Megan Jespersen, Surveillance Epidemiologist and Tribal Liaison, also gave us an overview of the Louisiana Early Event Detection System, which is Louisiana’s Syndromic Surveillance System, and the Louisiana Indian Health Surveillance.

Overall, the consultation was very valuable, as we received what we sought from the trip: foundational knowledge and technical guidance about VBD to support a younger public health entity. The consultation provided ample opportunity for us to bring back technical knowledge about VBD surveillance to CTEC. We hope to implement what we learned in our future work and thank CSTE and the Louisiana Department of Health for this opportunity.

To learn more about CSTE’s Vector-Borne Diseases Subcommittee or to participate in a peer to peer technical assistance consultation, please visit or contact Jordan Peart at

Tags:  epidemiology  infectious disease  local epidemiology  surveillance 

Share |
PermalinkComments (0)

Western States Occupational Network (WestON): Celebrating 10 Years

Posted By Song Xue, MPH, Friday, September 8, 2017
Updated: Friday, September 8, 2017

Derry Stover (NE) presents on working in occupational safety and health.

Fall not only brings the changing of leaves and cozy sweaters, but the annual Western States Occupational Network, or WestON, meeting. Every September, participants from 19 Western states come together in Denver, CO, for a day and a half meeting to advance and build capacity for occupational safety and health in the region. This year marks the 10th anniversary of the annual WestON meeting. Each year, WestON attracts over 60 participants from the NIOSH-funded Education and Research Centers (ERCs), Agricultural Centers and Training Project Grants; Federal, State and Tribal agencies; public health scientists; trainees and policymakers. Participants present and exchange ideas while identifying collaborative activities to address occupational safety and health issues in the West.


Recognizing the need to build occupational health surveillance at the state level in the West, the Council of State and Territorial Epidemiologists (CSTE), NIOSH Western States Office (now part of the NIOSH Western States Division), and Mountain and Plains Education and Research Center (MAPERC) established WestON in 2008. WestON includes participants from 19 Western states (AK, AZ, CA, CO, HI, ID, KS, MT, NE, NV, NM, ND, OK, OR, SD, TX, UT, WA, WY) who are working or strongly interested in occupational safety and health.

Western states share some collective identity based on common priority areas in workplace safety and health, such as mining, construction, and agriculture. The goal of WestON is to build and strengthen capacity among these 19 Western states to conduct state-based epidemiology, surveillance, and prevention of work-related injuries and illnesses. The framework of the WestON meeting is based on the concept that “regional” identification of common issues can help support the development of occupational epidemiology capacity in states that historically have had limited funding in this core area of public health.

Over the past 10 years, WestON agendas and topics have shifted from basic surveillance concepts to setting strategic priorities for interventions in the Western region and engaging a more diverse group of partners. Initial meetings provided participants with an opportunity to refine their surveillance skills and establish contacts in their field. More recent meetings have included participants from the NIOSH Centers of Excellence, Tribal Epidemiology Centers and journalists. The WestON meeting is one of the few venues where state, Federal and academic partners gather in a relatively small setting to share findings, promote collaboration and strategize about future activities.

WestON 2017

The 10th annual WestON meeting will take place September 13-14, 2017, in downtown Denver, with over 70 participants from the Western region. This year’s keynote speaker is Michael Grabell, a reporter from ProPublica, who will highlight workers’ compensation issues. Presentations will cover a wide array of topics, including novel uses of occupational health data, using Informatics in occupational safety and health and occupational issues related to marijuana. As with all WestON meetings, ample time will be devoted to networking and exchanging ideas for future projects. Next year’s meeting will be held in Denver on September 13-14, 2018.

How can you get involved?

Join the WestON Listserv to learn about occupational safety and health research, news, and announcements. If you would like to join, please email Song Xue at For more information about the annual WestON meetings, please contact Yvonne Boudreau at

This post has not been tagged.

Share |
PermalinkComments (0)

Update on CSTE International Surveillance Assessments

Posted By Rachelle Boulton, MSPH, Utah Department of Public Health, Friday, August 18, 2017
Updated: Thursday, August 17, 2017
Untitled Document

CDC’s Influenza Division uses cooperative agreements, paired with technical assistance, to assist Ministries of Health in countries throughout the world in establishing and improving capacity for sustainable epidemiologic and virologic influenza surveillance programs. Ensuring these systems generate useful, reliable data consistently involves routine assessment of how well they are functioning, identification of problems and assistance in solving those problems. CSTE frequently collaborates with CDC and the Association of Public Health Laboratories (APHL) to conduct international influenza surveillance assessments using standardized reporting tools that capture information, such as how potential influenza cases are identified at sentinel sites; how epidemiologic data and laboratory specimens are collected; how surveillance staff manage, analyze and report data; and how data quality is monitored. Following these assessments, detailed reports that provide recommendations for improvement in laboratory and epidemiologic surveillance are shared with the countries. Recently, Rachelle Boulton of the Utah Department of Health (DOH) completed two consecutive international influenza surveillance assessments in Sri Lanka and Maldives. Rachelle has graciously agreed to contribute a blog post on her experience during this opportunity.

I had the opportunity to represent CSTE on three international influenza surveillance assessments. I traveled to Uganda in June 2016 and most recently to Sri Lanka and the Maldives in May 2017. For each assessment, I was accompanied by the CDC Project Officer and an APHL representative conducting a concurrent influenza laboratory capacity assessment. Each of my assessments lasted four to five days, and I spend the majority of my time with the epidemiology surveillance staff. Each country begins influenza surveillance with varying amounts of existing resources and infrastructure, and each country encounters vastly different challenges throughout the process of building and maintaining influenza surveillance. One of my favorite components of the assessments is the site visits to hospitals and clinics that see patients and collect epidemiologic and laboratory data. I am always impressed with the enthusiasm, dedication and ingenuity of the surveillance staff and their clinical and laboratory partners to build and maintain high-quality influenza surveillance systems for their country.

My favorite part of my most recent trip to the Maldives was the opportunity to put down the clipboard, step out of the role of the assessor and work in depth with the data alongside surveillance staff. We worked together to develop several charts and graphs that demonstrated influenza trends in the Maldives, discussed how these figures could be compiled into different reports to tell a comprehensive and meaningful story, and identify future data collection and analysis goals.

I have thoroughly enjoyed my time spent in Uganda, Sri Lanka and the Maldives, and I look forward to future opportunities to contribute to international efforts to strengthen global influenza surveillance capacity.

Additional Information:
CDC’s Influenza Division International Program
WHO’s Global Influenza Programme Surveillance and Monitoring
CDC’s Influenza Division International Program Evaluation and Capacity Review Tools
Improved Global Capacity for Influenza Surveillance. Emerg Infect Dis. 2016;22(6):993-1001.

Pictured: Rachelle Boulton (second from left) joins assessors and surveillance staff in Sri Lanka.

Pictured: Meeting the Maldivian Minister of Health in the Maldives

Pictured: The pediatric inpatient ward at Tororo General Hospital in Uganda, Africa

This post has not been tagged.

Share |
PermalinkComments (0)

Prevention Fund Lives to Fight another Day

Posted By Emily J. Holubowich, MPP, Friday, August 4, 2017
Updated: Thursday, August 3, 2017

In the wee hours of Friday, July 28, Senator John McCain (R-AZ) unexpectedly cast the deciding “no” vote on the “Health Care Freedom Act,” a bare bones version of Affordable Care Act (ACA) “repeal and replace” legislation. Senator McCain joined Senators Susan Collins (R-ME) and Lisa Murkowski (R-AK) in defeating this final amendment to the House-passed American Health Care Act, bringing debate on the bill to a close. Even though the Health Care Freedom Act was a shell of all previously introduced – and failed – repeal and replace legislation, the bill nevertheless included a provision to terminate the Prevention and Public Health Fund beginning in fiscal 2019.

What happens next is anyone’s guess. The administration is pressuring Congress to bring the bill back up for another vote or else, threatening to end cost sharing subsidy payments to insurers that will create a “death spiral” in the marketplace. Leading Senate Republicans, including the powerful Finance Committee Chairman Orrin Hatch (R-UT) and Senator John Thune (R-SD), who serves in the number three position in Senate Republican leadership, are pushing back. They insist that Republicans will move on from ACA repeal and replace to focus on tax reform. At the same time, bipartisan groups of lawmakers are coming together to find ways to “repair” the ACA.

Regardless of where the ACA debate goes from here, it is clear Republicans are intent on repealing the Prevention Fund given that provision was included in every iteration of ACA repeal and replace legislation. These bills were not the first attempt to repeal the Prevention Fund, and they certainly won’t be the last. The public health community must continue its efforts to educate lawmakers about the value of public health, and the perils of repealing the Prevention Fund.

August is an ideal time to connect with lawmakers while they’re back home in district/state to educate them on the value of public health broadly and applied epidemiology particularly. We recommend downloading this guide prepared by the Association of State and Territorial Health Officials (ASTHO), which explains why it’s important for public health professionals to interact with policymakers and how to do so.

Emily J. Holubowich, Senior Vice President at CRD Associates, is CSTE’s Washington representative and leads our advocacy efforts in the nation’s capital.

This post has not been tagged.

Share |
PermalinkComments (0)

Public Health Funding Hangs in the Balance

Posted By Emily Holubowich, Thursday, July 27, 2017
Updated: Thursday, July 27, 2017
Emily Holubowich, Senior Vice President at CRD Associates, is CSTE’s Washington representative and leads our advocacy efforts in the nation’s capital.

There was a flurry of activity on Capitol Hill last week – and this week – with big implications for public health funding. The House Appropriations Committee approved along party lines its fiscal 2018 spending bill for the Departments of Labor, Health and Human Services, Education and Related Agencies (Labor-HHS). Starting from $5 billion lower than the current, already austere funding level, the bill forces more cuts in many health programs to support increases in others. As in years past, the bill is a mixed bag for applied epidemiology.

To be sure, the bill is a marked improvement from the president’s fiscal 2018 budget request for the Centers for Disease Control and Prevention (CDC), which proposed an 18 percent cut to the agency’s total budget, deeper cuts to many of the agency’s programs, and the outright elimination of others. The House’s proposal largely rejects many of the President’s priorities, and provides the agency roughly $7 billion – nearly 2.5 percent below current levels.

Within CDC’s budget, the Public Health Workforce activities, through which the CDC/CSTE Applied Epidemiology Fellowship receives funding, are cut by roughly $5 million, with total proposed funding of $45 million. The appropriations bills do not specify how much funding would be dedicated to the Applied Epidemiology Fellowship program per se, but with a cut in funding for the program we might expect a cut in available funding for our fellows. The president had requested a $7 million cut in the program.

The National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) receives $599.5 million, $33.4 million less than current funding, but $122.5 million more than the president’s request. Within NCEZID, the emerging infectious diseases programs absorbs most of the proposed cut. Most other programs receive flat funding – antibiotic resistance ($163 million), advanced molecular detection ($30 million), food safety ($54 million), vector-borne diseases ($26.4 million) – which means we might expect Epidemiology and Laboratory Capacity (ELC) grants to be flat funded since much of ELC funding is driven by NCEZID’s overall budget.

Interestingly, the House’s spending bill would appropriate funding from the Affordable Care Act’s (ACA) Prevention and Public Health Fund, including flat funding of $40 million for ELC and $12 million for hospital acquired infections at the same time the House voted to repeal the Prevention Fund beginning in fiscal 2019 as part of its ACA repeal effort, the American Health Care Act (AHCA). As we’ve noted before, elimination of the Prevention Fund would deal a devastating blow to CDC and public health more broadly, resulting in a 12 percent cut to CDC’s overall budget, a 20 percent cut to ELC, a 33 percent cut to immunizations, and complete elimination of all funding for core public health capacity supported by the Preventive Health and Health Services Block Grant.

On Tuesday, the Senate narrowly agreed to begin debate on ACA repeal or rather, the various repeal options released to date, and potentially others yet to be released. Of the bills made publicly available, all include repeal of the Prevention Fund.

First up was a vote on the Better Care Reconciliation Act (BCRA) – the repeal and replace legislation that would repeal the Prevention Fund beginning fiscal 2019. The BCRA was rejected by a vote of 43-57. On Wednesday, Senators rejected 45-55 the Obamacare Repeal Reconciliation Act (ORRA), the “repeal” only bill that was vetoed by President Barak Obama in early 2016. If enacted, ORRA would've repealed the Prevention Fund immediately more or less, and rescinded unobligated funds.

As a last ditch effort to pass some sort of ACA repeal, Senate Majority Leader Mitch McConnell is reportedly considering a “skinny repeal” bill that may be more likely to gain 50 votes needed for passage, since it would simply eliminate the penalty for the ACA's individual mandate – possibly along with its employer mandate and some taxes on the health care industry. There are also credible reports this “skinny repeal” will include a provision to repeal the Prevention and Public Health Fund to ensure the bill complies with reconciliation instructions. If introduced, this legislation would likely be the last and final bill to be considered, possibly around 5:00 am Friday morning (check out this helpful article and up-to-date flowchart on the procedural timetable here).

With Congress set to leave Washington for the August recess, there won’t be any further activity on fiscal 2018 spending legislation until after Labor Day when they return to the Capitol. At that time, we should have a better sense of where the Prevention Fund stands and when the Senate will consider its own public health spending bill. In any event, a continuing resolution to keep the government running on autopilot after September 30 will be needed.

In the meantime, August is an ideal time to connect with lawmakers while they’re back home in district/state to educate them on the value of public health broadly and applied epidemiology particularly. We recommend downloading this guide prepared by the Association of State and Territorial Health Officials (ASTHO), which explains why it’s important for public health professionals to interact with policymakers and how to do so. With all the threats facing public health, your voices are needed now more than ever.


This post has not been tagged.

Share |
PermalinkComments (0)
Page 1 of 17
1  |  2  |  3  |  4  |  5  |  6  >   >>   >| 
Association Management Software Powered by YourMembership  ::  Legal