By Chris Adams

From Zika to opioids to advocating vaccinations, state health officials are on the front lines of some of the nation’s emerging epidemics.

And beyond that, they have to contend with the old standbys: obesity, poor nutrition, environmental toxins and lack of access to health insurance and to treatment.

For the 59 members of the Association of State Territorial Health Officials (all U.S. states, plus the District of Columbia and territories such as Guam, Puerto Rico and the U.S. Virgin Islands), the task can be daunting.

Michael Fraser, the association’s executive director, led National Press Foundation fellows through a description of the widely varying structures and missions of the nation’s state health departments.

“It really is diverse – every state has a unique operation,” he said.

There are wildly differing problems to address. In Minnesota in 2017, for example, there was an outbreak of measles tied to an immigrant community that wasn’t vaccinating its children. In several states, opioid overdoses have killed hundreds of people while in other states the problem has been far less severe. Some states have been hotspots for infectious diseases.

Fraser gave an overview of the key issues facing states and talked about funding of those efforts. In 2017, a key funding issue is the future of the CDC’s Prevention and Public Health Fund, which was created by the Affordable Care Act – Obamacare – but is at risk by congressional repeal efforts.