1059: Charting the Next Four Years: Inside ASTHO’s 2026–2029 Strategic Plan

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This is Public Health Review
Morning Edition for Wednesday,

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January 28th, 2026.
I'm John Sheehan for the

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Association of State and
Territorial Health Officials.

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Today we discuss Astos 2026 to
2029 Strategic Plan with ASTO

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CEO Doctor Joseph Cantor.
He'll explain how the plan was

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developed, why now was the right
time for a refresh, and walk us

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through the plan itself from the
shifting public health landscape

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that created the need for the
plan and the four pillars that

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comprise it.
This is a great milestone for us

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that we took about a year to go
through the strategic planning

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process and a couple things
stood out.

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We were very interested at the
forefront of this process of

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having a highly inclusive
process.

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So through that we reached out
to all types of stakeholders.

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We reached out to ASTO alumni,
former state health officials,

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we reached out to our
affiliates, our close partners,

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We reached out to partners both
within and outside of

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government.
We certainly reached out to our

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board and and within our own
team as well.

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We we really tried to have as
many voices and viewpoints as

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possible to help inform where we
as ASTO want to go over the next

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four years.
The product which we launched

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earlier this month, our
strategic plan will take us

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through the end of 2029.
It lays out where we think ASTO

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as an organization and public
health at large can have an

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impact and ultimately help make
people's lives healthier, make

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people's lives better.
Given the current context, we're

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really excited to embark on this
work and we feel it's a great

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place for ASTA to be right now.
And could you talk a little bit

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about sort of the need to
refresh these strategic plans?

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I don't think it's obvious
necessarily that these plans do

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go through iterations and they
change over time.

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Can you talk a little bit about
how?

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This process.
Is is designed to meet today's

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needs rather than past
iterations.

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One of the things that struck us
at the beginning of this process

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is how much the public health
landscape has changed over the

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past five years or so and
continues to change quite

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rapidly.
We've gone through a pandemic,

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We've gone through a change in
administration.

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We've gone through various
changing priorities and

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conversation shifts.
All of that, we feel, presents

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an immense opportunity to
provide value and and ultimately

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help state health officials and
the departments they lead do a

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better job in keeping their
constituencies healthy.

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Our vision, the strategic vision
for ASTA that we coalesced

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around this plan is optimal
health for all in that we see

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the opportunity to help health
departments meet folks where

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they are and capitalize on
various opportunities.

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Coming out of the pandemic is
perilous time for public health.

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And then we've had a lot of
changes over the past year, but

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there are a lot of opportunities
in there.

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One of the things that I think
is true of public health is we

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sometimes get in the rut of
doing the same thing the same

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way.
And this plan for us is an

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opportunity to challenge
ourselves to get out of that, to

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think, what are we leaving on
the table, What can we do a

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better job of?
And ultimately, how can we exert

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leadership in this process?
And this plan was developed with

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sort of four main tenets or 4
pillars in mind.

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Can you talk about those 4
pillars and maybe how they work

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together?
You know, three of the pillars

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of this plan are outward facing
and the 4th is internal facing.

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I'll, I'll spend a second going
through the four pillars because

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they're important to us.
The 1st is public health

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leadership and working to help
elevate state health officials

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and empower them to exert
leadership in a rapidly changing

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public health landscape.
We find that even as public

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trust varies and there's all
types of threats in that space,

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folks really do trust their lead
public health official who's on

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the news all the time talking
about health threats within that

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jurisdiction and has the support
of that state's infrastructure.

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We want to help those state
health officials exert

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leadership in the most effective
means possible, particularly as

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the field of public health is
shifting so rapidly.

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So we're going to put concerted
effort into making sure that

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health officials have everything
they need to exert leadership

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during these changing times.
The second pillar is health

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department capacity and
innovation, with a concerted

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focus on health IT and the data
modernization space.

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This space is changing so
quickly, and it is too often

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been the case that in government
in general, but particularly in

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public health, we're behind the
8 ball.

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When technology changes, we want
state health departments to lead

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in this area.
So we'll be putting work towards

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building capacity and helping
state health departments

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innovate in this space.
Third pillar is expanded

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partnerships and we feel there
is a lot of opportunity for

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public health to partner
strategically with entities that

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have not been traditional
partners of public health.

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And this could be governmental
entities, it could be non

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governmental entities.
We're particularly interested in

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helping state health departments
broker beneficial partnerships

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with the private world.
As we've learned the past year,

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there is an immense appetite in
this country to improve the

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lives of people, to make
people's lives healthier, to

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help give people healthier
choices to make.

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And the private world has a big
role to play in this and has a

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lot of interest in that.
We see a big opportunity to help

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explore what mutually beneficial
partnerships in this area can

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look like, particularly with
private entities.

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And the fourth pillar is more
internal looking.

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It's, it's our own operations
within ASTO and sustainability.

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Like everyone else, I think we
we fall victim sometimes to

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being stagnant.
And as we look at the other

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three pillars that I just
mentioned, we recognized within

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ask though that we have Simone
work to do on our end, some

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cleaning up to do on our end and
how we organize ourselves as a

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organization, how we ensure our
own organization's stability and

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sustainability.
And so the 4th pillar will

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direct us to do that hard work
internally to make sure that

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ASTO is a strong, resilient and
sustainable organization in the

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years ahead.
And could you talk a little bit

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about the tension between
planning for now versus sort of

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trying to future proof it and
and you know, shoot for where

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you're going?
You know, that's that's the

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challenge right there.
And speaking as a former state

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health official, you know, you
do your best job making plans

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and then you wake up and then
there's a new fire to put out.

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And, you know, we saw that with
big fires like the pandemic.

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But for folks that have
experience working in

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government, there is, you know,
100 fires to put out before

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lunch on any given day.
You know, I'm reminded of the

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Mike Tyson quote that everyone's
got a plan until they're punched

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in the teeth.
That said, it's important to put

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pen to paper of what you want to
do over the medium and long

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term.
As an organization, it's

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important to us to structure
ourselves around aspirational

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goals.
That's important to us to

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involve stakeholders in that
process and ultimately set a

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vision.
That doesn't mean that there

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won't be hiccups or distractions
along the way, but we feel that

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this is a incredibly pivotal
time for public health, but one

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with so much opportunity.
I mean, the issues of health and

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Wellness are at the forefront of
the public's attention in a way

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that they've just never been
before.

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They weren't even to that extent
during the pandemic.

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There's a lot of opportunity in
there.

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And so even though we know there
will be distractions and

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unforeseen challenges, it's
really important to us to try

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and set a vision of where we
want to go as an organization

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and to paint the picture of what
we think is possible in the

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public health space.
And along those lines, finally,

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could you talk a little bit more
about that, that mission

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statement that you mentioned
earlier, the optimal health for

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all, what does that mean to you?
You know, the reason why this

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vision Optimal Health for All
spoke to us so clearly is it's

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so it's so universally
relatable.

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And you talk to folks in the
community, everyone has things

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that they think they could do to
be healthier to to improve their

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own Wellness.
That is probably the one

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fundamental universal truth that
that we all share.

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And at the end of the day, when
you engage with folks working

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within state and territorial
health departments, from the

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health official, you know, from
the lead all the way down the

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org chart, it's that one vision
that is shared by everyone.

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That's why folks show up to
work.

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Ultimately, it's to help make
the lives of other people in

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their community better.
So we wanted to put that front

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and center and try and focus
everything we do to that

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ultimate goal of helping folks
leave a better, healthier life.

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Doctor Joseph Cantor is chief
executive officer at ASTO.

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National overdose trends
indicate the need for a

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comprehensive public health
approach that encompasses

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primary prevention of substance
use, overdose and mortality

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prevention, monitoring and
surveillance, and access to

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treatment and recovery services.
ASTO provides capacity building

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and technical assistance for
state and territorial health

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agencies in these areas to build
strong public health leadership

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for substance use prevention and
surveillance, establish

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effective multidisciplinary
partnerships, and support the

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implementation of policies that
are informed by evidence.

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Find more at the link in the
show notes.

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This has been Public health
review Morning edition.

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I'm John Sheehan for the
Association of State and

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Territorial Health Officials.