Association of State and Territorial Health Officials (ASTHO)
2007, 2010, 2012, 2016
Mode of Collection
Census: web-based survey.
The Association of State and Territorial Health Officials (ASTHO) fields the ASTHO Profile of State and Territorial Public Health. The Profile is the only comprehensive source of information about state and territorial public health agency activities, structure, and resources. First fielded and published in 2007, the Profile 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. The Profile highlights descriptive findings from each survey round; provides comparisons of agencies by governance classification, geographic region, and state population size; and includes summaries of the structure and priorities of individual state and territorial agencies.
The survey covers the following topic areas related to state and territorial health agencies: (1) structure, governance, and priorities; (2) workforce capacity, composition, and development; (3) health agency activities; (4) planning and quality improvement; and (5) finance.
State and territorial health agencies in the United States (U.S.), U.S. territories, and U.S. freely associated states.
ASTHO sends a link to the web-based survey to senior deputies at State health agencies in the 50 states, the District of Columbia, the 5 territories (American Samoa, Guam, Northern Mariana Islands, Puerto Rico, U.S. Virgin Islands) and 3 freely associated states (Republic of the Marshall Islands, Federated States of Micronesia, Republic of Palau). Agencies in the territories and freely associated states receive a slightly modified version of the survey sent to states, with several specific activities added or removed and a more limited financial questionnaire. Along with general instructions, senior deputies receive recommendations on the most appropriate staff and departments to fill out each section of the survey. Multiple personnel may complete the survey in multiple sittings. ASTHO holds question-and-answer webinars several weeks prior to survey launch and through the administration period to clarify instructions and resolve technical issues. Extensive follow-up is conducted with the states and territories to verify responses. When response errors are identified, ASTHO's Research and Evaluation team works with the agency to correct these responses. In instances where the agency does not respond to multiple follow-up attempts, the Research and Evaluation team uses its expertise to determine whether or not to retain the data.
Response Rates and Sample Size
The full survey is disseminated to 51 health agencies in the states and the District of Columbia. A modified survey collects data from the territories and freely associated states. In 2016, for the baseline data, the response rate was 98% among the 50 states and the District of Columbia, and 88% among the territories and freely associated states.
The 2019 Profile gathered selected data about health agencies' workforce and finances from secondary sources. The survey itself was shortened and the activities section reordered. This redesign will not directly affect the data points utilized by Healthy People. Health agencies representing the U.S. territories and freely associated states receive a slightly modified version of the survey (largely affecting the types of activities surveyed and the length of the finance section). However, state and territorial health agencies answer the same questions for all items reported by Healthy People.
All data collected through the ASTHO Profile is reported directly by respondents in state and territorial health agencies and is not verified with any external sources.
- ASTHO Profile of State and Territorial Public Health, Volume Four. Association of State and Territorial Public Health Officials, 2017.
- Association of State and Territorial Public Health Officials; ASTHO Profile website.