As evidence-based science continues to be erased across federal health agencies, a recent growth of regional public health alliances is working to fill critical gaps.

The Trump administration has rejected science on everything from vaccines and pollution standards to school nutrition and fluoridation this year, rewriting guidance that health practitioners rely on and setting back decades of policies that protect health.

Fortunately, health leaders across the U.S. are stepping up. In September, officials in Oregon, California and Washington state launched the West Coast Health Alliance, with Hawaii joining soon after. The alliance is designed to ensure health practitioners can access science-based information they can use with their patients and communities. Public health experts from each state review data sets and share state-specific insights to develop evidence-based recommendations that member states can translate into health policies.

Among the high-priority issues for the alliance is vaccines. With decisions this year by the federal government on immunizations undermining both trust and access, the alliance’s immediate focus has been on bringing clarity to vaccine policies to participating states. 

For example, the alliance has issued guidance on COVID-19, flu and RSV immunizations, said Sejal Hathi, MD, MBA, director of the Oregon Health Authority and part of the alliance team. Ultimately, the alliance wants to strengthen data sharing and joint communication across states to quicken responses to emerging infections, climate-driven health risks and other threats.

“The goal is to ensure that people across the coast experience one consistent standard of care,” Hathi told The Nation’s Health. “And that’s the objective we have in mind when we both determine what to address and then formulate shared guidance to do so.” 

The Northeast Public Health Collaborative also launched this fall, encompassing cities, states and one territory. Participants include Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont, as well as Boston, Philadelphia, New York City, Washington, D.C., and Puerto Rico.

“No matter what the politics of any state is anywhere in the U.S., generally every state health department has the same goal, which is to protect the health and well-being of their population," New York State Health Commissioner James McDonald, MD, MPH, told The Nation's Health.

The Northeast collaborative includes work groups that are focused on public health laboratory capacity, emergency preparedness, epidemiology, disease surveillance and vaccines. Vaccine access is a priority, given that fall kicks off the respiratory virus season, said Massachusetts Department of Public Health Commissioner Robbie Goldstein, MD, PhD. This group is keeping pace with decisions being made at the federal level, releasing a recommendation this month that all newborns receive a hepatitis B vaccine, even as a Trump administration-controlled advisory group rejected science and recommended otherwise.

But vaccines are not the only concern on the Northeast collaborative's radar. The epidemiology and vaccine work groups have partnered to shape return-to-work guidelines for health care workers sick with respiratory viruses, Goldstein said. Outbreak response is also top of mind, especially in the absence of cooperative agreements from the Centers for Disease Control and Prevention that help states and territories with surveillance.   

Another multi-state leadership group that has formed in recent months is the Governors Public Health Alliance. An initiative of the nonprofit Governors Action Alliance, the group is also aimed at ensuring data sharing and vaccine access. Trusted health leaders serve as advisors to the offices, offering expertise, materials and resources to tackle public health dilemmas.

Fifteen states and territories make up the alliance of governors: Colorado, California, Connecticut, Delaware, Hawaii, Illinois, Maryland, Massachusetts, New Jersey, New York, North Carolina, Oregon, Rhode Island, Washington and Guam. 

“As we are reevaluating this role between this federation of states and our relationship with the federal government, there’s a real need to reorient the knowledge and diverse structure to support those who actually have the legal responsibility and authority on health — which is very much more the state and local level than at the national level,” Anne Zink, MD, a Governors Public Health Alliance advisor and Alaska’s former chief medical officer, told The Nation’s Health.

Though all the initial governors in the alliance are Democrats, Zink said public health is never partisan. Governors from all states are welcome to join. 

 “That’s a real hope and focus that this is a space for governors and their staff to learn from each other, to think about how to support the health and well-being of the people they serve," Zink said. 

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