Laws, regulations, and public policy can have a major effect on public health. The New Hampshire Public Health Association (NHPHA) utilizes education and advocacy to help enact effective policies that support both population-based and individual health throughout our state and communities. The NHPHA tracks public health legislative bills and looks at policy matters in terms of their potential impact on the public's health in New Hampshire. NHPHA follows legislative bills that align with its legislative priorities, including 1) prevention and access, 2) public health infrastructure, 3) financial security, and 4) food security. NHPHA advocacy work ranges from action alerts to legislative updates, giving testimonies, and lobbying on behalf of the public health community. Our goal is to increase awareness within our membership, influence relevant regulations and legislation, and support public health partners who share our mission of improving the public's health in New Hampshire.

NHPHA Priorities

  • PREVENTION & ACCESS
  • PUBLIC HEALTH INFRASTRUCTURE
  • FINANCIAL SECRUITY​
  • FOOD SECRUITY
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​Prevention and Access

Public Health Preventive Efforts and Health Access, Particularly for Underserved Populations
  • Advocate* for community health workers' infrastructure funding.
  • Advocate for funding and infrastructure for equitable distributions of vaccines.

*Policy actions beginning with the word advocate are those for which NHPHA will take an active role. Those beginning with the word support are those for which NHPHA will assist others in leading advocacy.

Public Health Infrastructure

Strong Local and State Public Health Infrastructure
  • Advocate for funding to support foundational public health services at the state and local levels.
  • Advocate for support to implement the State Health Improvement Plan and assure it addresses the need of marginalized and vulnerable populations

Financial Security

Policies that Enable Families to Earn a Living Wage and Care for Their Families
  • Support efforts to provide for a living/minimum wage
  • Support efforts for job training for skill-based careers, particularly for marginalized populations
  • Support a step-down approach to public benefits reductions

Food Security

Policies and Programs that Increase Access to Healthy, Affordable Foods
  • Advocate to expand use of the WIC program (farmer's market, online purchasing)
  • Support expansion of SNPA, Granite State Market Match, and farm-to-school initiatives
The NHPHA adopts policy positions related to the critical functions of public health. These policy positions are designed to inform the public of critical areas that require public health attention. Here is a list of the NHPHA position statements.

2023 Legislative Priorities

  • Medicaid Expansion
  • Violence Prevention
  • Vaccination
  • Reproductive Health
  • Extreme Heat (CC)
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Permanent Reauthorization of Medicaid Expansion
​NHPHA recognizes that all New Hampshire (NH) residents should have an equal opportunity to attain optimal health regardless of factors affecting access to high-quality care and health outcomes. Such factors include race, ethnicity, disability, sexual orientation, gender identity, socioeconomic status, geography, preferred language, and other factors that affect access to high-quality care and health outcomes. Medicaid is one of the US's most significant health insurance programs, moving the nation closer to universal coverage than ever before. Data shows that Medicaid expansion improved the quality of life and economic stability of low-income patients, increased access to care, and reduced healthcare costs. 

The Granite Advantage Health Care Program, New Hampshire's Medicaid Expansion program, provides health insurance coverage to over 93,000 Granite Staters earning less than $18,075 per year (individual) or $36,908 (a family of four). The program ensures access to regular medical check-ups, emergency room visits, prescription drugs, visits to specialists, and more.

NHPHA will continue to work closely with our partners through efforts led by New Futures and the Bi-State Primary Care Association to advocate for permanent reauthorization of Medicaid Expansion in 2023. NHPHA is confident that this state-wide joint effort would bring stability and security to NH residents and our health care system.
Advocate for Policies that Prevent Violence
NHPHA believes that violence is a public health issue affecting millions of US residents every year. New Hampshire has the 46th-highest rate of gun violence in the US. According to the Everytown for Gun Safety Support Fund (EGSSF), in an average year, 142 people die, and 117 are wounded by guns in NH. EGSSF reported a 30% increase in gun violence since 2010, and over 70% of gun violence incidences are related to domestic violence in some manner.

Gun and domestic violence pose a public health, social, and development threat to our communities. It's not only the leading cause of death, but it has long-lasting health and mental consequences depending on the age and sex of the individual and the form of violence. This includes depression, anxiety, post-traumatic stress disorder, suicide, and heart disease, to name a few. 

Policies, programs, and interventions should continue to find, and focus on, ways to reduce gun violence and domestic violence in New Hampshire. Thus, in 2023, the NHPHA will take active steps to support legislation that centers on the reduction and prevention of gun violence and domestic violence. 
Increase Vaccine Confidence, Use, Access, and Equitable Distribution
We are no strangers to the anti-vaccination movement. It started in the early nineteenth century when European nations made smallpox mandatory for the army, the poor, and the populace. This resulted in anti-vaccine protests, and eventually, the movement spread to the United States. We continue to see these movements during the AIDS pandemic and, most recently, the COVID pandemic, spreading misinformation, fear, denial, and mistrust. 

The NHPHA is committed to reducing vaccine-preventable diseases by increasing immunization rates throughout NH. This is accomplished in collaboration with local and national partners by organizing educational programs, sharing vaccination updates, planning vaccination campaigns, and supporting legislation that promotes vaccine confidence, use, access, and equitable distribution.
Enhance and Strengthen Access to Reproductive Healthcare Services
​According to the WHO, reproductive health involves physical, mental, emotional, and social aspects of women's reproductive systems. 

NHPHA believes that women should have affordable access to all reproductive health services, including family planning. In 2023, the NHPHA will continue to advocate for legislation and funding that seek to enhance and strengthen access to reproductive health care in New Hampshire.

Concerning the budget, NHPHA aims to support DHHS's effort to retain family planning and women's preventative care funding.
Improve Resilience to Future Extreme Heat Climate Events
The New Hampshire Public Health Association (NHPHA) recognizes the interdependent relationship between greenhouse gas emissions, climate change, and public health. Over the last century, the Northeast US has become significantly warmer and wetter, and these trends have increased since the 1970s. According to Climate Central, the typical number of heat wave days in New Hampshire will quadruple from 10 to more than 40 days a year by 2050. According to their report, more than 20,000 people living in New Hampshire are especially vulnerable to extreme heat. Extreme heat poses many risks to an individual's health, including heat cramps, heat exhaustion, heat stroke, sunburns, and skin cancer, to name a few. 

Low-income individuals, those with existing medical conditions, and/or those living in urban-area homes without sufficient tree cover are the most affected by extreme heat. Therefore, in 2023, NHPHA plans to launch an awareness campaign in collaboration with local organizations and public health departments to educate the public and reduce illnesses and deaths from extreme heat exposure. NHPHA will also support legislation that improves resilience to future extreme heat events and, as a result, enhances the public's health. ​

Legislative Brief

Policy Update Monthly Meetings
The weekly Legislative Brief provides information on upcoming committee hearings, the type of action needed, legislative bill summary, and more.
The New Hampshire Public Health Association invites you to attend Members Policy Update Monthly Meetings scheduled on the second Thursday of the month at 4:00 PM. At the monthly meetings, the NHPHA and its partners will share legislative updates, discuss top priority bills, and engage our membership. These meetings are designed for NHPHA members. 

Upcoming Meetings

February 9, 2023  I  4:00 PM EST
March 9, 2023  I  4:00 PM EST
April 13, 2023  I  4:00 PM EST
May 11, 2023  I  4:00 PM EST
June 8, 2023  I  4:00 PM EST

Position Statements

Equity and Health Outcomes
Food Access and Public Health
This policy statement outlines the New Hampshire Public Health Association’s (NHPHA) support for policies, programs, and practices that enhance food security among Granite State residents. The NHPHA recognizes that regular access to affordable, nutritious food is essential to promote the public’s health and ensure that New Hampshire households are food secure. Download the position statement.
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​Public Health and Social Justice
The core mission of public health is to improve the health of all populations. A social justice approach to public health challenges the public health community to acknowledge and confront underlying root causes, and recognize that racism, socioeconomic inequality, gender discrimination, ableism, and all other forms of discrimination have negative consequences on health. According to a large body of public health literature, in order to improve the health of a population the root causes need to be addressed. Download the position statement.
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Child Health and Safety
The New Hampshire Public Health Association (NHPHA) recognizes the critical importance of healthy New Hampshire children. Good health is essential to children’s academic achievement, successful transition to adulthood, and lifelong contributions to society. Download the position statement.
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​Health Equity for People with Disabilities
The New Hampshire Public Health Association (NHPHA) recognizes that all New Hampshire (NH) residents, including people with disabilities, should have the opportunity to engage in activities that add to their growth, development, fulfillment, and community contribution. Download the position statement.
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​NH's Aging Population and Public Health
The New Hampshire Public Health Association (NHPHA) recognizes that the population of New Hampshire is aging and that in the next few decades we will have one of the highest proportions of older residents in the nation. Download the position statement.
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Assuring the Quality and Accessibility of Health Services
Access to Appropriate Health Care and Social Services
The New Hampshire Public Health Association (NHPHA) supports universal access to high quality evidence based, integrated health care at a level of cost that does not create barriers to care. Download the position statement.
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Integrated Health Care
The New Hampshire Public Health Association (NHPHA) believes that optimal health requires an effective collaboration among public, non-profit and private health service providers and organizations, encompassing a health promotion approach that integrates, medical, behavioral and mental health care. Download the position statement.
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Mental Health
The New Hampshire Public Health Association (NHPHA) holds that mental health is an essential component to overall health and reaffirms findings that a distinction between health of mind and body is not supported by scientific evidence. Download the position statement.
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Oral Health
The New Hampshire Public Health Association (NHPHA) recognizes that oral health is linked with overall health. Dental caries, an easily-transferable bacterial infection of tooth enamel, affects individuals throughout the lifespan. Download the position statement.
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Sexual and Reproductive Health​
Affordable and accessible sexual and reproductive health care and education are essential to the overall health and wellness of New Hampshire people and families. These services prevent unintended pregnancies, reduce the incidence and impact of preterm and low birth weight births, and reduce maternal mortality. Download the position statement.
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Public Health Infrastructure
Public Health Infrastructure​​
The New Hampshire Public Health Association (NHPHA) recognizes that the purpose of public health is to prevent disease, injury and disability, promote health and wellbeing and protect the community. It is a shared responsibility among public, private and volunteer entities in NH and is best achieved through strong integration at state, regional and local levels. Download the position statement.
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​Emergency Preparedness, Response, and Recovery
​The New Hampshire Public Health Association (NHPHA) recognizes the key role public health plays in emergency preparedness, mitigation, response, and recovery. Public health emergencies may be natural, accidental, or intentional, and require collective action to prevent, respond to, and recover from. Download the position statement.
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​Disease Management
The New Hampshire Public Health Association (NHPHA) recognizes that disease management systems, when properly developed, have the potential to improve treatment outcomes and promote cost effective delivery of care. Download the position statement.
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​Infectious Diseases
The New Hampshire Public Health Association (NHPHA) recognizes that infectious diseases such as tuberculosis, HIV, influenza, and chicken pox continue to threaten the health of the public. The NHPHA recognizes that cooperation and coordination among a wide range of public and private organizations is needed to effectively prevent, detect and respond to emerging and re-emerging infections. Download the position statement.
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​Monitoring Health Status
The New Hampshire Public Health Association (NHPHA) acknowledges the essential role of public health in measuring, analyzing and reporting on the health status of the people of NH to inform programs and public policy development. Download the position statement.
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​Health Education and Promotion
The New Hampshire Public Health Association (NHPHA) holds that good health requires active participation in health education and promotion programs by individuals, organizations and communities. Health education involves opportunities for learning involving communication designed to improve health literacy, including improving knowledge, and developing life skills which are conducive to individual and community health. Download the position statement.
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Healthy Environments – Natural, Built, and Social
Protecting against Environmental Hazards: Tobacco Use and Secondhand Smoke Exposure
The New Hampshire Public Health Association (NHPHA) recognizes that tobacco use via smoking, smokeless tobacco, or electronic nicotine devices (ENDs) and exposure to secondhand smoke, including marijuana is harmful to the public’s health. Download the position statement.
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Protecting against Environmental Hazards: Food System and Public Health
The New Hampshire Public Health Association (NHPHA) recognizes that a healthy, sustainable and equitable food system is essential to promote the public’s health and protect the population from food system-related harms. Download the position statement.
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Protecting against Environmental Hazards: Indoor and Outdoor Built Environment
The Indoor and Outdoor built environment has a major impact on the health of individuals and populations. The NH PHA recognizes that by supporting initiatives that improve the quality of our built environment, we can help people maintain good health and prevent disease. Download the position statement.
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Protecting against Environmental Hazards: Occupational Health
Work-related injuries and illnesses are preventable, and control of occupational hazards is the most effective means of prevention. The New Hampshire Public Health Association (NHPHA) recognizes that all New Hampshire workers have the right to safe and healthful working conditions.  Download the position statement.

Protecting against Environmental Hazards: Air, Water, and Land
The New Hampshire Public Health Association (NHPHA) recognizes that clean air, water and land are essential to the public’s health, and that hazardous substances or harmful conditions in our air, water, and land negatively impact individuals, animals, and ecological systems. Download the position statement.
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​Protecting against Environmental Hazards: Public Health and Climate Change
The New Hampshire Public Health Association (NHPHA) recognizes the inter-dependent relationship between greenhouse gas emissions, climate change, and public health. Download the position statement.
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Preventing Injuries: Unintentional Injury
The New Hampshire Public Health Association (NHPHA) supports statewide and community-based efforts to reduce the risk and incidence of unintentional Injury. Download the position statement.
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Preventing Injuries: Violence
The New Hampshire Public Health Association (NHPHA) recognizes that violent behaviors included the full continuum: bullying, assault, domestic violence, child and elder abuse, sexual assault and suicide and can result in deaths as well as in long term physical and psychological disability. Download the position statement.
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​Preventing Injuries: Gun Violence Prevention
The New Hampshire Public Health Association recognizes that guns are part of American culture and believes that the pursuit of gun safety is substantially different from the pursuit of gun control. Improving gun safety, in contrast to traditional gun control, reflects a focused, multidisciplinary effort to limit violence and harm subsequent to inappropriate use of a prevalent technology. Download the position statement.
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Substance Misuse – Improving Prevention, Treatment, and Recovery
​Substance Misuse – Improving Prevention, Treatment, and Recovery: Substance Use Disorders and Substance Misuse
The New Hampshire Public Health Association (NHPHA) recognizes that substance use disorders are a chronic brain disease, and that substance misuse is a problem that negatively impacts individuals, families, and communities throughout New Hampshire. Download the position statement.
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Substance Misuse – Improving Prevention, Treatment, and Recovery: Cannabis
The New Hampshire Public Health Association recognizes that legalization of cannabis by states is a relatively new phenomenon. As a result, there is limited research on the public health impact of legalization. Download the position statement.
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Publications

Letter to the Editor

Draft Budget Provides Much Needed Public Health Funding

July 13, 2019
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​By Joan H. Ascheim and Marcella Jordan Bobinsky
The New Hampshire Public Health Association is a statewide membership organization composed of health care and public health professionals. For over 25 years, it has brought together members who share a common goal of making sure that all New Hampshire citizens live, learn, work and play in safe and healthy environments.

On behalf of its members, NHPHA wants to thank the state Senate and the House of Representatives for their bipartisan work compiling the 2020–21 budget for the state of New Hampshire. If a state budget is a reflection of what our elected officials value and are willing to fund, then this proposed budget values children, education, mental health, and the health and economic well-being of individuals of all ages who live in New Hampshire ...
OP-ED

Bill Passed by House Would Weaken Children’s Behavioral Health Treatment Systems

By Emma Sevigny & Hanan Babikir Bedri

​Our kids are in crisis.

Over the last two years, the COVID-19 pandemic has exacerbated the behavioral health concerns facing our children and families. Data shows that children in New Hampshire and across the country are experiencing higher rates of depression and anxiety, and we fear this will only get worse in the years to come.

During these tumultuous times, it’s critical that we use every tool at our disposal to support our children, and the Youth Risk Behavioral Survey (YRBS) is an invaluable resource we depend on to inform our prevention efforts and strengthen public health policies.

Developed by the U.S. Centers for Disease Control and Prevention, the YRBS uses valid and anonymous data with safeguards in place to discount false answers, monitor key health and wellness indicators and experiences for school-aged youth, track changes in behavior, and empower students to have ...

New Hampshire Public Health Association Urges COVID-19 Vaccination of New Hampshire Residents

By ​April Mottram, RPh
The New Hampshire Public Health Association (NHPHA ) supports and encourages statewide efforts to provide increased access to COVID-19 vaccines to achieve population immunity. Further, NHPHA calls on the Legislature to provide funding that will aid local efforts to promote vaccine access. NHPHA encourages consistent guidance for our communities. Local partnerships, best informed about their own communities’ needs, are also best positioned to help residents achieve full ...

Epidemic of Binge Drinking Since COVID Shutdown

By ​Kate Frey and Joan Ascheim
New Hampshire has made some gains in recent years in our battle against the ongoing addiction crisis. But, without an end in sight, the COVID-19 pandemic is threatening to undo that hard-fought progress and put more lives in jeopardy.

The pandemic’s impact can be clearly seen in rising alcohol sales across the Granite State. Since the start of the pandemic, alcohol sales have increased about 5% compared to 2019, according to the New Hampshire Liquor Commission ...

Honoring the Critical Role of Public Health Workers

By ​Joan H. Ascheim
This week through April 12 is National Public Health Week, a week that has been celebrated for 25 years to recognize the contributions of public health and highlight issues that are important to improving our nation’s health.

Sadly, this year the week falls just as we are being told by U.S. Surgeon General Jerome Adams, “This is going to be the hardest and saddest week of most Americans’ lives,” in reference to the escalating COVID-19 pandemic ...