The report equips state and territorial leaders with actionable insights and solutions to develop informed policies for an evolving public health landscape
LEXINGTON, Ky. (Dec. 18, 2025) — As states continue to navigate evolving public health demands, The Council of State Governments (CSG) has released the fourth installment of its nonpartisan 50-State Scan research series, “Building Healthy Communities, Strengthening States: How States are Meeting Today’s Public Health Challenges.” This strategic overview of the public health landscape provides state and territorial officials with actionable insights and emerging trends to guide effective policy decisions.
These insights are especially important given shifts in public health trends. In recent decades, improved infrastructure and advances in medical treatment contributed to notable gains in public health across the U.S. Despite this, states continue to confront unique challenges shaped by differences in funding models, workforce capacity, legislation, demographics and regional needs.
This report compiles state-level indicators examining public perception data, legislative activity, health system capacity and outcomes. The measures illustrate how health challenges affect workforce readiness, state budgets and community well-being.
“The CSG 50-State Scan gives policymakers a clear, comparative view of how their colleagues across the country are responding to policy challenges,” said David Adkins, executive director/CEO of The Council of State Governments. “It’s one more way CSG helps state officials learn from one another and strengthen governance in every state.”
The report’s comparative insights also highlight five major health issues states are prioritizing. The Association of State and Territorial Health Officials (ASTHO) identifies these issues as:
- Overdose Prevention and Substance Misuse
- Containing Infectious Diseases and Preventing Outbreaks
- Strengthening Health Care Workforces
- Maternal and Child Health
- Modernizing Public Health Systems
As of late November, 40 states have introduced 439 bills addressing these focus areas, with mental health, education and health care costs emerging as common themes. Among those, 86 bills have been enacted. States leading the way in each issue include Texas on strengthening health care workforces; Nevada on modernizing public health systems; New York on maternal and child health; Tennessee on containing infectious diseases and preventing outbreaks; and Rhode Island on overdose prevention and substance misuse.
Complementing the report’s analysis and associated solutions to each issue are state and territory performance data on key health indicators. These indicators build on existing research from reputable sources, citing state examples that highlight successes and lessons learned from each public health challenge.
Earlier reports in the four-part CSG 50-State Scan series have addressed government efficiency and accountability, as well as tax policy and artificial intelligence. To access the full CSG 50-State Scan series, click here.