Because of term limits or retirements, 17 states had no incumbent nominee for governor in November 2018. In all, 20 states elected new governors, and 8 saw a change in political party as well. More than 150 million Americans are beginning 2019 with new leadership presiding over the factors that influence their health, including education, housing, taxes, and economic development.

In partnership with the de Beaumont Foundation, the National Academy for State Health Policy (NASHP) released a new toolkit, “Upstream Priorities for New Governors,” in December 2018 to help governors and their teams address upstream health issues. This resource provides practical, real-world tools and strategies for agency leaders and governors to assist their residents in living long, healthy, and productive lives. While the tools were produced for governors and their senior staff, they can also help state and local health professionals and other advocates promote their priority issues.

  • An overview of what influences health;
  • One-pagers on priority issues; and
  • Tips on framing these issues for stakeholders and opinion leaders.

Governors are uniquely positioned to leverage state resources to address the conditions that affect health. By coordinating resources, advancing evidence-based health policies, and leading multisector coalitions, governors can advance their priorities, control costs, and improve lives. With more than 80% of health determined by social and economic conditions, one way to improve health and lower health care costs is by improving education, transportation, housing, economic development, and other areas. Transition teams and new staff have been working hard to support governors in preparing initiatives in their states—and decisions made now will affect citizens for many years to come.

In addition, NASHP conducted an assessment of governors’ state-of-the-state and inaugural addresses revealing that governors are emphasizing upstream issues including:

  • Education
  • Jobs
  • Infrastructure
  • Opioids
  • Environment
  • Housing
  • Violence prevention
  • Child welfare
  • Justice
  • Government structure
  • Equity
  • Cannabis

View the toolkit and related resources.

Click image to download “Health in All Priorities” chart, covering health-related issues including education, housing, jobs, opioids, transportation, and more.


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