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ASTHO, the Association of State and Territorial Health Officials, is a nonprofit organization that supports the chief health officials of U.S. states, Washington, D.C., five U.S. territories, and three Freely Associated States. For researchers, ASTHO is best known for the ASTHO Profile of State and Territorial Public Health, a survey of how state and territorial health agencies (S/THAs) are organized, funded, and staffed, within the wider field of public health.
This guide covers who ASTHO represents, what the Profile survey contains, how researchers obtain its data, and how ASTHO compares with peer organizations.
What It Is
ASTHO describes itself as a nonprofit organization committed to supporting the work of state and territorial public health officials and furthering the development and excellence of public health policy nationwide. Its stated primary functions are to develop strong and effective public health leaders, to improve public health through capacity building, technical assistance, and thought leadership, and to advocate for resources and policies that improve the public’s health and well-being.
ASTHO also supports peer communities of state and territorial health leaders and senior executives in health departments.
Who Runs It and What It Covers
ASTHO’s membership is made up of chief health officials from states, Washington, D.C., five U.S. territories, and three Freely Associated States. ASTHO states that the agencies it serves employ over 100,000 public health professionals.
- The 50 U.S. states and the District of Columbia.
- Five U.S. territories: American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands.
- Three Freely Associated States: the Federated States of Micronesia, the Marshall Islands, and Palau.
ASTHO’s topic areas include data modernization and informatics, research, analytics, and data visualization, public health infrastructure and systems improvement, the public health workforce, and health equity.
How to Search or Use It
Researchers who want ASTHO Profile data can follow this workflow.
- Define the question. Decide whether the study concerns agency structure, finance, workforce, or the services agencies provide.
- Learn the survey. The Profile began in 2007 and, according to ICPSR, was fielded on average every three years between 2007 and 2022. It asks S/THAs about their activities, structure, and resources. ICPSR describes the 2022 data as a census of state and territorial agencies rather than a sample.
- Check the public materials. ASTHO publishes the Profile dashboards and documentation at https://www.astho.org/Profile/.
- Find the dataset and codebook. ICPSR archives the Profile by survey year, for example the 2022 study (ICPSR 39285) and the 2020 study (ICPSR 38139), each with its documentation.
- Request restricted files where required. Access to some files is restricted. For the 2019 study, ICPSR states that users must complete a Restricted Data Use Agreement, state the reason for the request, and obtain IRB approval or a notice of exemption. For the 2020 study, ICPSR asks users to contact [email protected] for the most current datasets. See the data use agreement template guide and the data use agreement definition for what such agreements usually cover.
- Plan reporting. For observational analyses, the STROBE checklist sets out reporting items, and the CDC program evaluation framework is a common reference for evaluation design.
Strengths and Limits
Key Strengths
- Near-complete coverage: For 2022, ICPSR reports a 100% response rate among U.S. states and 98% among states, territories, and freely associated states.
- Long time span: Surveys since 2007 allow trend work across waves, subject to changes in the instrument.
- Several jurisdiction types: Between 2012 and 2022 the Profile was administered to all 50 states, Washington, D.C., and eight island areas.
Key Limits
- Agency-level data: The Profile describes agencies, not individual patients.
- Small universe: With a census of a few dozen jurisdictions, sample sizes limit complex models.
- Changing instrument: ICPSR notes that the 2020 instrument was significantly shortened and separated into three surveys, which affects cross-wave comparison.
- Restricted files: Some files, including financial details in the 2012 study, are available only under a restricted use agreement.
Alternatives
Researchers studying governmental public health often use ASTHO data alongside other organizations’ materials. For the field-level comparison, see also epidemiology versus public health.
| Organization | Who it represents | Research data asset |
|---|---|---|
| ASTHO | State and territorial health officials | ASTHO Profile of State and Territorial Public Health |
| NACCHO | County and city health officials (National Association of County and City Health Officials) | National Profile of Local Health Departments |
| CSTE | Applied epidemiologists (Council of State and Territorial Epidemiologists) | Epidemiology Capacity Assessment |
Frequently Asked Questions
What does ASTHO stand for?
ASTHO stands for the Association of State and Territorial Health Officials.
What is the ASTHO Profile?
It is a survey of state, territorial, and freely associated state public health agencies about their activities, structure, and resources. It began in 2007 and ICPSR archives the survey years.
How do researchers get ASTHO Profile microdata?
Some files are public-use: ICPSR states that the 2016 public-use files are available to the general public. Others are restricted, and restricted access has required a Restricted Data Use Agreement, a stated reason, and IRB approval or exemption. Contact [email protected] for current datasets.
How is ASTHO different from NACCHO?
ASTHO’s members are state and territorial health officials; NACCHO’s members are county and city health officials, and each organization runs its own national profile survey.
Does ASTHO hold patient records?
The Profile is an agency survey about structure and resources, not patient-level data.
Sources
Date checked: 2026-11-07.
- ASTHO. About Us. https://www.astho.org/about/
- ASTHO. ASTHO Profile. https://www.astho.org/Profile/
- ICPSR. ASTHO Profile Survey of State and Territorial Public Health, United States, 2022 (ICPSR 39285). https://www.icpsr.umich.edu/web/ICPSR/studies/39285
- ICPSR. ASTHO Profile Survey, 2020 (ICPSR 38139). https://www.icpsr.umich.edu/web/ICPSR/studies/38139/staff
- ICPSR. ASTHO Profile Survey, 2019 (ICPSR 37996). https://www.icpsr.umich.edu/web/ICPSR/studies/37996/staff
- ICPSR. ASTHO Profile Survey, 2016 (ICPSR 37216). https://www.icpsr.umich.edu/web/ICPSR/studies/37216
- ICPSR. ASTHO Profile Survey, 2012 (ICPSR 37823). https://www.icpsr.umich.edu/web/ICPSR/studies/37823/versions/V1
