The role of states in ensuring essential public health services: development of state-level performance measures.

The Association of State and Territorial Health Officials (ASTHO) has worked with other public health partners across the country to develop National Public Health Performance Standards, nationally recognized measures by which state public health systems can compare themselves with similar systems across the country. The lead federal agency is the Centers for Disease Control and Prevention (CDC), and other partners include the Public Health Foundation, the American Public Health Association, the National Association of City and County Health Officials, and the National Association of Local Boards of Health. Both challenges and opportunities emerged during the development of the state public health system standards.