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Dear Friends and Colleagues, Columbia, U.S. territories, and nations like India, China, and
Kenya.
We are pleased to present the 2018–20 Council of State and
Territorial Epidemiologists (CSTE) Annual Report. The global CSTE continued progress on the pillars of the 2018-2020
COVID-19 pandemic has dramatically altered our daily lives Strategic Plan with its central challenge, “Strengthen the Role
and the resultant public health crisis continues to be the of Applied Epidemiology to Drive Public Health and Policy
biggest challenge we have ever faced. Since the U.S. response Actions.” As we implemented our Strategic Plan, we worked to
began in January 2020, CSTE members have done remarkable meet the organizational priorities central to CSTE. We have also
work, effectively heightening the profile of epidemiologists worked collaboratively on the new 2021 CSTE Strategic Impact
to the national stage. As COVID-19 redefines public health, Plan. Diversity, equity, and inclusion are a significant focus of
we are inspired daily by the resilience and calm courage of this plan, brought to the forefront by the health inequities that
our members. They have worked grueling hours in the face have emerged during the COVID-19 pandemic.
of turmoil, infrastructure challenges, and even threats to the
delivery of data that informs public health action and produces Prior to the pandemic, CSTE launched the Data: Elemental to
epidemiologically sound guidance. You can learn more about Health campaign, a first-of-its-kind advocacy effort to secure
CSTE’s COVID-19 response with federal, state, local, territorial, meaningful, sustained funding for public health surveillance.
and industry partners on pages 9–11 of this report. However, COVID-19 exposed the critical core need for a strong
public health surveillance system capable of detecting and
While applied epidemiologists combat the pandemic, another facilitating the immediate response to and containment of
long-standing challenge has been brought to the forefront: the emerging health threats. Alongside several key partners, CSTE
disproportionate effect of disease on communities of color. As secured nearly $1 billion in new federal appropriations for data
we move forward in this ‘new normal’ era, it has become clear modernization efforts for public health.
that public health must redouble its commitment to protect
the health of all Americans. Addressing structural racism and Applied epidemiologists responded to a wide range of disease
health disparities must be reinforced as a key component of threats during this time—acute, chronic, and emerging alike.
good epidemiological science, informing policies that reverse The 2019 E-cigarette, or Vaping, Product Use-Associated Lung
inequity and disparate approaches to public health. Injury (EVALI) epidemic response was CSTE’s first-ever activation
of its Concept of Operations (ConOps) Plan for emergency
Due to the COVID-19 pandemic, the 2020 CSTE Annual response, one in which CSTE staff and members led federal and
Conference scheduled for Seattle, WA was canceled—the first state partners via regular calls, technical assistance, and critical
Conference cancellation in CSTE’s 70-year history. The 2019 communications. Both the COVID-19 and EVALI responses
CSTE Annual Conference was held in Raleigh, NC. Despite highlight CSTE’s unique and crucial role in mobilizing public
several jurisdictions having travel restrictions in place, we health while serving as a conduit between federal, state, and
hosted over 1,600 attendees from all 50 states, the District of local responses. CSTE also continued to address the U.S. opioid

