Public health has faced many challenges over the past two years, with federal funding cuts, shifting policies and increasing demands on state agencies forcing leaders to rethink how they serve their communities. Even with these obstacles, however, many states continue to find innovative ways to improve health outcomes through collaboration, persistence and creative policymaking, experts said at the “Defining the Wins: Statewide Policy Change Strategies for Public Health,” webinar hosted by Trust for America’s Health.
Bringing together public health leaders from Arkansas, Wisconsin and New Jersey, the discussion focused not on the setbacks facing public health but on the successes that continue to emerge at the state level.
Dr. Breanca Merritt, TFAH’s director of policy, acknowledged that recent federal policy changes have significantly affected public health systems. Funding reductions to agencies such as the CDC and the Substance Abuse and Mental Health Services Administration, along with changes to Medicaid and the Supplemental Nutrition Assistance Program, have placed additional pressure on state governments. Many programs have lost resources, technical assistance has declined, and communities have experienced disruptions in services.
Even so, Merritt said that states have adapted, finding opportunities to improve health through partnerships, innovative programs and bipartisan cooperation.
Arkansas succeeds in expanding free school meals
In Arkansas, a 15-year effort to expand access to school meals finally resulted in the passage of universal free school breakfast legislation in early 2025. Patty Barker, campaign director of the No Kid Hungry campaign at the Arkansas Hunger Relief Alliance, described the achievement as the product of years of relationship-building and steady progress.
Rather than seeking one single sweeping reform, advocates focused on incremental improvements, including expanding reduced-price meals before pursuing universal breakfast. They also worked closely with governors from both political parties, legislators, educators and community organizations to build broad support.
“Patience and persistence led the way,” Barker said, noting that successful advocacy depends on maintaining long-term partnerships and staying focused on improving children’s health and academic success.
Wisconsin protects access to SNAP
Wisconsin took a similar collaborative approach while confronting different challenges. Kirsten Johnson, secretary of the Wisconsin Department of Health Services, said the state worked across political divides to protect access to food assistance during periods of federal uncertainty.
When federal funding disruptions threatened SNAP benefits, Wisconsin leaders acted quickly to ensure residents continued receiving food assistance. The state also invested additional resources to improve program administration and maintain low error rates, so benefits continued as the state’s financial stability was protected.
Johnson said another major accomplishment was the recent expansion of postpartum Medicaid coverage. Although Wisconsin was one of the last states to adopt the policy, she said it represents an important step toward improving maternal health.
Johnson said that bipartisan relationships are essential to these accomplishments. Despite political differences between the governor’s office and the Wisconsin Legislature, leaders found common ground by focusing on practical solutions that directly benefit residents.
New Jersey creates public health institute
In New Jersey, Denise Anderson, executive director of The Center for Health Equity & Wellbeing, described another milestone: the creation of the state’s first designated public health institute. Although public health professionals had advocated for such an organization for more than two decades, the effort only became a reality after years of sustained outreach to legislators, stakeholders and community leaders.
The new institute is designed to strengthen collaboration across the state’s public health system while promoting health equity and supporting evidence-based policies. Anderson said that the legislative victory required countless meetings, public testimony and ongoing communication with policymakers and partners throughout the state. “Building effective relationships cannot be underestimated,” Anderson said.
Common themes for success
As different as these accomplishments may seem, several common themes are behind their success. One of the most important one may be that relationships matter. Each panelist stressed the importance of building trust with policymakers, community organizations, healthcare providers, educators, businesses and residents. Public health cannot succeed through government action alone.
The panelists also emphasized the power of effective communication. Anderson encouraged advocates to tell real stories that illustrate how public policies affect people’s daily lives. Personal experiences, she explained, often resonate more strongly than statistics alone and can help decision-makers better understand the importance of investing in public health.
Another recurring theme was resilience. Even as funding decreased and administrative burdens increased, public health leaders continued searching for practical ways to improve services with the resources available. Johnson described Wisconsin’s efforts to strategically invest available funding in workforce development and statewide health information systems, while Barker discussed continuing efforts to expand child nutrition programs despite new federal restrictions.
Future challenges, such as Medicaid changes, new SNAP eligibility requirements and uncertainty surrounding federal grants, are expected to create additional financial and administrative pressures for states. The panelists said they were concerned that these changes could reduce access to healthcare and nutrition assistance, while placing greater strain on already stretched public health systems. Even so, Johnson urged public health professionals to stay focused on their mission. “The work that we do has never been more important than it is now when it’s under threat,” she said.
The panel encouraged public health professionals to recognize and celebrate incremental progress. Small victories can often create the foundation for larger policy changes over time.