DOI: 10.3886/icpsr37223
title: ASTHO Forces of Change Survey, United States, 2017
title: Archival Version

description: The Forces of Change Survey is an annual survey completed by the state and territorial health agencies that comprise the membership of the Association of State and Territorial Health Officials (ASTHO). ASTHO is the national nonprofit organization representing public health agencies in the United States, the U.S. territories and freely associated states, and the District of Columbia, and the over 100,000 public health professionals these agencies employ. The Forces of Change Survey primarily focuses on emergent and rapidly changing trends. The data collected sought to determine the current climate at state and territorial health agencies as it related to budget, workforce, accreditation, and special interest topics. The 2017 Forces of Change Survey examined the following topics:

Health agency resources
Activities related to the Zika virus
Opioid epidemic response
Communicating the value of public health
Efforts to advance health equity
The web-based survey, fielded by ASTHO in May of 2017, was administered to state and territorial health agencies through their senior deputies. A total of 52 health agencies responded (from 46 states, Washington, D.C., and five territories and freely associated states). Data included as part of this collection includes one dataset with 122 variables for 52 cases.
description: The Association of State and Territorial Health Officials (ASTHO) conducted its third Forces of Change Survey in May of 2017, in order to determine the current climate at state and territorial health agencies as it related to budget, workforce, accreditation, and special interest topics. In 2014, ASTHO began monitoring the current climate at member health agencies related to budget, workforce, billing capacity, and other changes as a result of the implementation of the Affordable Care Act.
description: The Forces of Change Survey is a census of state and territorial public health agencies. The web-based survey was administered to state and territorial health agencies through their senior deputies. Forces of Change data is collected approximately yearly.
description: Response Rates: A total of 52 health agencies (from 46 states, D.C., and 5 territories and freely associated states) responded, for an overall response rate of 88 percent, and a 92 percent response rate for the fifty states and D.C.
description: Presence of Common Scales: Several Likert-type scales were used.
description: Datasets: 
DS1: ASTHO Forces of Change Survey, United States, 2017
description: State, territorial, and freely associated state health agencies in the United States, the U.S. territories and freely associated states, and the District of Columbia. Smallest Geographic Unit: State/Territory
description: web-based surveyFor additional information on the ASTHO Forces of Change Survey, United States, 2017 study, please visit the ASTHO website.The National Association of County and City Health Officials (NACCHO) publishes their own Forces of Change report, which can be used in conjunction with the state-level data produced by the Association for State and Territorial Health Officials (ASTHO). For additional information on the NACCHO Forces of Change Surveys, please visit the NACCHO website. Additionally, users can reference the following NACCHO Forces of Change studies:

Forces of Change Survey, United States, 2014, Restricted-Use Level 1 Data (ICPSR 36153)
Forces of Change Survey, United States, 2014, Restricted-Use Level 2 Data (ICPSR 37139)
Forces of Change Survey, United States, 2015, Restricted-Use Level 1 Data (ICPSR 37069)
Forces of Change Survey, United States, 2015, Restricted-Use Level 2 Data (ICPSR 37140)
Forces of Change Survey, United States, 2017, Restricted-Use Level 1 Data (ICPSR 37103)
Forces of Change Survey, United States, 2017, Restricted-Use Level 2 Data (ICPSR 37141)The time period for this data collection expands beyond 2017 in order to reflect the 2016-2017 fiscal year of the health agencies surveyed.