Advancing Policies that Create Conditions for Good Health
Federal cuts to health promoting programs will require that states and community partners work creatively and across sectors to protect and advance residents' health.
(Washington, DC – December 17, 2025) – Population-level health is influenced by a variety of social and economic factors, including housing access, food affordability, access to early childhood education, the built environment, and workplace policies. This report examines state policies that support good health and analyzes the legislative landscape for their implementation. The report discusses recent federal actions that have cut funding and led to program eliminations at the federal and state level, changes that in many cases will slow the implementation of state-level policies that promote health. These program changes will create gaps that states and cross-sector partnerships could help address through support for collaboration and innovation.
The report is the newest in TFAH’s Promoting Health and Cost Control in States (PHACCS) series highlighting evidence-based policies and programs states can pursue to improve residents’ health and reduce healthcare spending. This new report considers these policies in the current legislative landscape, based on input from advocates, service providers, and government staff across different jurisdictions and policy areas. It analyzes how the changed legislative environment is impeding policy action and what new innovations and cross-sector collaborations are needed to create or protect policy momentum.
“The nation’s public health infrastructure has been changed in consequential ways that will impact states and communities across the country. These changes, including funding cuts and the elimination of effective programs, risk reversing progress in improving Americans’ health,” said J. Nadine Gracia, M.D. MSCE, President and CEO of Trust for America’s Health. “In order to fill some of these gaps, state-based organizations and policymakers are developing strategies to support health promoting policies, particularly in communities with the greatest need.”
The report is organized into three sections and encourages states and cross-sector partners to continue their work promoting good health in every community by sharing information, evidence, and innovative strategies.
“Leaders within policy areas supported by the PHACCS initiative continue to leverage strategies that help advance policies in ways that uniquely fit their states despite fiscal constraints created by the current budget environment,” said Breanca Merritt, Ph.D., Director of Policy at Trust for America’s Health. “This report identified recent progress and policy wins using these approaches, including bipartisan and community-driven efforts within multiple states.”
The first section, Creating Conditions for Good Health: A Changing Policy Environment, outlines federal policies that have supported states in advancing health promoting programs, as well as recent federal policy decisions and state actions that limit states’ ability to do so.
The second section, Creating Conditions for Good Health: What’s Working for States, summarizes input from advocacy organizations and government partners collected during national and regional level convenings. During the convenings, participants discussed effective strategies for advancing health promoting policies in states as well as barriers to their implementation.
The last section of the report, Creating Conditions for Good Health: Progress and Highlights of PHACCS Policies reviews trends in state-level adoption within policy areas highlighted by PHACCS, including:
- Universal pre-kindergarten programs
- School nutrition programs
- Drug overdose and infectious disease prevention strategies, including harm reduction
- Smoke-free policies
- Tobacco and alcohol pricing strategies
- Complete Streets policies
- Housing rehabilitation and rapid re-housing programs
- Earned Income Tax Credit
- Earned employee sick leave
- Paid family leave
- Fair hiring practices
These policies have shown strong or emerging evidence for their ability to improve health and can offer return on investment for states that implement them.
Read the full report
