The AI Divide: Bridging the Implementation Gap in State and Territorial Public Health Departments

Generative AI presents an opportunity for state and territorial health agencies to manage escalating workloads and workforce shortages. The 2025 ASTHO Profile found an implementation gap with most agencies having an AI policy, but a third reporting no AI use. While 80% prioritize data governance, only 15% use AI for public health tasks like disease surveillance, opting instead for administrative efficiency (30%) or content creation (28%). Implementation is fragmented, with 34% avoiding AI. The top challenges are lack of established staff guidance (61%) and workforce skills (54%). Closing this gap requires expanding "AI literacy" training and adopting shared enterprise infrastructure models.