Kaiser Family Foundation

The State of Public Health Preparedness

Kaiser Family Foundation

Background

American Journal of Public Health, Public Health Preparedness, April 2007.
The April 2007 issue of the American Journal of Public Health focuses on public health preparedness and covers a variety of related topics such as ethics, government, law, preparing for the future, and new research in public health preparedness.

Centers for Disease Control and Prevention. 2001. Updated Guidelines for Evaluating Public Health Surveillance Systems: Recommendations from the Guidelines Working Group. Morbidity and Mortality Weekly Report 50(RR-13):1–35.
This report provides updated guidelines for evaluating surveillance systems based on the Center for Disease Control and Prevention Framework for Program Evaluation in Public Health, research and discussion of concerns related to public health surveillance systems, and comments received from the public health community. The authors delineate many tasks and related activities that can be applied to public health surveillance systems.

Health Affairs, The State of Public Health 25(4), July/August 2006.
This July/August 2006 edition of Health Affairs features a series of articles on the public health system, addressing issues such as public health infrastructure, prevention, bioterrorism, preparedness, current challenges, and policy issues.

Kayman, H. and A. Ablorh-Odjidja. July/August 2006. Revisiting Public Health Preparedness: Incorporating Social Justice Principles into Pandemic Preparedness Planning for Influenza. Journal of Public Health Management & Practice 12(4):373–380.
This article discusses the role and implementation of social justice principles in addressing the racial disparities of influenza preparedness planning.

Institute of Medicine. The Future of the Public’s Health in the 21st Century. National Academies Press, November 2002.
This report examines the current state of public health and makes recommendations for improving the field, including strengthening infrastructure and enhancing communication between different public health agencies.

Salinsky, E. and E.A. Gursky. July/August 2006. The Case for Transforming Governmental Public Health. Health Affairs 25(4):1017–1028.
This article discusses the public health system’s need to address the demands of preparedness and health protection through better organization and more effective leadership.

Tilson, H. and B. Berkowitz. July/August 2006. The Public Health Enterprise: Examining Our Twenty-First Century Policy Challenges. Health Affairs 25(4):900–910.
This paper examines cross-cutting issues facing the public health system, including collaboration across public health agencies, accountability and measurement, workforce, research agenda, and agreement on essential services.

Financing

Garfield, R. July 2005. State Preparedness for Bioterrorism and Public Health Emergencies. The Commonwealth Fund.
This issue brief compares different levels of state funding for and assesses the current status of public health preparedness across the nation.

Katz, A., A.B. Staiti, and K.L. McKenzie. 2006. Preparing for the Unknown, Responding to the Known: Communities and Public Health Preparedness. Health Affairs 25(4):946–957.
This paper examines the current state of community public health preparedness and the impact of major increases in funding for public health emergencies since September 11th have affected the public health system. The authors also address key challenges facing community public health systems.

Turnock, B.J. 2004. Public Health Preparedness at a Price: Illinois. The Century Foundation.
This report uses Illinois as a case study to analyze the level of federal support and funding for state public health infrastructure and preparedness efforts.

Infrastructure and Workforce

Baker, E.L. Jr. and J.P. Koplan. November/December 2002. Strengthening the Nation’s Public Health Infrastructure: Historic Challenge, Unprecedented Opportunity. Health Affairs 21(6):15–27.
This paper gives an overview of progress during the past decade on storing up the nation’s public health infrastructure.

Beitsch, L.M., R.G. Brooks, N. Menachemi, et al. July/August 2006. Public Health at Center Stage: New Roles, Old Props. Health Affairs 25(4):911–922.
This paper examines the need for greater resources in order for the public health system to prevent and respond to infectious diseases, growth in chronic medical conditions, and responding to disasters.

Gebbie, K.M. and B.J. Turnock. 2006. The Public Health Workforce, 2006: New Challenges. Health Affairs 25(4):923–933.
This article offers policy recommendations for development of an organized, well-trained public health workforce.

Hajat, A., K. Stewart, and K.L. Hayes. November/December 2003. The Local Public Health Workforce in Rural Communities. Journal of Public Health Management Practice 9(6):481–488.
This article describes the public health workforce and the training needs of rural public health agencies compared to suburban and metropolitan areas.

Hasse, L.W. 2004. Breathing Easier? Century Foundation Working Group on Bioterrorism Preparedness.
This report examines federal bioterrorism preparedness efforts and policies and makes recommendations for improvement of the public health infrastructure to address health threats such as anthrax.

Lurie, N., RAND Corporation, Public Health Preparedness in the 21st Century, Testimony to the Senate Subcommittee on Bioterrorism and Public Health Preparedness on March 28, 2006.
In this testimony presented before the Senate Subcommittee on Bioterrorism and Public Health Preparedness on March 28, 2006, the author discusses her recommendations for the improvement of public health preparedness including more comprehensive information systems and work force preparedness.

Lurie, N., J. Wasserman, and C.D. Nelson. 2006. Public Health Preparedness: Evolution or Revolution? Health Affairs 25(4):935–945.
This paper describes recent changes in public health systems with a specific emphasis on how technological innovations are changing the field.

Mair, M., R.W. Grow, J.S. Mair, et al. 2006. Universal Influenza Vaccine: The Time to Act is Now. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science 4(1).
The authors use annual influenza epidemics as case studies to examine strengths and weaknesses in vaccination programs and bioterrorism readiness.

Rosenblatt, R. S. Casey, and M. Richardson. 2002. Rural-Urban Differences in the Public Health Workforce: Findings from Local Health Departments in Three Rural Western States. American Journal of Public Health 92:1102–1105.
This study provides quantitative, population-based data on the rural public health workforce in three states—Alaska, Montana, and Wyoming and discusses the different needs between rural and urban settings.

Schoch-Spana, M., J. Fitzgerald, B.R. Kramer, et al. 2005. Influenza Vaccine Scarcity 2004–2005: Implication for Public Health Preparedness. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science 3(3).
This article examines the vaccine shortage of 2004–2005 and the response from public health officials. The authors use the shortage as a case study to explore the practical and ethical dilemmas of managing medical resources during a public health emergency.

Setliff, R., J.E. Porter, M. Malison, et al. March–April 2003. Strengthening the Public Health Workforce: Three CDC Programs that Prepare Managers and Leaders for the Challenges of the 21st Century. Journal of Public Health Management Practice 9(2):91–102.
This article discusses the lessons learned from practices in health management and leadership development through three programs established by the Centers for Disease Control and Prevention.

Turnock, B.J. November/December 2003. Roadmap for Public Health Workforce Preparedness. Journal of Public Health Management & Practice 9(6):471–480.
This report examines the current state and future of the public health workforce, including a roadmap for recognizing and enhancing competent performances in the field.

United States General Accounting Office, Bioterrorism: Information Technology Strategy Could Strengthen Federal Agencies’ Abilities to Respond to Public Health Emergencies, May 2003.
This report emphasizes the ability of information technology systems to increase communication among public health agencies and responsiveness to public health emergencies. The report outlines different available systems and recommends continued expansion and improvement of these systems.

Health Care Delivery System

Davis, L.M., J.S. Ringel, S.K. Cotton, et al. Public Health Preparedness: Integrating Public Health and Hospital Preparedness Programs. Santa Monica, CA: RAND Corporation, 2006.
This report examines different models for coordination between hospitals and public health departments in an effort to improve public health preparedness.

Institute of Medicine. Hospital-Based Emergency Care: At the Breaking Point. Washington, DC: National Academies Press, June 2006.
This report examines the state of emergency departments and medical care across the country and offers recommendations to increase hospital efficiency, coordination and regionalization of emergency services. The report also recommends the establishment of a federal agency to address the problems with the emergency care system.

Joint Commission on Accreditation of Healthcare Organizations, Surge Hospitals: Providing Safe Care in Emergencies, 2006.
This paper explains the role and future of surge hospitals, temporary facilities to treat large numbers of patients following a disaster, in public health preparedness. The paper provides examples of surge hospitals as well as recommends standards for surge hospital establishment and care for the future.

Joint Commission on Accreditation of Healthcare Organizations, Health Care at the Crossroads: Strategies for Creating and Sustaining Community-Wide Emergency Preparedness Systems, 2003.
This paper discusses the role of local providers in responding to public health emergencies and provides specific recommendations for preparing and integrating local health systems into emergency preparedness plans.

Rubinson, L., J.B. Nuzzo, D.S. Talmor, et al. 2005. Augmentation of Hospital Critical Care Capacity after Bioterrorist Attacks or Epidemic. Critical Care Medicine 33(10).
This report examines the potential effects of a large bioterrorist attack on regional hospitals and offers recommendations for capacity building in hospitals to respond to such an attack.

State and Local

Association of State and Territorial Health Officials, Top 10 Suggestions from Public Health Officials Who Have Been There, January 2002.
These guidelines were compiled for public health agencies by state health officials affected by the September 11th terrorist attack.

Bashir, Z., V. Lafronza, M.R. Fraser, et al. September/October 2003. Local and State Collaboration for Effective Preparedness Planning. Journal of Public Health Management & Practice 9(5):344–351.
This paper outlines guidelines for effective practices in local and state public health collaborations for preparedness planning and programs.

Kaiser Family Foundation, Kaiser Commission on Medicaid and the Uninsured, Health Care and Hurricane Katrina.
This site provides a number of resources related to an ongoing effort to monitor and study the health coverage and needs of victims of Hurricane Katrina. Included are survivor experiences, surveys, state facts, and other issues.

Lillie-Blanton, M. January–February 2006. Hurricane Katrina: Health Impacts in Louisiana. Joint Center for Political and Economic Studies Focus Magazine 34(10).
This article explores the impact of Hurricane Katrina on health and medical services with an emphasis on racial disparities in the health system and federal response to the crisis.

Lurie, N., R. Burciaga Valdez, J. Wasserman, et al. Public Health Preparedness in California: Lessons Learned from Seven Health Jurisdictions. Santa Monica, CA: RAND Corporation, August 2004.
This report uses local health departments in California as case studies on the role of increased levels of federal funding in preparedness activities. The authors examine the leadership, organization and staff training levels at each health department.

National Conference of State Legislatures, Terrorism Preparedness: A Series of Reports about States Responses to Public Health Threats, September 2003.
This website includes several reports on state preparedness in different public health areas which could be affected by terrorist attacks, such as mental health and access to vaccines.

Rudowitz, R., D. Rowland, and A. Shartzer. August 26, 2006. Health Care in New Orleans Before and After Hurricane Katrina. Health Affairs Web Exclusive.
This paper examines the impact of the storm on New Orleans, the current state of health care in the city, and lessons learned about the city’s health care delivery system.

Seid, M., D. Lotstein, V.L. Williams, et al. Quality Improvement: Implication for Public Health Preparedness. Santa Monica, CA: RAND Corporation, 2006.
This paper discusses the implications of applying a stringent data and performance driven management system to the field of public health preparedness. The authors use case studies of local health departments to examine the status and effects of Quality Improvement implementation on preparedness programs.

Shugarman, L.R., E. Eiseman, A. Jain, et al. Enhancing Public Health Preparedness: Exercises, Exemplary Practices, and Lessons Learned. Santa Monica, CA: RAND Corporation, 2005.
This publication summarizes examples of model practices in preparedness from local, state, regional, national, or international levels, as well as a template for public health officials to evaluate practices in their local areas.

Tanielian, T., K. Ricci, M.A. Stoto, et al. Exemplary Practices in Public Health Preparedness. Santa Monica, CA: RAND Corporation, 2005.
This report defines the criteria of an exemplary practice in public health and then identifies such practices already in place in public health departments around the country.

U.S. Department of Health and Human Services, Pandemic Planning Update, March 2006.
This report discusses the importance of the public health infrastructure at a state and local levels and communication among public health professionals at all levels in planning for a flu pandemic.

U.S. General Accountability Office, Bioterrorism: Preparedness Varied Across State and Local Jurisdictions, April 2003.
This report examines state infrastructure capacity, communication and coordination as well as guidance from the federal government, with regard to bioterrorism.

Winston, P., O. Golden, K. Finegold, et al. June 27, 2006. Federalism after Hurricane Katrina: How Can Social Programs Respond to a Major Disaster? Urban Institute.
This report examines readiness to respond to public health disasters before and after Hurricane Katrina in four social sectors: housing, unemployment, healthcare and welfare.

Zuckerman, S. and T.A. Coughlin. February 17, 2006. Initial Health Policy Responses to Hurricane Katrina and Possible Next Steps. Urban Institute.
This article outlines the consequences of Hurricane Katrina on the Louisiana health system, as well as insurance coverage and health status of the local populations. The authors analyze the public health response and provide recommendations for policies to address long-term needs of rebuilding the health system.