Health Care Policies: Week 6
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Chapter 12:
Public Health Preparedness
Policy
Chapter Overview
• Describe what public health preparedness is and the
role of the public health community in preparing for
and responding to emergencies
• Understand the breadth of public health emergencies,
and the types of communities public health must
work with to prepare for and respond to specific
events
• Understand the threats from and history of use of
weapons of mass destruction
Chapter Overview
• Define public health threats from biological
agents and naturally occurring diseases
• Discuss both the federal, state, and local
policies and laws that support public health
preparedness and the infrastructure that has
been built to support preparedness activities at
the federal, state and local levels
Defining Public Health Preparedness
• “[P]ublic health emergency preparedness . . . is the
capability of the public health and health care systems,
communities, and individuals, to prevent, protect
against, quickly respond to, and recover from health
emergencies, particularly those whose scale, timing, or
unpredictability threatens to overwhelm routine
capabilities. Preparedness involves a coordinated and
continuous process of planning and implementation that
relies on measuring performance and taking corrective
action.” – The RAND Corporation
Defining Public Health Preparedness
• Public health “emergencies” fit into four basic
categories:
– the intentional or accidental release of a chemical,
biological, radiological, or nuclear (CBRN) agent;
– natural epidemics or pandemics, which may involve
a novel, emerging infectious disease, a re-emerging
agent, or a previously controlled disease;
– natural disasters such as hurricanes, earthquakes,
floods, or fires; and
– manmade environmental disasters such as oil spills.
Defining Public Health Preparedness
• A fifth category of public health emergency, as
defined by the World Health Organization’s
International Health Regulations, is “an extraordinary
event which is determined . . . to constitute a public
health risk to other States through the international
spread of disease and to potentially require a
coordinated international response.” Such an
emergency can involve any of the above four types of
public health events, as long as it has the potential to
cross borders.
Public Health Preparedness Policy
• While government officials have long been aware of
public health emergencies and the need for
coordinated action to detect, report, and respond
appropriately, the U.S. preparedness infrastructure
did not truly take shape until after the attacks of
September 11, 2001
• The two initial, significant organizational changes:
the establishment of the federal Office of Homeland
Security and the Homeland Security Council within
the White House, and the creation of the Department
of Homeland Security
Public Health Preparedness Policy
• In addition to the creation of DHS, in the wake of the
9/11 attacks many existing government departments
and agencies established new offices, expanded
existing ones, and redirected resources towards
preparedness and homeland security. The following
agencies and offices are most directly linked to public
health preparedness policy at the federal level:
– Office of the Assistant Secretary for Preparedness
and Response
– Centers for Disease Control and Prevention
Public Health Preparedness Policy (continued)
– Centers for Disease Control and Prevention
– National Institutes of Health
– The Food and Drug Administration
– Department of Agriculture
– Department of Justice, Federal Bureau of
Investigation
– Department of Defense
Public Health Preparedness Policy (continued)
• These agencies and offices are charged with
enforcing many statutes, regulations, and
policy guidance documents that form the
foundation of public health preparedness.
Public Health Preparedness Federalism
• Public health preparedness requires cooperation
among multiple levels of government. Indeed, while
a strong federal policy and infrastructure is essential,
public health professionals recognize that most public
health activities occur at the local and state level.
• Not only is this a reality in practice, it is codified by
the 10th Amendment of the Constitution: “The
powers not delegated to the United States by the
Constitution, nor prohibited by it to the States, are
reserved to the States respectively, or to the people.”
Public Health Preparedness Federalism
• States have responsibility for developing their own
emergency preparedness plans, and all have some
level of planning and preparedness training in place.
Public Health Preparedness Federalism (continued)
• Preparedness efforts at the state level focus on the
unique threats, challenges, assets, and populations
specific to particular jurisdictions. States that are
subject to relatively more frequent hurricanes may have
well developed plans to address that particular hazard,
while landlocked states far from oceans may have
better-developed plans for other disasters. States will
also take into account the particular demographics of
their region when planning how to address vulnerable
populations, nursing homes, and schools in
emergencies.