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.