Public Health Preparedness

Regional strategies to prepare for public health disasters in Texas offer lessons about community resource allocation

In 2002, The Centers for Disease Control and Prevention (CDC) sent out a blueprint to State health departments to develop strategies to prepare for public health disasters. Funding to the States was contingent upon written submission of these strategies. Two case studies of strategies developed with use of the CDC funds in two public health regions in Texas (San Antonio and Dallas/Fort Worth areas) offer lessons about resource allocation to prepare for bioterrorism and other public health disasters.

With support from the Agency for Healthcare Research and Quality (HS13715), the researchers conducted interviews with regional directors, the State epidemiologist, and public health officials individually and in a focus group. Those interviewed emphasized that personal relationships are the cornerstone of public health preparedness. Public health officials at all levels, emergency managers, firefighters, health care workers, pharmacists, and hospital administrators must work together. Trust and cooperative working relationships must be developed through person-to-person meetings, planning sessions, and training exercises, and are essential for preparedness.

Second, funding from Federal agencies to State and local public health agencies has generally been allocated on a per capita basis. However, in Texas, regional use of funds (with input from local jurisdictions) was more effective based on the satisfaction of those involved 1 year after strategy implementation. Third, those interviewed recommended streamlining the planning processes with up-to-date computer networks in every county public health office, as well as software and software training. Finally, they stressed the importance of a communication plan to link the regional director, State epidemiologist's office, and local public health officials.

More details are in "Lessons learned from a regional strategy for resource allocation," by Janine C. Edwards, Ph.D., Jonathan Stapley, Ph.D., Ralitsa Akins, M.D., Ph.D., and others, in Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science 3(2), pp. 113-118, 2005.

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