FEMA Blog

Posted by: Nicole Lurie, M.D., MSPH, Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services

As National Public Health Week draws to a close, as events in Japan shift toward recovery, they act as an important reminder of how closely tied disaster emergency management is to health. Indeed, medical concerns of citizens are always a preeminent focus of any disaster response.

Regardless of the nature of a particular disaster, the underlying health of affected populations has a significant impact on disaster management. Populations across the U.S. struggle on a day-to-day basis against a myriad of chronic health conditions such as heart disease, asthma and other common illnesses. With good planning and the implementation of effective public health measures, care of patients with these types of common health conditions can be managed effectively in a disaster without increased negative effects to the health and well being of the affected populations. However, our systems of day-to-day public health must be closely tied with disaster management to ensure that our hospitals and clinics are equipped to handle the surge of patients that often accompanies a major disaster. In order to work well during a crisis, these systems work together on a regular basis. Developing a system for educating the public about prevention of common illness and disease and managing small-scale personal emergencies is a great example of an area public health and emergency management can work together. Individuals and communities need to understand both how to manage their own health issues on a day-to-day basis as well as how they would manage these issues if a disaster were to strike. Having a public that is educated about how to manage their own health issues during a disaster is a key component to mitigating the health effects of disasters on individuals and communities.

Federal preparedness grant programs emphasize the need for planning, coalition building, and exercises. Yet in order to function effectively such efforts must be integrated in a coordinated fashion throughout health and medical systems, as well as systems of emergency management across federal, state and local levels. While these systems work well together in some communities, as a nation, we need these efforts to be integrated and seamless in every town and every region across the country. We may need to start thinking differently about how we approach preparedness and response - for instance encouraging the healthcare sector to think in a more geographical sense about how resources can be shared between hospitals, or how communities can work together to assess and address acute needs in disaster situations.


Galveston Island, TX, September 18, 2008 -- Members of the Iowa-1 Disaster Medical Assistance Team help to move a patient along with flight nurses and medics who will be transporting patients to hospitals that are operating outside of the area impacted by Hurricane Ike

One of the challenges we face is that the health communities reside both in public and private sectors. Hospitals and healthcare facilities are businesses, and while it's not always easy for emergency managers and health officers to coordinate seamlessly with one another during a crisis, it's even more difficult for public health entities and the private sector to share information and address needs during the height of a disaster. During the course of the past few years we have seen some successful examples, such as corporate pharmacies working with the federal government to disseminate flu vaccine during H1N1. We know success in this realm is possible, it’s now a matter of integrating these practices as a part of day-to-day business so that the system functions naturally in an emergency.

In public health, we want communities to be resilient which they are means being capable of preventing, withstanding and mitigating the stress of a health incident and to recover in a way that restores the community to self-sufficiency, to pre-incident health levels (or better). I'm sure that's your goal, too. So, please, if you haven't already, reach out to your local hospitals, healthcare facilities and public health offices. Invite them into your exercises and to be part of your planning.  And remember that as a citizen, you personally play a key role in this as well by preparing in advance for your own health-related needs and having a family plan to support those needs. It's important to work together and for each of us to be prepared now if we're going to respond effectively as a whole community when every minute counts.

- Nicole Lurie, M.D., MSPH