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Aid Increased Community Preparedness for Public Health Emergencies

Despite Progress and New Funding, Gaps in Preparedness Remain

News Release
May 4, 2004

Alwyn Cassil: (202) 264-3484

ASHINGTON, D.C.—Many U.S. communities are better prepared for public health emergencies since the Sept. 11 terrorist attacks, but weaknesses remain, particularly in communications and information technology (IT) and workforce education and training, according to a study by researchers from the Center for Studying Health System Change (HSC) published in the May/June edition of the journal Health Affairs.

Following the 2001 attacks, federal and local governments made public health emergency preparedness a top priority, and many communities received new federal funding to support preparedness efforts. This funding has aided community preparedness, but differences among communities remain. In general, larger communities and those with previous experience with public health emergencies or with higher perceived risk—for example, a nearby nuclear power plant—exhibit stronger response capabilities.

"In addition to adequate funding, experience with public health emergencies, successful collaboration and strong leadership were the keys to a high level of preparedness," said Paul B. Ginsburg, Ph.D., president of HSC, a nonpartisan policy research organization funded principally by The Robert Wood Johnson Foundation.

The study by Megan McHugh, an HSC consulting research analyst from Mathematica Policy Research, HSC Research Assistant Andrea B. Staiti and HSC Research Analyst Laurie E. Felland is based on HSC’s 2002-03 site visits to 12 nationally representative communities: Boston; Cleveland; Greenville, S.C.; Indianapolis; Lansing, Mich.; Little Rock, Ark.; Miami; northern New Jersey; Orange County, Calif.; Phoenix; Seattle; and Syracuse, N.Y.

The study identified several key challenges facing local public health officials as they work to improve preparedness for public health emergencies, including:

Lack of funding. Despite the large inflow of federal dollars to some communities, the cost of implementing or improving communications and surveillance systems, training, planning and labs remains daunting and exceeds available funds.

Budget deficits. Each of the 12 communities were located in states with impending budget deficits that had to be addressed, raising concerns about cuts to public health budgets. Because federal funds cannot be used to supplant state or local funding, observers were concerned about preserving traditional public health activities in the face of state deficits.

Workforce shortages. In some communities, public health officials reported difficulties in hiring qualified public health workers, particularly nurses and epidemiologists, because of the short supply of these professionals and an inability to offer competitive salaries.

Comments on the HSC Study

John Lumpkin, M.D., M.P.H., senior vice president and director, Health Care Group, The Robert Wood Johnson Foundation,

"This study shows that much improvement has been made in the past couple of years, but more needs to be done to address a public health infrastructure in need of repair. Preparedness is not an endpoint, it is a constant state that will require long-term investments in the public health system to raise and maintain our state of readiness."

Virginia A. Caine, M.D., director of the Marion County Health Department (Indianapolis) and president, American Public Health Association,

"As this study points out, adequate funding is critical. However, as the study also observes, strong local leadership is equally important. It’s vital to building and maintaining communications and collaboration across the community—the public, media, first responders, business, public health, health systems, and many others. Strong local leadership also provides clarity, vision, and a unified sense of urgency and mission."

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The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.

Health Affairs, published by Project HOPE, is a bimonthly multidisciplinary journal devoted to publishing the leading edge in health policy thought and research. For more information, contact Jon Gardner at Health Affairs at (301) 656-7401, ext. 230, or via e-mail,


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