Preparedness

by

Linda Young Landesman

• LAST REVIEWED: 22 April 2013
• LAST MODIFIED: 22 April 2013
• DOI: 10.1093/obo/9780199756797-0088

Introduction

The body of research investigating public health considerations in disasters has only recently received dedicated attention. This was stimulated when the Pandemic and All Hazards Preparedness Act 2006 called for research to improve the public health preparedness and response to emergencies. The Institute of Medicine published a study that called for research to protect vulnerable populations in emergencies, strengthen systems of response, prepare the public health workforce, improve emergency communications, and improve information management. Following the release of this report, the Centers for Disease Control and Prevention (CDC) conducted workshops to inform the development of a research agenda. CDC subsequently established the Preparedness and Emergency Response Research Centers. In 2008 nine centers began research in these areas; investigators should monitor current journals to be aware of the findings as they become available. The intent of this bibliography is to provide the overarching and foundational resources for a researcher to locate works in the field of emergency preparedness. Preparedness activities converge with the entire gamut of public health practice—everything from management to environment. Further, there is lack of agreement about what public health preparedness encompasses. Thus the topic is presented broadly so that public health investigators can benefit from knowing what previous investigators might have learned in a different professional group or setting.

Definitions

Despite efforts since the 1990s to achieve a universally accepted definition of public health preparedness, none has been reached. Following the establishment of a national priority for public health to prepare and respond to incidents of bioterrorism, federal funding was available for the development of guidance for the profession. Landesman led the initial effort at defining the educational and training needs for public health preparedness through three national conferences. This effort culminated in a preparedness model based on public health functions, guidelines for curriculum development (Landesman 1996), and the first national curriculum. Turnock 2003 describes how to enhance preparedness by focusing on the public health workforce. Lurie, et al. 2006 suggests that preparedness was not a new domain for public health agencies, but a progression of practice in the field. Through work sponsored by the Department of Health and Human Services, Nelson, et al. 2008 presents a conceptual definition of public health preparedness. Barnett, et al. 2009 addresses the ethical and legal issues confronted by public health practitioners in the allocation of scarce resources during disaster response. In a review of research, Savoia, et al. 2009 finds that robust methodological design is lacking in published studies on public health preparedness. Potter, et al. 2010 determines that the content of publications on public health preparedness is limited in both scope and content. Finally, building upon Nelson, et al. 2008, Gibson, et al. 2012 maintains that public health preparedness has not been well defined and presents a model that is being vetted by the key national organizations representing health departments.

• Barnett, D. J., H. A. Taylor, J. G. Hodge Jr., and J. M. Links. 2009. Resource allocation on the frontlines of public health preparedness and response: Report of a summit on legal and ethical issues. Public Health Reports 124.2 (March–April): 295–303.

  An invitational panel developed ethical and legal principles for making resource triage decisions during emergencies. The principles were categorized into three categories: obligations to the community; balancing autonomy and community needs/benefit; and good preparedness practice. These principles were designed as a framework to guide real-world practices.

• Gibson, P. J., F. Theadore, and J. B. Jellison. 2012. The common ground preparedness framework: A comprehensive description of public health emergency preparedness. American Journal of Public Health 102.4 (April): 633–642.

  DOI: 10.2105/AJPH.2011.300546

  Contending that public health emergency preparedness is not well defined, the authors present a framework for public health agencies to prepare for and respond to emergencies. The identified activities are organized into six groups: prepare, monitor, investigate, intervene, manage, and recover, which all occur before, during, and after an emergency.

• Landesman, L. Y., ed. 1996. Guidelines for developing curricula for emergency public health in schools of public health. Washington, DC: Association of Schools of Public Health.

  This monograph, an outcome of three conferences that defined the role and education of public health professionals in disasters, was the first to outline the scope of public health preparedness and education of the workforce. It describes strategies for both creating new courses and incorporating preparedness content in existing courses.

• Lurie, N., J. Wasserman, and C. D. Nelson. 2006. Public health preparedness: Evolution or revolution? Health Affairs 25.4: 935–945.

  DOI: 10.1377/hlthaff.25.4.935

  Arguing that public health preparedness represents an evolution of public health practice, this paper describes how preparedness activities have been added to ongoing public health responsibilities and how state and local public health agencies have developed new partnerships, changed the workforce, incorporated new technologies, and redefined the structure of organizations.

• Nelson, C., N. Lurie, J. Wasserman, S. Zakowski, and K. J. Leuschner. 2008. Conceptualizing and defining public health emergency preparedness. Santa Monica, CA: RAND Health.

  An expert panel developed a definition of public health emergency preparedness from which standards and measures can be developed to assess achievement.

• Potter, M., K. Miner, D. Barnett, et al. 2010. The evidence base for effectiveness of preparedness training: A retrospective analysis. Public Health Reports 125, Supplement (November–December): 15–23.

  This analysis found that public health articles covered three main topics: leadership and command structure, information and communications, and organizational systems. The educational usefulness of the articles was suboptimal due to an emphasis on organizational topics and differences between the needs of educators, policymakers, and public health agencies.

• Savoia, E., S. B. Massin-Short, A. M. Rodday, L. A. Aaron, M. A. Higdon, and M. A. Stoto. 2009. Public health systems research in emergency preparedness: A review of the literature. American Journal of Preventive Medicine 37.2 (August): 150–156.

  DOI: 10.1016/j.amepre.2009.03.023

  In an evaluation of the research literature in public health preparedness, the authors report that the majority of the articles were based on qualitative analyses. The authors conclude that despite a huge growth in the number of publications, few studies were rigorously designed.

• Turnock, B. J. 2003. Roadmap for public health workforce preparedness. Journal of Public Health Management & Practice 9.6 (November–December): 471–480.

  Dr. Turnock assesses the current state and argues the need for a competent public health workforce to carry out the tasks required in preparing for and responding to disasters.