A State-Based Analysis of Public Health Preparedness Programs in the United States

Beitsch, Leslie M.; Kodolikar, Samata; Stephens, Tim; Shodell, Daniel; Clawson, Art; Menachemi, Nir; Brooks, Robert G.

doi:10.1177/003335490612100614

Cited by 16 publications

(13 citation statements)

References 23 publications

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“…Although the term regionalization can apply to countries (e.g., coordination between the United States and Canada), as well as counties or even hospitals (23), we apply it here to collections of either local areas within a single state or metropolitan areas that cross state boundaries. Many states have now subdivided themselves into preparedness regions, and more than half of these regions were created after 9/11 (3). In addition, 24% of local health departments currently serve more than one jurisdiction, such as a city and its surrounding county or multiple counties (27).…”

Section: Introductionmentioning

confidence: 99%

Regionalization of Local Public Health Systems in the Era of Preparedness

Koh

Elqura

Judge

et al. 2008

Annu. Rev. Public Health

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Post-9/11, preparedness planning has catalyzed intrastate regionalization of local public health resources throughout the United States. Investigating this trend unveils several regionalization themes, relevant in other sectors of government, which are applicable to local public health. In this review article, we begin by briefly examining the lessons learned from regionalization for police and fire services, drawing comparisons to public health. Then we provide a brief history of the accelerating regionalization of local public health services sparked by the current attention to emergency preparedness. In particular, we offer case studies from Massachusetts and the National Capital Region to highlight examples of regionalization outcomes related to networking, coordination, standardization, and centralization of public health services. The impact of social capital on preparedness is also explored. Finally, we summarize research needs for the future.

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Section: Introductionmentioning

confidence: 99%

Regionalization of Local Public Health Systems in the Era of Preparedness

Koh

Elqura

Judge

et al. 2008

Annu. Rev. Public Health

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“…Unfortunately, studies from the past three decades have found evidence of wide variation in the delivery of these types of services at both the state and local level (IOM 1988; Mays et al 2004; Turnock and Handler 1997; Turnock et al 1994). Gaps in the delivery of effective, evidence‐based interventions have been found in a wide range of service areas, including nutrition and physical activity programming (Brownson, Ballew, Brown, et al 2007; Brownson, Ballew, Dieffenderfer et al 2007; Slater, Powell, and Chaloupka 2007), tobacco control (Mueller et al 2006), emergency preparedness (Beitsch, Kodolikar et al 2006; Lurie et al 2004), food safety, and communicable disease control (Gilbert et al 2005; Harris 2009).…”

mentioning

confidence: 99%

Understanding the Organization of Public Health Delivery Systems: An Empirical Typology

et al. 2010

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Context: Policy discussions about improving the U.S. health care system increasingly recognize the need to strengthen its capacities for delivering public health services. A better understanding of how public health delivery systems are organized across the United States is critical to improvement. To facilitate the development of such evidence, this article presents an empirical method of classifying and comparing public health delivery systems based on key elements of their organizational structure.Methods: This analysis uses data collected through a national longitudinal survey of local public health agencies serving communities with at least 100,000 residents. The survey measured the availability of twenty core public health activities in local communities and the types of organizations contributing to each activity. Cluster analysis differentiated local delivery systems based on the scope of activities delivered, the range of organizations contributing, and the distribution of effort within the system. Findings: Public health delivery systems varied widely in organizational structure, but the observed patterns of variation suggested that systems adhere to one of seven distinct configurations. Systems frequently migrated from one configuration to another over time, with an overall trend toward offering a broader scope of services and engaging a wider range of organizations. Conclusions:Public health delivery systems exhibit important structural differences that may influence their operations and outcomes. The typology developed through this analysis can facilitate comparative studies to identify which delivery system configurations perform best in which contexts.

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“…By 2006, most states had established preparedness regions, with over half of these regions created after 2001[3]. North Carolina was among those states that created preparedness regions following the terrorist attacks of September 11, 2001.…”

Section: Introductionmentioning

confidence: 99%

Changes in public health preparedness services provided to local health departments by regional offices in North Carolina: a comparison of two cross-sectional studies

2014

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BackgroundIn 2011, seven decentralized Public Health Regional Surveillance Teams (PHRSTs) were restructured into four centralized Public Health Preparedness and Response (PHP&R) regional offices to realign preparedness priorities and essential services with appropriate infrastructure; field-based staff was reduced, saving approximately $1 million. The objective of this study was to understand the impact that restructuring had on services provided to local health departments (LHDs) throughout North Carolina.MethodsA survey to document services that regional offices provide to LHDs in North Carolina was administered by the North Carolina Preparedness and Emergency Response Research Center in 2013. The results were compared to a similar survey from 2009, which identified services provided by regional teams prior to restructuring.ResultsOf 69 types of assistance, 14 (20%) were received by 50% or more LHDs in 2012. Compared to 2009, there was a significant decrease in the proportion of LHDs receiving 67% (n = 47) of services. The size of the region served by regional offices was shown to inversely impact the proportion of LHDs receiving services for 25% of services. There was a slight significant decline in perceived quality of the services provided by regional teams in 2012 as comparison to 2009.ConclusionsFollowing a system-wide review of preparedness in North Carolina, the state’s regional teams were reorganized to refine their focus to planning, exercises, and training. Some services, most notably under the functions of epidemiology and surveillance and public health event response, are now provided by other state offices. However, the study results indicate that several services that are still under the domain of the regional offices were received by fewer LHDs in 2012 than 2009. This decrease may be due to the larger number of counties now served by the four regional offices.

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A State-Based Analysis of Public Health Preparedness Programs in the United States

Cited by 16 publications

References 23 publications

Regionalization of Local Public Health Systems in the Era of Preparedness

Regionalization of Local Public Health Systems in the Era of Preparedness

Understanding the Organization of Public Health Delivery Systems: An Empirical Typology

Changes in public health preparedness services provided to local health departments by regional offices in North Carolina: a comparison of two cross-sectional studies

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