Willingness of the Local Health Department Workforce to Respond to Infectious Disease Events: Empirical, Ethical, and Legal Considerations

Abstract

According to the Institute of Medicine, the local health department workforce is at the hub of the public health emergency preparedness system. A growing body of research has pointed to troubling attitudinal gaps among local health department workers, a vital response cohort, regarding willingness to respond to emergent infectious disease threats, ranging from naturally occurring pandemics to bioterrorism events. A summary of relevant literature on the empirical evidence, ethical norms, and legal standards applicable to the willingness of public health professionals to respond to an infectious disease emergency is presented. Recommendations are proposed for future work to be done to bring the relevant empirical, ethical, and legal considerations together to develop practical guidance for the local response to infectious disease emergencies.

Perceived Facilitators and Barriers to Local Health Department Workers' Participation in Infectious Disease Emergency Responses

“…15 Our results, while generally consistent with limited prior research about response willingness among LHD workers, expand on these findings and provide new insights into steps LHDs can take to bolster infectious disease response participation. 9,11 …”

Healthcare Ethics During a Pandemic

“…Emergency physicians may also feel that in these situations they are compelled to use their special knowledge about triage, allocation of scarce resources (eg, vaccines, prophylactic or treatment medications, or intensive care unit [ICU] ventilators), public health mandates (eg, isolation or quarantine, or mandatory vaccination), and the use of altered standards of care. 4,6…”

Promoting public health legal preparedness for emergencies: review of current trends and their relevance in light of the Ebola crisis

“…Studies dealing with preparedness are designed to reveal and resolve ethical and legal dilemmas in order to promote an optimal response for future situations. In addition to extensive coverage of legal aspects dealing with pandemic scenarios ( 3 , 19 , 34 , 48 , 49 ), publications also consider the impact of PHLP on issues such as legal triage ( 10 ), motivating health workers during emergencies ( 2 , 48 , 49 ), human rights during crises, legal coordination of relevant emergency bodies ( 10 ), and the effect of an emergency declaration on health system management ( 2 , 50 ). Hodge ( 19 ) notes that upon declaration of a public health emergency the Model State Emergency Health Powers Act (2001) authorises public health officials to undertake a set of activities dealing with early detection, as well as to care for and protect public health, treat exposed or infected persons, and seek out-of-state volunteers.…”