Public Health Preparedness Laws and Policies: Where Do We Go after Pandemic 2009 H1N1 Influenza?

2011 ◽  
Vol 39 (S1) ◽  
pp. 51-55 ◽  
Author(s):  
Jean O’Connor ◽  
Paul Jarris ◽  
Richard Vogt ◽  
Heather Horton
Keyword(s):  
Public Health ◽  
H1n1 Influenza ◽  
The United States ◽  
Federal State ◽  
High Morbidity ◽  
Public Health Preparedness ◽  
Local Public Health ◽  
2009 H1n1 ◽  
State And Local ◽  
Laws And Policies

The detection and spread of pandemic 2009 H1N1 influenza in the United States led to a complex and multi-faceted response by the public health system that lasted more than a year. When the first domestic case of the virus was detected in California on April 15, 2009, and a second, unrelated case was identified more than 130 miles away in the same state on April 17, 2009, the unique combination of influenza virus genes in addition to its emergence and rapid spread at the end of the typical Northern Hemisphere influenza season suggested the potential for a high morbidity, high mortality event. In response, federal, state, and local public health officials conducted epidemiologic investigations with federal and state laboratory support to help to determine the scope of the H1N1 pandemic. On April 26, the Secretary of the U.S. Department of Health and Human Services (HHS) declared a public health emergency that was renewed through June 23, 2010. The pandemic that ensued tested virtually every aspect of U.S. public health preparedness and response systems, from laboratory capabilities and capacities to social distancing plans.

Different Responses to COVID-19 in Four US States: Washington, New York, Missouri, and Alabama

2021 ◽  
pp. e1-e5
Author(s):  
Paul C. Erwin ◽  
Kenneth W. Mucheck ◽  
Ross C. Brownson
Keyword(s):  
Public Health ◽  
New York ◽  
Large Scale ◽  
United States Public Health ◽  
H1n1 Influenza ◽  
The United States ◽  
Local Public Health ◽  
The Us ◽  
Us Constitution ◽  
State And Local

In the United States, public health is largely the responsibility of state governments’ implementing authority specified in their constitutions or reserved to states under the 10th Amendment to the US Constitution. The public health–related powers granted to the federal government are substantially less and derive primarily from the Commerce Clause (Article 1, Section 8) of the US Constitution. In public health emergencies over the past several decades, however, the Centers for Disease Control and Prevention (CDC) has played a major role in providing guidance, resources, and other support to state and local public health departments, for example, in large foodborne disease outbreaks, in response to major natural disasters, and especially in response to large-scale infectious disease threats (e.g., West Nile virus, severe acute respiratory syndrome, and H1N1 influenza).1 (Am J Public Health. Published online ahead of print January 28, 2021: e1–e5. https://doi.org/10.2105/AJPH.2020.306111 )

scholarly journals COVID-19 and US Health Financing: Perils and Possibilities

2020 ◽  
Vol 50 (4) ◽  
pp. 396-407 ◽  
Author(s):  
Adam Gaffney ◽  
David U. Himmelstein ◽  
Steffie Woolhandler
Keyword(s):  
Public Health ◽  
United States ◽  
Health Care ◽  
Health Financing ◽  
Early Response ◽  
The United States ◽  
Federal State ◽  
Medical Care System ◽  
Local Public Health ◽  
State And Local

While the COVID-19 pandemic presents every nation with challenges, the United States’ underfunded public health infrastructure, fragmented medical care system, and inadequate social protections impose particular impediments to mitigating and managing the outbreak. Years of inadequate funding of the nation’s federal, state, and local public health agencies, together with mismanagement by the Trump administration, hampered the early response to the epidemic. Meanwhile, barriers to care faced by uninsured and underinsured individuals in the United States could deter COVID-19 care and hamper containment efforts, and lead to adverse medical and financial outcomes for infected individuals and their families, particularly those from disadvantaged groups. While the United States has a relatively generous supply of Intensive Care Unit beds and most other health care infrastructure, such medical resources are often unevenly distributed or deployed, leaving some areas ill-prepared for a severe respiratory epidemic. These deficiencies and shortfalls have stimulated a debate about policy solutions. Recent legislation, for instance, expanded coverage for testing for COVID-19 for the uninsured and underinsured, and additional reforms have been proposed. However comprehensive health care reform – for example, via national health insurance – is needed to provide full protection to American families during the COVID-19 outbreak and in its aftermath.

Lessons About the State and Local Public Health System Response to the 2009 H1N1 Pandemic

2013 ◽  
Vol 19 (5) ◽  
pp. 428-435 ◽  
Author(s):  
Michael A. Stoto ◽  
Christopher Nelson ◽  
Melissa A. Higdon ◽  
John Kraemer ◽  
Lisle Hites ◽  
...  
Keyword(s):  
Public Health ◽  
Health System ◽  
Public Health System ◽  
The State ◽  
System Response ◽  
H1n1 Pandemic ◽  
Local Public Health ◽  
2009 H1n1 ◽  
State And Local

School Closure Decisions Made by Local Health Department Officials During the 2009 H1N1 Influenza Outbreak

2015 ◽  
Vol 9 (4) ◽  
pp. 464-471 ◽  
Author(s):  
Harvey Kayman ◽  
Sarah Salter ◽  
Maanvi Mittal ◽  
Winifred Scott ◽  
Nicholas Santos ◽  
...  
Keyword(s):  
Public Health ◽  
Decision Making ◽  
H1n1 Influenza ◽  
School Closure ◽  
Local Public Health ◽  
Public Health Decision ◽  
Health Decision ◽  
Decision Making Processes ◽  
Public Health Officials ◽  
2009 H1n1

AbstractObjectivesThe goal of this study was to gain insights into the decision-making processes used by California public health officials during real-time crises. The decision-making processes used by California public health officials during the 2009 H1N1 influenza pandemic were examined by a survey research team from the University of California Berkeley.MethodsThe survey was administered to local public health officials in California. Guidelines published by the Centers for Disease Control and Prevention had recommended school closure, and local public health officials had to decide whether to follow these recommendations. Chi-squared tests were used to make comparisons in the descriptive statistics.ResultsThe response rate from local public health departments was 79%. A total of 73% of respondents were involved in the decision-making process. Respondents stated whether they used or did not use 15 ethical, logistical, and political preselected criteria. They expressed interest in receiving checklists and additional training in decision-making.ConclusionsPublic health decision-makers do not appear to have a standard process for crisis decision-making and would benefit from having an organized decision-making model. The survey showed that ethical, logistical, and political criteria were considered but were not prioritized in any meaningful way. A new decision-making tool kit for public health decision-makers plus implementation training is warranted. (Disaster Med Public Health Preparedness. 2015;9:464–471)

After September 11: Rethinking Public Health Federalism

2002 ◽  
Vol 30 (2) ◽  
pp. 201-211 ◽  
Author(s):  
Wendy E. Parmet
Keyword(s):  
Public Health ◽  
Public Health System ◽  
The United States ◽  
Federal State ◽  
The Public ◽  
Control And Prevention ◽  
Local Officials ◽  
State And Local ◽  
Effective Public Health ◽  
Suspicious Case

In the fall of 2001, the need for a vigorous and effective public health system became more apparent than it had been for many decades. With the advent of the first widescale bioterrorist attack on the United States, the government's obligation to respond and take steps to protect the public health became self-evident.Also obvious was the need for of an effective partnership between federal, state, and local officials. Local officials are almost always on the front lines of the struggle against bioterrorism. They are the first to recognize a suspicious case and to provide testing and treatment for the affected population. At the same time, state officials are needed to support and coordinate local efforts, providing an expertise that may be lacking in many communities, especially smaller ones.But few would doubt that the federal government has a key role to play. The Centers for Disease Control and Prevention (CDC) is expected to lead the epidemiological investigation and provide expertise on how to cope with diseases that remain unfamiliar to most physicians.

scholarly journals Job Satisfaction and Expected Turnover Among Federal, State, and Local Public Health Practitioners

2016 ◽  
Vol 106 (10) ◽  
pp. 1782-1788 ◽  
Author(s):  
Jonathon P. Leider ◽  
Elizabeth Harper ◽  
Ji Won Shon ◽  
Katie Sellers ◽  
Brian C. Castrucci
Keyword(s):  
Public Health ◽  
Job Satisfaction ◽  
Federal State ◽  
Local Public Health ◽  
Health Practitioners ◽  
State And Local ◽  
Public Health Practitioners

Domestic Legal Preparedness and Response to Ebola

2015 ◽  
Vol 43 (S1) ◽  
pp. 15-18 ◽  
Author(s):  
James G. Hodge ◽  
Matthew S. Penn ◽  
Montrece Ransom ◽  
Jane E. Jordan
Keyword(s):  
Public Health ◽  
Virus Disease ◽  
Developed Countries ◽  
The United States ◽  
University Hospital ◽  
African Countries ◽  
Extensive Discussion ◽  
Local Public Health ◽  
Emory University ◽  
State And Local

While the global threat of Ebola Virus Disease (EVD) in 2014 was concentrated in several West African countries, its effects have been felt in many developed countries including the United States. Initial, select patients with EVD, largely among American health care workers (HCWs) volunteering in affected regions, were subsequently transported back to the states for isolation and treatment in high-level medical facilities. This included Emory University Hospital, which sits adjacent to the federal Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia.The first domestic case of EVD occurred in late September in Dallas, Texas. Additional exposures of two HCWs generated an array of legal issues for state and local public health authorities, hospitals, and providers. Consideration of these issues led to extensive discussion among lawyers, public health practitioners, and other attendees at a late-breaking session on EVD and Legal Preparedness at the 2014 National Public Health Law conference. In this commentary, session presenters from CDC and Emory University share their expert perspectives on legal and policy issues underlying state and local powers to quarantine and isolate persons exposed to or infected with Ebola, as well as facets of hospital preparedness underlying the successful treatment of patients with EVD.

Proposed “Exposure And Symptom Triage” (EAST) Tool to Assess Radiation Exposure After a Nuclear Detonation

2017 ◽  
Vol 12 (3) ◽  
pp. 386-395 ◽  
Author(s):  
John L. Hick ◽  
Judith L. Bader ◽  
C. Norman Coleman ◽  
Armin J. Ansari ◽  
Arthur Chang ◽  
...  
Keyword(s):  
Public Health ◽  
Radiation Exposure ◽  
Significant Risk ◽  
Geographic Location ◽  
Signs And Symptoms ◽  
Whole Body ◽  
Federal State ◽  
Local Public Health ◽  
State And Local ◽  
Complete Blood Counts

ABSTRACTOne of the biggest medical challenges after the detonation of a nuclear device will be implementing a strategy to assess the severity of radiation exposure among survivors and to triage them appropriately. Those found to be at significant risk for radiation injury can be prioritized to receive potentially lifesaving myeloid cytokines and to be evacuated to other communities with intact health care infrastructure prior to the onset of severe complications of bone marrow suppression. Currently, the most efficient and accessible triage method is the use of sequential complete blood counts to assess lymphocyte depletion kinetics that correlate with estimated whole-body dose radiation exposure. However, even this simple test will likely not be available initially on the scale required to assess the at-risk population. Additional variables such as geographic location of exposure, sheltering, and signs and symptoms may be useful for initial sorting. An interdisciplinary working group composed of federal, state, and local public health experts proposes an Exposure And Symptom Triage (EAST) tool combining estimates of exposure from maps with clinical assessments and single lymphocyte counts if available. The proposed tool may help sort survivors efficiently at assembly centers near the damage and fallout zones and enable rapid prioritization for appropriate treatment and transport. (Disaster Med Public Health Preparedness. 2018; 12: 386–395)

Legal Innovations to Advance a Culture of Health

2015 ◽  
Vol 43 (4) ◽  
pp. 904-912
Author(s):  
James G. Hodge ◽  
Kim Weidenaar ◽  
Andy Baker-White ◽  
Leila Barraza ◽  
Brittney Crock Bauerly ◽  
...  
Keyword(s):  
Public Health ◽  
Technical Assistance ◽  
Federal State ◽  
Robert Wood Johnson Foundation ◽  
Local Public Health ◽  
Health Practitioners ◽  
New Ideas ◽  
Laws And Policies ◽  
Public Health Practitioners ◽  
Health Laws

Since its inception in 2010, the Network for Public Health Law (Network) has aligned with federal, state, tribal, and local public health practitioners to assess how law can promote and protect the public’s health. In 2013, Network authors illustrated major trends in public health laws and policies emanating from an internal assessment of thousands of requests for technical assistance nationally. More recently, the Robert Wood Johnson Foundation (RWJF) has invited the Network and other partners to consider new ideas and strategies toward building a “culture of health.” Per Figure 1, RWJF’s conception of a culture of health emphasizes key action areas essential to the promotion of health across all sectors and diverse populations.

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