Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA,...
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Transcript of Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA,...
Preparing for Public Health Emergencies:
Meeting the Challenges in Rural America
Paul Campbell, MPA, ScD
Harvard School of Public HealthCenter For Public Health Preparedness
© HSPHCPHP 2005
Public Health Emergencies
Terrorism• Biological
• Chemical
• Nuclear
9/11/01 World Trade Center Attack
Bioterrorism Preparedness
Public Health Emergencies
Terrorism• Biological
• Chemical
• Nuclear
Emerging Diseases
2003 SARS Epidemic in Singapore
Public Health Emergencies
Terrorism• Biological• Chemical• Nuclear
Emerging Diseases
Accidents
Natural Disasters
Why Are We Researching and Advocating for
Rural Public Health Preparedness?
• Capacity
• Probability/Seriousness of Threats
• Policy/Resources
Why Are We Assessing and Advocating for
Rural Public Health Preparedness?
• Capacity
• ProbabilitySeriousness of Threats
• Policy/Resources
Ready or Not: Protecting the Public’s Health in the Age of Bioterrorism
2004
• RWJ Foundation Funded
• Trust for America’s Health
• 50 States included
• 10 Criteria developed by expert panel
• Results: Poor performance in heavily rural states
The Weakest Link? Bioterrorism Readiness in America’s Rural Hospitals
2004
• ANSER Institute for Homeland Security
• Elin Gursky, Senior Fellow
• Case research
• Results: Rural hospitals not equipped or staffed to address emergencies
Rural America
• Approximately 20% of US population
• Rural residents are:– More likely to be poor and elderly– More likely to die if injured– More (4X) likely to live in a medically
underserved area– Less likely to be served by well-staffed local
public health agency
Rural Preparedness Challenges
• Inadequate health care resources
• Inadequate public health resources
• Distances
• International borders
• Tribal relationships
• Complacency
Comparing Massachusetts & Maine
Massachusetts MainePopulation 6.4M 1.3M
Population density
Land Area: 8,000 sq. miles
810 persons per sq. mile
Land Area: 31,000 sq. miles
41 persons per sq. mile
Cities and towns
351 492
Per Capita Income
Rank, US
3 36
Massachusetts Maine
Health Dept.
Staff
3,000 365
Local Public
HealthMunicipal
Across State
Only 2
City
Acute Care Hospitals
74 44
EMS withMMRS
Fire with Mutual Aid State, Federal & Int’l Assets
LocalAcademicAssets with (A-CPHP)
Hospitals withDMAT and
NDMS and Promoted and Rejuvenated
Caregivers
Police withNat’l Guard
Local withRegionalGovernmentLocal
Public Health
Why Are We Assessing and Advocating for
Rural Public Health Preparedness?
• Capacity
• Probability/Seriousness of Threats
• Policy/Resources
Threats in Rural America
Bioterrorism– Food– Water– Defense installations– Seasonal population surges– Urban exodus
Threats in Rural America
Bioterrorism– Food– Water– Defense installations– Seasonal population surges– Urban exodus
All Hazards
New Sweden Arsenic Poisoning, 2003
Why Are We Assessing and Advocating for
Rural Public Health Preparedness?
• Capacity
• Probability/Seriousness of Threats
• Policy/Resources
Cities Readiness Initiative2004
• Redirection of CDC Funds
• $1 million removed from each state
• Funds redirected to 23 largest cities
Conference Sponsoring Organizations
• Harvard School of Public Health
• Maine Center for Public Health
• Maine Dept of Human Services
• Texas A&M Rural School of P.H.
• University of Minnesota S.P.H.
• University of North Carolina S.P.H.
• University of Pittsburgh SPH
Conference Conclusions
1. Rural America is vulnerable
2. Rural public health and health care systems need to be
strengthened
Conference Conclusions
3. Policymakers need to acknowledge resource requirements
4. Rural public health and health care leaders need to work together to optimize cost-effectiveness