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,...

Page 1: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.
Page 2: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

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

Page 3: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Public Health Emergencies

Terrorism• Biological

• Chemical

• Nuclear

Page 4: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

9/11/01 World Trade Center Attack

Page 5: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Bioterrorism Preparedness

Page 6: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Public Health Emergencies

Terrorism• Biological

• Chemical

• Nuclear

Emerging Diseases

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2003 SARS Epidemic in Singapore

Page 8: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Public Health Emergencies

Terrorism• Biological• Chemical• Nuclear

Emerging Diseases

Accidents

Natural Disasters

Page 9: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.
Page 10: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Why Are We Researching and Advocating for

Rural Public Health Preparedness?

• Capacity

• Probability/Seriousness of Threats

• Policy/Resources

Page 11: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Why Are We Assessing and Advocating for

Rural Public Health Preparedness?

• Capacity

• ProbabilitySeriousness of Threats

• Policy/Resources

Page 12: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

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

Page 13: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

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

Page 14: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

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

Page 15: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Rural Preparedness Challenges

• Inadequate health care resources

• Inadequate public health resources

• Distances

• International borders

• Tribal relationships

• Complacency

Page 16: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Comparing Massachusetts & Maine

Page 17: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

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

Page 18: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Massachusetts Maine

Health Dept.

Staff

3,000 365

Local Public

HealthMunicipal

Across State

Only 2

City

Acute Care Hospitals

74 44

Page 19: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

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

Page 20: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Why Are We Assessing and Advocating for

Rural Public Health Preparedness?

• Capacity

• Probability/Seriousness of Threats

• Policy/Resources

Page 21: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Threats in Rural America

Bioterrorism– Food– Water– Defense installations– Seasonal population surges– Urban exodus

Page 22: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Threats in Rural America

Bioterrorism– Food– Water– Defense installations– Seasonal population surges– Urban exodus

All Hazards

Page 23: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.
Page 24: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

New Sweden Arsenic Poisoning, 2003

Page 25: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Why Are We Assessing and Advocating for

Rural Public Health Preparedness?

• Capacity

• Probability/Seriousness of Threats

• Policy/Resources

Page 26: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Cities Readiness Initiative2004

• Redirection of CDC Funds

• $1 million removed from each state

• Funds redirected to 23 largest cities

Page 27: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.
Page 28: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

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

Page 29: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

Conference Conclusions

1. Rural America is vulnerable

2. Rural public health and health care systems need to be

strengthened

Page 30: Preparing for Public Health Emergencies: Meeting the Challenges in Rural America Paul Campbell, MPA, ScD Harvard School of Public Health Center For Public.

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