Local health department workers, public policy, and willingness to respond during emergencies
DOI:
https://doi.org/10.5055/ajdm.2015.0187Keywords:
disaster planning/legislation & jurisprudence, health policy, rescue workAbstract
Objectives: To determine whether an association exists between a state's authority to declare a public health emergency and local public health workers’ response willingness.
Design: The 2009-2010 Johns Hopkins~Public Health Infrastructure Response Survey Tool included questions about demographics and attitudes/beliefs regarding local public health workers’ response willingness during public health emergencies. Survey data were merged with data about presence/absence of a law granting states the authority to declare a public health emergency. Logistic regression analyses were performed with the presence/absence of the law and were adjusted for individuals’ demographic and locale characteristics.
Setting: Data were collected from eight clusters of local health department workers in nine states.
Participants: Two thousand nine hundred ninety-three local health department workers.
Main outcome measure: Willingness to respond to four different public health emergency scenarios.
Results: For naturally occurring and human-caused disasters, in unadjusted analyses, there was no statistically significant difference in willingness to respond between individuals living in states with a law that allowed for a governmental declaration of public health emergency and those living in states without such a law. Adjusted analyses yielded similar results.
Conclusions: While laws giving the state the authority to declare a public health emergency are not associated with response willingness, findings may reflect the fact that states rarely declare public health emergencies, giving local public health workers few opportunities to become familiar with the implementation of these laws. In light of this, local health departments should consider altering their own internal policies to promote response willingness among their employees.
References
National Association of County and City Health Officials: The Local Health Department Workforce. Washington, DC: NACCHO, 2010.
National Association of County and City Health Officials: Operational Definition of a Functional Local Health Department. Washington, DC: NACCHO, 2005.
Institute of Medicine: Research Priorities in Emergency Preparedness and Response for Public Health Systems: A Letter Report. Washington, DC: National Academies Press, 2008.
National Association of County and City Health Officials: 2010 National Profile of Local Health Departments. Washington, DC: NACCHO, 2011.
Riederer-Trainor C, Wilkinson T, Snook WD, et al.: When bioterrorism strikes: Communication issues for the local health department. Health Promot Pract. 2005; 6(4): 424-429.
Ringel JS, Trentacost E, Lurie N: How well did health departments communicate about risk at the start of the Swine flu epidemic in 2009? Health Aff. 2009; 28(4): w743-w750.
DiBiase LM, Davis SE, Rosselli R, et al.: Evaluation of the implementation of the H1N1 pandemic influenza vaccine in local health departments (LHDs) in North Carolina. Vaccine. 2011; 29(23): 3969-3976.
Enanoria WT, Crawley AW, Tseng W, et al.: The epidemiology and surveillance response to pandemic influenza A (H1N1) among local health departments in the San Francisco Bay Area. BMC Public Health. 2013; 13: 276.
Hunter JC, Rodriguez DC, Aragon TJ: Public health management of antiviral drugs during the 2009 H1N1 influenza pandemic: A survey of local health departments in California. BMC Public Health. 2012; 12: 82.
Cantey PT, Chuk MG, Kohl KS, et al.: Public health emergency preparedness: Lessons learned about monitoring of interventions from the National Association of County and City Health Official's survey of nonpharmaceutical interventions for pandemic H1N1. J Public Health Manag Pract. 2013; 19(1): 70-76.
McCabe OL, Barnett DJ, Taylor HG, et al.: Ready, willing, and able: A framework for improving the public health emergency preparedness system. Disaster Med Public Health Prep. 2010; 4(2): 161-168.
National Association of County and City Health Officials: Local Health Department Job Losses and Program Cuts: Findings from January 2012 Survey. Washington, DC: NACCHO, 2012.
Barnett DJ, Thompson CB, Errett NA, et al.: Determinants of emergency response willingness in the local public health workforce by jurisdictional and scenario patterns: A cross-sectional survey. BMC Public Health. 2012; 12: 164.
Rutkow L, Vernick JS, Thompson CB, et al.: Emergency preparedness law and willingness to respond in the EMS workforce. Prehosp Disaster Med. 2014; 29(4): 358-363.
Basta NE, Edwards SE, Schulte J: Assessing public health department employees’ willingness to report to work during an influenza pandemic. J Public Health Manag Pract. 2009; 15(5): 375-383.
Gostin LO, Sapsin JW, Teret SP, et al.: The Model State Emergency Health Powers Act: Planning for and response to bioterrorism and naturally occurring infectious diseases. JAMA. 2002; 288(5): 622-628.
Taylor HA, Rutkow L, Barnett DJ: Willingness of the local health department workforce to respond to infectious disease events: Empirical, ethical, and legal considerations. Biosecur Bioterror. 2014; 12(4): 178-185.
Barnett DJ, Thompson CB, Semon NL, et al.: EPPM and willingness to respond: The role of risk and efficacy communication in strengthening public health emergency response systems. Health Commun. 2014; 29: 598-609.
Rutkow L, Vernick JS, Gakh M, et al.: The public health workforce and willingness to respond to emergencies: A 50-state analysis of potentially influential laws. J Law Med Ethics. 2014; 42(1): 64-71.
Johns Hopkins Center for Law and the Public's Health: Effect of variations in state emergency preparedness laws on the public health workforce's willingness to respond in emergencies. Available at http://www.jhsph.edu/research/centers-and-institutes/center-for-lawand-the-publics-health/research/StateEmergencyPreparednessLaws.html. Accessed July 26, 2014.
Devnani M: Factors associated with the willingness of health care personnel to work during an influenza public health emergency: An integrative review. Prehosp Disaster Med. 2012; 27(6): 551-566.
Barnett DJ, Balicer RD, Thompson CB, et al.: Assessment of local public health workers’ willingness to respond to pandemic influenza through application of the extended parallel process model. PLoS One. 2009; 4(7): e6365.
Witte K, Allen M: A meta-analysis of fear appeals: Implications for effective public health campaigns. Health Educ Behav. 2000; 27(5): 591-615.
Balicer RD, Omer SB, Barnett DJ, et al.: Local public health workers’ perceptions toward responding to an influenza pandemic. BMC Public Health. 2006; 6: 99.
US Census: State & county quick facts. Available at http://quickfacts.census.gov/qfd/index.html#. Accessed May 21, 2014.
Rosenblatt RA, Casey S, Richardson M: Rural-urban differences in the public health workforce: Local health departments in 3 rural Western states. Am J Public Health. 2002; 92(7): 1102-1105.
Wagenaar AC, Burris S (eds.): Public Health Law Research: Theory and Methods. San Francisco: Jossey-Bass, 2013.
Federal Emergency Management Agency: Disaster declarations by state/tribal government. Available at http://www.fema.gov/disasters/grid/state-tribal-government. Accessed May 21, 2014.
US Census: Zip code™ tabulation area. Available at http://www.census.gov/geo/reference/zctas.html. Accessed May 21, 2014.
US Census: American fact finder. Available at http://factfinder2.census.gov/faces/nav/jsf/pages/index.xhtml. Accessed May 21, 2014.
US Census: American fact finder, American community survey. Available at http://factfinder2.census.gov/faces/nav/jsf/pages/wc_acs.xhtml. Accessed May 21, 2014.
Harrell F: Regression Modeling Strategies. New York: Springer, 2001.
Hodge JG: The changing nature and scope of public health emergencies in response to annual flu. Biosecur Bioterror. 2013; 11(2): 142-144.
Godin G, Belanger-Gravel A, Eccles M, et al.: Healthcare professionals’ intentions and behaviors: A systematic review of studies based on social cognitive theories. Implement Sci. 2008; 3: 36.
Perlman D: Public health practice vs research: Implications for preparedness and disaster research review by State Health Department IRBs. Disaster Med Public Health Prep. 2008; 2(3): 185-191.
Morton M, Levy JL: Challenges in disaster data collection during recent disasters. Prehosp Disaster Med. 2011; 26(3): 196-201.
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