Building Back Healthier: The Role of Public Health in State Disaster Recovery Law

When communities are impacted by disasters, state officials must implement efficient and competent recovery strategies with the health and wellbeing of residents in mind. This research brief summarizes findings from a peer-reviewed study showing that few U.S. states explicitly integrate public health into their disaster recovery laws, and the types of public health requirements and authorizations vary substantially across states

FRIEND OR FOE? THE RELATIONSHIP OF INTERLOCAL COLLABORATION AND EMERGENCY PREPAREDNESS

Background Horizontal intergovernmental coordination, or interlocal collaboration, is an ongoing strategy to enhance U.S. emergency preparedness. The Urban Area Security Initiative (UASI) grant program, administered by the Federal Emergency Management Agency since 2003, has provided 64 high-risk metropolitan areas funding to enhance their interlocal preparedness capabilities. As preparedness funding begins to dwindle, it is important to understand how interlocal collaboration relates to emergency preparedness, how federal homeland security dollars contribute to such an association, and how emergency preparedness exercises can be used to enhance and assess interlocal collaboration. Methods A cross-sectional on-line survey was developed and administered in late 2013 to points of contact from FFY2010-funded UASI regions. Summary statistics were calculated to describe the current informal and formal regional collaboration infrastructure. Additionally, rates of agreement with eight collaborative preparedness statements at three time points were collected in the cross-sectional survey, and analyzed for changes over time. In early 2014, key informants (KIs), knowledgeable about the UASI program, were interviewed. An initial, purposive sample of KIs was identified in coordination with practice-based partners. A snowball sampling strategy was subsequently employed until data saturation was attained. Interviews were recorded, transcribed, coded, and iteratively analyzed. Results Forty-nine (77.8%) FFY2010 UASI regions responded to the survey. UASIs reported engaging in collaborative activities and investments to build capabilities, and conducting assessments of their capabilities at the UASI regional level. Collaborative relationships in preparedness among emergency managers and municipal chief executive officers improved during the FFY2010 UASI performance period compared to the pre-UASI award period, with lasting effects among urban areas with discontinued funding. Twenty-eight KIs were interviewed during 24 interviews. Impacts, barriers, incentives, facilitators, and disadvantages to interlocal collaboration were identified. The UASI program was thought to have a profound and unique impact on the association of interlocal collaboration and national preparedness. KIs felt exercises could enhance interlocal collaboration through seven distinct mechanisms. Exercise design characteristics to promote interlocal collaboration were identified. Conclusions Interlocal collaborations contribute to overall national preparedness. Grant programs, such as the UASI, as well as exercise programs, can be used to incentivize, foster, and evaluate preparedness-related interlocal collaboration

Fitness, Parks, and Active Transportation Organizations Support Community Recovery and Physical Activity After Disasters

Disaster-impacted communities face many threats to health and wellbeing during the recovery period. Fitness, parks, and active transportation organizations support physical activity and social connectedness on an everyday basis and are well-positioned to support communities’ diverse needs during disaster recovery. This research brief summarizes findings from a peer-reviewed study showing that fitness, parks, and active transportation organizations’ trusted relationships, large organizational networks, and health promotion expertise enables them to support disaster recovery efforts and community health after disasters

Street View Data Collection Design for Disaster Reconnaissance

Over the last decade, street-view type images have been used across disciplines to generate and understand various place-based metrics. However efforts to collect this data were often meant to support investigator-driven research without regard to the utility of the data for other researchers. To address this, we describe our methods for collecting and publishing longitudinal data of this type in the wake of the COVID-19 pandemic and discuss some of the challenges we encountered along the way. Our process included designing a route taking into account both broad area canvassing and community capitals transects. We also implemented procedures for uploading and publishing data from each survey. Our methods successfully generated the kind of longitudinal data that can be beneficial to a variety of research disciplines. However, there were some challenges with data collection consistency and the sheer magnitude of data produced. Overall, our approach demonstrates the feasibility of generating longitudinal street-view data in the wake of a disaster event. Based on our experience, we provide recommendations for future researchers attempting to create a similar data set.Comment: 11 pages, 2 figures, 1 tabl

Challenges to evidence-informed decision-making in the context of pandemics: qualitative study of COVID-19 policy advisor perspectives

INTRODUCTION: The exceptional production of research evidence during the COVID-19 pandemic required deployment of scientists to act in advisory roles to aid policy-makers in making evidence-informed decisions. The unprecedented breadth, scale and duration of the pandemic provides an opportunity to understand how science advisors experience and mitigate challenges associated with insufficient, evolving and/or conflicting evidence to inform public health decision-making. OBJECTIVES: To explore critically the challenges for advising evidence-informed decision-making (EIDM) in pandemic contexts, particularly around non-pharmaceutical control measures, from the perspective of experts advising policy-makers during COVID-19 globally. METHODS: We conducted in-depth qualitative interviews with 27 scientific experts and advisors who are/were engaged in COVID-19 EIDM representing four WHO regions and 11 countries (Australia, Canada, Colombia, Denmark, Ghana, Hong Kong, Nigeria, Sweden, Uganda, UK, USA) from December 2020 to May 2021. Participants informed decision-making at various and multiple levels of governance, including local/city (n=3), state/provincial (n=8), federal or national (n=20), regional or international (n=3) and university-level advising (n=3). Following each interview, we conducted member checks with participants and thematically analysed interview data using NVivo for Mac software. RESULTS: Findings from this study indicate multiple overarching challenges to pandemic EIDM specific to interpretation and translation of evidence, including the speed and influx of new, evolving, and conflicting evidence; concerns about scientific integrity and misinterpretation of evidence; the limited capacity to assess and produce evidence, and adapting evidence from other contexts; multiple forms of evidence and perspectives needed for EIDM; the need to make decisions quickly and under conditions of uncertainty; and a lack of transparency in how decisions are made and applied. CONCLUSIONS: Findings suggest the urgent need for global EIDM guidance that countries can adapt for in-country decisions as well as coordinated global response to future pandemics

Determinants of emergency response willingness in the local public health workforce by jurisdictional and scenario patterns: a cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>The all-hazards willingness to respond (WTR) of local public health personnel is critical to emergency preparedness. This study applied a threat-and efficacy-centered framework to characterize these workers' scenario and jurisdictional response willingness patterns toward a range of naturally-occurring and terrorism-related emergency scenarios.</p> <p>Methods</p> <p>Eight geographically diverse local health department (LHD) clusters (four urban and four rural) across the U.S. were recruited and administered an online survey about response willingness and related attitudes/beliefs toward four different public health emergency scenarios between April 2009 and June 2010 (66% response rate). Responses were dichotomized and analyzed using generalized linear multilevel mixed model analyses that also account for within-cluster and within-LHD correlations.</p> <p>Results</p> <p>Comparisons of rural to urban LHD workers showed statistically significant odds ratios (ORs) for WTR context across scenarios ranging from 1.5 to 2.4. When employees over 40 years old were compared to their younger counterparts, the ORs of WTR ranged from 1.27 to 1.58, and when females were compared to males, the ORs of WTR ranged from 0.57 to 0.61. Across the eight clusters, the percentage of workers indicating they would be unwilling to respond regardless of severity ranged from 14-28% for a weather event; 9-27% for pandemic influenza; 30-56% for a radiological 'dirty' bomb event; and 22-48% for an inhalational anthrax bioterrorism event. Efficacy was consistently identified as an important independent predictor of WTR.</p> <p>Conclusions</p> <p>Response willingness deficits in the local public health workforce pose a threat to all-hazards response capacity and health security. Local public health agencies and their stakeholders may incorporate key findings, including identified scenario-based willingness gaps and the importance of efficacy, as targets of preparedness curriculum development efforts and policies for enhancing response willingness. Reasons for an increased willingness in rural cohorts compared to urban cohorts should be further investigated in order to understand and develop methods for improving their overall response.</p

Integrating Climate Change into Hazard Mitigation Planning: A Survey of State Hazard Mitigation Officers

The increased number of catastrophic disasters in the United States in recent decades has been accompanied by consequences of climate change, including rising sea levels, floods, storms, extreme temperatures, drought, and wildfires. Climate change and extreme events are interrelated, and climate change is likely to lead to more frequent and severe hazards. Hazard mitigation offers tools to address the hazards that are influenced by climate change and minimize community-level exposure or vulnerability. State Hazard Mitigation Officers in the 56 U.S. states, territories, and the District of Columbia involved in FEMA&#8217;s Hazard Mitigation Grant Program were surveyed to assess the extent to which climate change has been integrated into State Hazard Mitigation Plans (SHMPs) and the barriers and facilitators to such climate change integration. The majority of responding states reported integration of climate change into SHMPs, and increased climate change projection evidence was commonly cited as a driver of such integration. However, lack of funding and competing hazard mitigation priorities were the most commonly reported barriers to integration. Political prioritization was reported as both a barrier to and facilitator of integration. There is an ongoing need to effectively translate climate change research to practitioners to support evidence-based hazard mitigation policy and practice

Working with Disaster-Affected Communities to Envision Healthier Futures: A Trauma-Informed Approach to Post-Disaster Recovery Planning

Disasters are becoming increasingly common and devastating, requiring extensive reconstruction and recovery efforts. At the same time, the level of available resources and the need to rebuild can present opportunities for more resilient land use and infrastructure, and to build healthier, more equitable and sustainable communities. However, disaster-affected individuals may experience trauma and mental health impacts that impede their ability to engage in long-range recovery planning. It is essential to consider and address community trauma when engaging with disaster-affected communities and in developing plans for recovery. Planners and engineers from outside the community (including public, private and non-profit practitioners) are often brought in to support long-term recovery. Most of these practitioners (particularly those focused on longer-range recovery) have no training in how disasters can affect mental health or what this could mean for their interactions with individuals or communities. In order to acknowledge and address disaster trauma in community recovery and redevelopment, we propose a trauma-informed approach which aims to provide practitioners supporting post-disaster community recovery planning guidance, in order to: avoid the causation of harm by re-traumatizing communities; better understand community needs; make sense of observed behaviors and avoid potential roadblocks; avoid becoming traumatized themselves; and facilitate community healing

A Threat- and Efficacy-Based Framework to Understand Confidence in Vaccines among the Public Health Workforce

vaccine