Healthy, Resilient, and Sustainable Communities After Disasters Strategies, Opportunities, and Planning for Recovery (2015) / Chapter Skim
Currently Skimming:
5 Public Health
5 Public Health
Pages 149-192
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 149... ...
, successful recovery requires that the public health sector galvanize and lead an interdisciplinary, team-based approach to the continual assessment of health status and needs, the development and prioritization of plans and policies for addressing those needs, and the assurance of access to essential health services throughout the continuum of disaster response and recovery. Given that components of the public health recovery mission cut across all other sectors, public health is integral to all of the committee's recommendations (as noted throughout this chapter)
|
From page 150... ...
• Identify opportunities for alignment between ongoing public health improvement processes (e.g., accreditation prerequisites of community health assessments and community health improvement plans) and recovery planning.
|
From page 151... ...
ments to vision to and institutional identify gaps and capacity develop strategies • Set priorities FIGURE 5-1 Linked community health improvement and disaster recovery cycles with associated core public health functions. NOTE: This figure can assist public health agencies in articulating roles in and the cyclical nature of planning for health improvement and disaster recovery and encouraging pre-disaster recovery planning as a best practice.
|
From page 152... ...
Existing recovery guidance for the public health sector (discussed later in this chapter) focuses on the restoration of public health (as well as health care and behavioral health1)
|
From page 153... ...
The PHEP cooperative agreement funds preparedness activities aimed at cultivating emergency-ready, flexible, and adaptable public health departments. The Community Recovery capability is intended to help community partners "plan and advocate for the rebuilding of public health, medical, and mental/behavioral health systems to at least a level of functioning comparable to pre-incident levels, and improved levels where possible" (CDC, 2011, p.
|
From page 154... ...
As is the case for many other governmental and professional organizations involved in both preparedness and healthy community development, however, the two efforts are poorly connected. An important opportunity is being missed to expand and leverage the PHEP guidance on recovery capabilities to encourage grantees to incorporate a healthy community vision into recovery planning before and after disasters.
|
From page 155... ...
Capabilities, with Rows Showing Alignment PHEP Capabilitiesa HPP Capabilitiesb Community preparedness Health care system preparedness Community recovery Health care system recovery Emergency operations coordination Emergency operations coordination Emergency public information and warning Fatality management Fatality management Information sharing Information sharing Mass care Medical countermeasure dispensing Medical material management and distribution Medical surge Medical surge Non-pharmaceutical interventions Public health laboratory testing Public health surveillance and epidemiological investigation Responder safety and health Responder safety and health Volunteer management Volunteer management a CDC, 2011.
|
From page 156... ...
For example, state public health agencies may have more responsibility than their local-level counterparts related to ensuring access to health care. This variability in responsibilities and governance among state and local public health agencies must be taken into consideration in national-level planning efforts and policy development as it will translate to variable roles and authorities, as well as 3 Some local health departments are local or regional units of the state health department (i.e., centralized)
|
From page 157... ...
. Unfortunately, the ability of state and local health agencies to carry out essential public health 4 Following a 1988 report of the Institute of Medicine (IOM, 1988)
|
From page 158... ...
P facing the community Community Preparedness capability: Determine risks to the health of the jurisdiction • HEP Community Recovery capability: Identify and P monitor public health, medical, and mental/behavioral health system recovery needs 2 Diagnose and Investigate health problems Post-disaster assessment of disaster impact on health and investigate health and environmental public medical needs (including environmental health hazards) problems and health health hazards to protect hazards in the the community • HEP Community Recovery capability: Identify and P community monitor public health, medical, and mental/behavioral health system recovery needs • HEP Public Health Surveillance and Epidemiological P Investigation capability: Conduct public health surveillance and detection • DRF, Health and Social Services RSF activity: N Maintain situational awareness to identify and mitigate potential recovery obstacles • DRF, Health and Social Services RSF activity: N Provide technical assistance in the form of impact analyses and support recovery planning of public health, health care and human services infrastructure.
|
From page 159... ...
PUBLIC HEALTH 159 TABLE 5-2 Continued Public Health 10 Essential Public Health Accreditation Board Associated Disaster Preparedness and Recovery Servicesa Standardsb Functionsc 5 Develop policies and Develop public health Participation in recovery planning to ensure that short plans that support policies and plans and long-term population health needs are considered individual and community health • HEP Community Recovery capability: Implement P efforts corrective actions to mitigate damages from future incidents • DRF, Health and Social Services RSF activity: N Develop strategies to address recovery issues for health, behavioral health, and social services 6 Enforce laws and Enforce public health laws Advocate for changes to codes that improve resiliency regulations that protect health and • HEP Community Recovery capability: Implement P ensure safety corrective actions to mitigate damages from future incidents • DRF, Health and Social Services RSF activity: N Promote the principles of sustainability, resilience and mitigation into preparedness and operational plans 7 Link people to needed Promote strategies to Support for clinical care sector recovery to ensure personal health improve access to health population access to needed health care providers services and assure the care provision of health • HEP Mass Care capability: Coordinate public health, P care when otherwise medical, and mental/behavioral health services unavailable 8 Assure a competent Maintain a competent Expansion of workforce capacity as needed to meet public and personal public health workforce community recovery needs health care workforce • PHEP Volunteer Management capability • DRF, Health and Social Services RSF activity: When N activated, deploy in support of the Health and Social Services RSF mission, as appropriate 9 Evaluate effectiveness, Evaluate and continuously Continual assessment of health status and progress accessibility, and improve processes, toward recovery goals to inform planning and develop quality of personal programs, and and share lessons learned and population-based interventions health services • HEP Community Recovery capability: Identify and P monitor public health, medical, and mental/behavioral health system recovery needs • HEP Community Recovery capability: Implement P corrective actions to mitigate damages from future incidents • DRF, Health and Social Services RSF activity: N Evaluate the effectiveness of federal health and social services recovery efforts 10 Research for Contribute to and apply new insights and the evidence base of public innovative solutions health to health problems NOTE: This table can assist public health agencies in identifying existing departmental assets for recovery.
|
From page 160... ...
However, the success of the public health sector in disaster recovery depends heavily on pre-planning, knowledge of pre-disaster community demographics and health status, and knowledge of and partnerships with other governmental and nongovernmental sectors to ensure alignment of priorities and activities. Public health needs to have effective relationships in place with other governmental and nongovernmental stakeholders across sectors (e.g., housing, behavioral health, transportation, education)
|
From page 161... ...
• risk and threat assessments, both community-wide and for specific facilities; • evaluation of overall community health status; • evaluation and identification of at-risk/vulnerable populations; • evaluation of services needed and identification of mechanisms for filling gaps; • assessment of local capabilities to fulfill ESF #8 responsibilities; • engagement of the health care system, ideally through local health care coalitions5 (discussed further in Chapter 6) , in healthy community planning, disaster response, and optimal healthy community recovery; and • collaboration with behavioral health/substance abuse service providers and social services providers.
|
From page 162... ...
The relationships forged between public health officials and emergency management/public safety entities during preparedness activities related to response planning can be leveraged to ensure that public health is also engaged in recovery planning. 7 Hazard or threat vulnerability analysis is a "systematic approach to identifying all hazards [and threats]
|
From page 163... ...
Partnerships with urban and regional planning agencies are critical to ensuring that a healthy community vision and health improvement priorities are incorporated into the community's strategic (comprehensive) plan (see Recommendation 1 in Chapter 3)
|
From page 164... ...
The key elements that need to be in place for recovery planning include community health assessments, community health improvement plans, and health department strategic plans. These elements are also prerequisites for national accreditation of health departments (PHAB, 2012)
|
From page 165... ...
The committee identified four key pre-disaster priorities in which the public health sector should be engaged to support implementation of the recommendations in this report and to ensure better short- and long-term health outcomes after a disaster: • Conduct community health assessments. • Engage community stakeholders in pre-disaster community health improvement and recovery planning.
|
From page 166... ...
Integrating these strategies into the community health improvement plan creates a road map for closing the gap between the current health assessment and the optimal healthy community. The development of a community health improvement plan utilizes many of the essential capabilities of the public health sector: mobilizing community partnerships; developing plans and policies that aid health improvement efforts; and educating and empowering the community with respect to health issues.
|
From page 167... ...
Ensure That Public Health Community Programs and Services Are Integrated into Healthy Community and Disaster Recovery Planning Processes The programs and services that are the foundational care functions of public health -- for example, creation of programs for prevention and education, disease control measures for outbreaks, immunizations, and direct health care provision and referrals to services -- all are critical tools for health protection and promotion during post-disaster recovery. After disasters, demand for public health organizations to carry out these routine health functions surges concurrently with new responsibilities related to emergency
|
From page 168... ...
that address potential funding sources health • Make plan available for public comment • ncourage citizens to use comment time to address health E • old hearings on final draft plan, formal adoption by H concerns governing body • Attend planning and zoning meetings • ppoint or elect public health officials to decision-making A boards Step 4: Adoption and Implementation • Plan goes to legislative body for adoption • e an advocate for adoption of the plan if it meets health B • Plan serves as a guide to future land use decisions goals • dditional functional plans are prepared (i.e., A • ake responsibility for implementation of health goals, or T pedestrian plans) work to keep them as a priority • lan is implemented through schedule set forth in the P • Review development proposals for health aspects plan • ttend public planning and zoning meetings A Step 5: Revise Development Regulations and Evaluate Plan Performance • evise zoning and subdivision regulations to be R • rovide decision makers with model zoning codes, P consistent with the new plan comprehensive plans, and land use ordinances that relate • Support rezoning initiatives when applicable to public health • chedule public investments (e.g., streetscape S • Support rezoning initiatives when applicable improvements, housing upgrades)
|
From page 169... ...
The Health and Social Services advisory committee should be charged with collaborating with emergency management and planning agency officials on the integration of the com munity health improvement plan into disaster recovery planning. The advisory committee should identify opportunities to improve the overall health status of the community after a disaster.
|
From page 170... ...
Under the Community Recovery function, PHEP guidance encourages the development of community partnerships in order to identify the health system needs after a disaster and to coordinate the provision of services and health systems recovery. However, partnerships developed for community preparedness purposes can and should be utilized in recovery planning as well (see the example in Box 5-6)
|
From page 171... ...
improving the community engagement skills of Los Angeles County health department staff to enable them to build sustainable multisector community partnerships; (2) developing a best practices and resilience curriculum for engagement of county health department staff with community organizations; (3)
|
From page 172... ...
The most pressing issues typically facing a community during and immediately following a disaster are ensuring the immediate safety and security of those present and the continuity of essential services. Coordination among stakeholders during this period should occur through ongoing operation of an incident command system that allows for active participation in public health recovery activities by social services agencies, behavioral health agencies, volunteer organizations, the medical examiner/coroner, mass sheltering organizations, and businesses and organizations regulated by the public health department.
|
From page 173... ...
Disaster-related communications should be written and designed to ensure that the general public can comprehend the basic health information necessary to make appropriate health-related decisions. The use and monitoring of social media during disaster response and recovery are increasingly important functions for public health agencies.
|
From page 174... ...
Delivering Public Health Services to Meet Post-Disaster Needs of the Community In addition to the essential services provided during steady-state times, a number of services must be ensured by the public health sector in the aftermath of a disaster. These services are described below.
|
From page 175... ...
For example, public health should be part of a multisector task force on interim and temporary housing to ensure that access needs are addressed. Providing Support to Impacted Health Care Delivery Systems Working with other community stakeholders (e.g., emergency management)
|
From page 176... ...
Public health officials agreed that long-term health improvement opportunities were of interest to them but not a priority because of their strong mission focus on disaster response and early recovery and the scarcity of resources and funding for existing public health programs. As described by one public health director: "As soon as the waters recede or there's no more disease going around or we've administered all the vaccine, it's really [about getting]
|
From page 177... ...
Engaging in Health-Informed Community Rebuilding and Redevelopment Planning Based on impact and damage assessments, public health leadership should work with elected and public officials, as well as leaders from relevant nonhealth sectors (e.g., housing, transportation) , to identify opportunities for integrating some or all of the goals and objectives of the community health improvement plan with long-term community recovery efforts.
|
From page 178... ...
Local, tribal, territorial, and state health officials should utilize state, regional, and national conferences, workshops, and discipline-specific professional meetings for this purpose and reach out to professional organizations representing traditionally nonhealth sectors to discuss opportunities for improved public health. Increased opportunities to share lessons learned both with other health departments and with other sectors -- such as
|
From page 179... ...
However, successful movement toward optimal health -- especially in the face of a disaster, which understandably demands attention to the immediate needs of the community -- requires strategic use of a comprehensive community health assessment and a community health improvement plan that is fully integrated into the disaster recovery decision-making process. This integration will not occur without the integration of public health into pre- and post-disaster planning for long-term recovery.
|
From page 180... ...
to integrate public health and other community partners into recovery planning. • Identify opportunities for alignment between ongoing public health improvement processes (e.g., accreditation prerequisites of community health assessments and community health improvement plans)
|
From page 181... ...
£ Proactively engage in health information technology infrastructure planning to connect relevant data sets and develop sharing policies across agencies. Priority: Engage Community Stakeholders in Pre-Disaster Community Health Improve ment and Recovery Planning Primary Actors: State/Local Health Departments Key Partners: Elected Officials and Community Leaders, Urban and Regional Planning Agen cies, Emergency Management Agencies, Community- and Faith-Based Organizations 1 See Appendix F for further description of terms used to describe Primary Actors and Key Partners in this checklist.
|
From page 182... ...
Priority: Ensure That Public Health Community Programs and Services Are Integrated into Healthy Community and Disaster Recovery Planning Processes Primary Actors: State/Local Health Departments Key Partners: Elected Officials and Community Leaders, Urban and Regional Planning Agen cies, Community- and Faith-Based Organizations, Emergency Management Agencies
|
From page 183... ...
£ Exercise and train for recovery activities. Priority: Leverage Pre-Disaster Preparedness Activities in Recovery Planning Primary Actors: State/Local Health Departments Key Partners: Emergency Management Agencies, Health and Medical System Partners, Community- and Faith-Based Organizations Key Recovery Strategy: • Identify opportunities for alignment between ongoing public health improvement processes (e.g., accreditation prerequisites of community health assessments and community health improvement plans)
|
From page 184... ...
£ Promote and develop public health rapid assessment teams familiar with local and state emergency response and recovery plans and trained to conduct post-disaster community assessments. £ Educate and train medical system and emergency management partners regarding the roles and responsibilities of the public health assessment team during recovery efforts.
|
From page 185... ...
Priority: Conduct Impact Assessments on the Health and Medical Needs of the Community Primary Actors: State/Local Health Departments Key Partners: Health and Medical System Partners, Social Services Agencies, Emergency Management Agencies Key Recovery Strategy: • Use and expand health technology infrastructure for data collection and analysis to facilitate data sharing, evidence-based decision making, and continual evaluation of progress toward an optimally healthy community. Activities include but are not limited to: £ Deploy public health rapid assessment teams familiar with local and state emergency response and recovery plans and trained to conduct pre- and post-disaster community assessments.
|
From page 186... ...
Priority: Deliver Public Health Services to Meet Post-Disaster Needs of the Community Primary Actors: State/Local Health Departments Key Partners: Social Services Agencies, Community- and Faith-Based Organizations Activities include but are not limited to: £ Conduct licensed and unlicensed food vendor inspections (including mass shelters with feeding operations)
|
From page 187... ...
£ Rapidly mobilize health department staff to expedite reviews of medical facility plans and surveys of facilities to determine readiness to be reopened to the public; reopen minimally damaged facilities. £ Identify opportunities to improve care and the configuration and location of services to best meet the needs of the community.
|
From page 188... ...
Priority: Engage in Community Rebuilding and Redevelopment Planning to Identify Op portunities to Enhance Population Health Primary Actors: State/Local Health Departments Key Partners: Emergency Management Agencies, Urban and Regional Planning Agencies, Education System, Transportation Agencies, Housing Agencies Key Recovery Strategies: • Leverage existing relationships and networks (e.g., coalitions, collaboratives) to integrate public health and other community partners into recovery planning.
|
From page 189... ...
£ Educate local and state leaders on lessons learned as a result of the disaster and ways to build stronger, more resilient communities. Priority: Share Lessons Learned with Other Communities to Improve Post-Disaster Re covery Planning Primary Actors: State/Local Health Departments, Health and Medical System Partners, Emergency Management Agencies Key Partners: Community- and Faith-Based Organizations, Elected Officials and Community Leaders Activities include but are not limited to: £ Participate in after-action processes, including analysis of lessons learned and identification of opportunities for improvement.
|
From page 190... ...
Paper presented at IOM Committee on Post-Disaster Recovery of a Community's Public Health, Medical, and Social Services: Meeting Two, February 3, Washington, DC. Community Commons.
|
From page 191... ...
Paper presented at IOM Committee on Post Disaster Recovery of a Community's Public Health, Medical, and Social Services: Meeting Three, April 28-29, Washington, DC. LACCDR (Los Angeles County Community Disaster Resilience)
|
From page 192... ...
Paper presented at IOM Committee on Post-Disaster Recovery of a Community's Public Health, Medical, and Social Services: Meeting Two, February 3, Washington, DC.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.