Skip to main content

Examining Challenges and Possible Strategies to Strengthen U.S. Health Security Proceedings of a Workshop (2018) / Chapter Skim
Currently Skimming:

4 Underlying Issues in Health Security
Pages 49-58

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 49...
... Understanding the challenges can enhance the health care and public health sector's ability to prepare, respond, and recover. ADAPTIVE AND TECHNICAL CHALLENGES Runnels drew a distinction between the adaptive and technical aspects of such challenges.
Read the entire page →
From page 50...
... Hospitals transferred particular patient populations into the communities, which created a surge for the home health and visiting nurse systems. As a result, other patients with complex treatment regimens (e.g., renal dialysis, HIV/AIDS, end-stage renal disease, methadone maintenance treatment programs)
Read the entire page →
From page 51...
... Department of Health and Human Services; HUD = U.S. Department of Housing and Urban Development; IRS = Internal Revenue Service; NCS = National ComNet Services; NJ = New Jersey; NJOEM = New Jersey Office of Emergency Management; NY = New York; NYFD = New York Fire Department; NYPD = New York Police Department; OSHA = Occupational Safety and Health Administration; PA = Pennsylvania; SBA = U.S.
Read the entire page →
From page 52...
... Hanfling reflected that this issue might be due to the competing calculus for identifying priorities in critical infrastructure protection: an emergency manager may think about critical infrastructure protection as strengthening buildings and hard space, while an emergency physician may think about it as breaking down those walls to provide access to care. Hanfling suggested that the challenge is brokering that calculus between many competing priorities.
Read the entire page →
From page 53...
... Margaret L Brandeau, professor of management science and engineering and medicine, Stanford University, explained that processing risk and threat information requires gathering information from multiple sources, determining the risk and level of uncertainty, and then disseminating information about risks and actions that can be taken to mitigate risk.
Read the entire page →
From page 54...
... . Redd commented that different emergencies require different types of preparation -- a natural weather disaster versus the Zika virus outbreak, for example -- although the structures for those responses might be similar.
Read the entire page →
From page 55...
... Anthony Barone, founder and principal advisor, Northern Virginia Emergility, LLC, noted that investigation and intelligence data are rarely used in ICS at the local and state levels. However, he reported that there is an explicit section on ICS in the National Incident Management System Intelligence/Investigations Function Guidance and Field Operations Guide, published by FEMA, which describes how and where to integrate research, response, and incident command; it contains explicit mention of where research, epidemiology, and complex biological chemical incidence could fit into ICS.
Read the entire page →
From page 56...
... Wolf remarked that the C-suite of the private sector has a vastly different paradigm for communicating, relying heavily on data to explain what needs to be done and why it needs to be done. LACK OF INSTITUTIONAL MEMORY AND LONG-TERM CONNECTIVITY Lien noted that there is a lack of institutional memory within the preparedness arena, partly driven by the annual funding cycle at the local and state levels, as well as a large amount of workforce turnover.
Read the entire page →
From page 57...
... SOURCES: Hick presentation, March 8, 2017; National Infrastructure Protection Plan, https://www.dhs.gov/sites/default/files/publications/national-infrastructureprotection-plan-2013-508.pdf (accessed August 8, 2017)
Read the entire page →
From page 58...
... He suggested that from an ethical perspective, there is value to that martyrdom, but from another perspective, it is enabling: "There is a critical intersection between personal devotion and resilience and enabling organizational malfeasance and bad decisions to continue." Runnels described this tension as arising in part from an "us versus them" mentality and suggested that resolving it will require striking a balance between the mission-driven work in public health and a broader system that has different drivers. Hick commented that the public health sector has historically continued to function, in whatever way possible, in the face of significantly scaled-back resources, but the public needs clear messaging to understand the consequences that scaling back entails.
Read the entire page →

Key Terms

  • critical infrastructure
  • health preparedness
  • emergency management
  • infrastructure protection
  • community context

  • zika virus
  • structured information
  • health emergency
  • health sector
  • starting state

  • competing priorities
  • threat information
  • measure success
  • state levels
  • hick commented

  • institutional memory
  • defining preparedness
  • abramson explained
  • effective leveraging
  • mitigate risk

  • percent prepared
  • improve health
  • home health
  • health departments
  • improvement runnels

  • value critical
  • emergency response
  • structure protection
  • hick noted
  • runnels drew


    • 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.