Assessment of public health infrastructure to determine public health preparedness

Abstract

Since September 2001, health threats associated with acts of terrorism have become an area of increasing concern. The Strategy for Homeland Security stresses the need for a robust public health component to quickly respond to and recover from attacks and other emergencies. The assumption that public health is an optimal system that simply needs to be aimed in new directions is fundamentally flawed. Public health baseline requirements for responding to threats are not as well understood as they might be. The purpose of this research is to help establish a common and accurate measure for assessing the public health infrastructure. Using the case study of Union County, New Jersey this thesis surveys the activities public health agencies are expected to perform; compares performance to target objectives; and employs a manpower matrix as a model for determining staffing requirements for local public health. This study argues that that the goal of sustainable funding for public health begins with an accurate measure of the capacities of the system in relation to demands placed upon it. Without such a measure public health will continue to fail in its primary functions and lack the capacity to meet Homeland Security goals.