Are We Ready?

Are We Ready?: Public Health since 9/11

David Rosner
Gerald Markowitz
Copyright Date: 2006
Edition: 1
Pages: 210
https://www.jstor.org/stable/10.1525/j.ctt1ppj09
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  • Book Info
    Are We Ready?
    Book Description:

    A contemporary history of a critical period,Are We Ready?analyzes the impact of 9/11, the anthrax attacks that followed, and preparations for a possible smallpox attack on the nation's public health infrastructure. David Rosner and Gerald Markowitz interviewed local, state, and federal officials to determine the immediate reactions of key participants in these events. The authors explore the extent to which these emergencies permanently altered the political, cultural, and organizational life of the country and consider whether the nation is now better prepared to withstand another potentially devastating attack. This well-reasoned and well-researched book presents compelling evidence that few with hands-on experience with disease and emergency preparedness believe that an adequate response to terrorism-whether biological, chemical, or radiological-is possible without a strong and vibrant infrastructure to provide everyday services as well as emergency responses.Are We Ready?begins with an examination of the experiences of local New York officials who were the first responders to 9/11 and follows them as events unfolded and as state and national authorities arrived. It goes on to analyze how various states dealt with changing federal funding for a variety of public health services. Using oral histories of CDC and other federal officials, the book then focuses on the federal reaction to 9/11 and anthrax. What emerges is a picture of dedicated public servants who were overcome by the emotions of the moment yet who were able to react in ways that significantly reduced the public anxiety and public health threat. Despite the extraordinary opportunity to revitalize and reinvigorate the nation's public health infrastructure, the growing federal and state budget deficits, the refocusing of national attention on the war in Iraq, and the passage of time all combined to undermine many of the needed reforms to the nation's public health defenses.Copub: Milbank Memorial Fund

    eISBN: 978-0-520-94047-5
    Subjects: Health Sciences

Table of Contents

  1. Front Matter
    (pp. i-iv)
  2. Table of Contents
    (pp. v-vi)
  3. FOREWORD
    (pp. vii-viii)
    Daniel M. Fox and Samuel L. Milbank

    The Milbank Memorial Fund is an endowed operating foundation that works to improve health by helping decision makers in the public and private sectors acquire and use the best available evidence to inform policy for health care and population health. The Fund has engaged in nonpartisan analysis and research on and communication about significant issues in health policy since its inception in 1905.

    Are We Ready? Public Health since 9/11is the fifteenth of the California/Milbank Books on Health and the Public. The publishing partnership between the Fund and the University of California Press seeks to encourage the synthesis and...

  4. PREFACE
    (pp. ix-xii)
  5. ACKNOWLEDGMENTS
    (pp. xiii-xvi)
  6. INTRODUCTION: Remembering the Moment
    (pp. 1-5)

    How can we understand the emotionally charged events surrounding September 11, 2001? How can we begin to comprehend the impact on our psyches, our institutions, and our people of the World Trade Center collapse, the attack on the Pentagon, and the crash of a jetliner in the fields of Pennsylvania? To what extent have these events permanently altered the political, cultural, and organizational life of the country? To what extent is the nation better prepared to withstand another potentially devastating attack? To what extent are we better prepared to deal with possible chemical, biological, or radiological attacks? Half a decade...

  7. ONE SEPTEMBER 11 AND THE SHIFTING PRIORITIES OF PUBLIC AND POPULATION HEALTH IN NEW YORK CITY
    (pp. 6-54)

    September 11, 2001, affected virtually all aspects of American life, from foreign policy and domestic security to philanthropy, social services, and health policy. Social welfare, public health, health care, and environmental issues, generally seen as separate spheres, are now increasingly understood as interrelated components essential to the mental and social well-being and emergency preparedness of a traumatized nation and city, and the opportunities to integrate these concerns are immense. The experience of 9/11 has highlighted the interrelationships between biological, sanitary, medical, social, and economic factors that together affect the well-being of populations. Perhaps more directly than any other recent event,...

  8. TWO EMERGENCY PREPAREDNESS, BIOTERRORISM, AND THE STATES
    (pp. 55-118)

    The newspaper headlines were stark and eerie: “Efforts to Calm the Nation’s Fears Spin Out of Control,” “Local Public Health Officials Seek Help,” “This Is Not a Test,” “State Can’t Handle Bioterrorist Attack,” “Scared into Action.” And the pictures that accompanied them were worse: investigators in moon suits; children ridden with smallpox; cold, stark laboratories staffed by masked personnel. State and local health departments were now supposed to be on a “war footing,” as one headline noted.¹ Health officials, knowing that their historical role was as the first line of defense against infectious disease, were simultaneously energized and terrified by...

  9. THREE EMERGENCY PREPAREDNESS, BIOTERRORISM, AND THE CDC: Federal Involvement before and after 9/11
    (pp. 119-155)

    Public health activities have traditionally been understood as state and local functions. Throughout the nineteenth and twentieth centuries, disease surveillance and reporting, quarantine, vaccination campaigns, and treatment—as well as sanitation and other preventive strategies—were carried out largely by local and state health departments. The Centers for Disease Control and Prevention (CDC) has steadily grown into the preeminent federal health authority, but it has always provided advice and support at the local level, not taken command. In the days after the attacks of 9/11, however, federal staff and resources quickly became more directly involved in what was clearly a...

  10. CONCLUSION: What Lessons Have We Learned?
    (pp. 156-162)

    What lessons are to be drawn from this historical account? September 11 presented the public health community and those involved with population health more generally an immense opportunity to revitalize and rethink the nation’s health agenda. Politicians, administrators, and the general public came to appreciate the vital role that public health agencies could play in a national emergency and in the fight against terrorism; public health administrators and advocates hoped that they could perhaps recapture the importance and promise that they believed their field had once possessed. Some observers called for revamping the nation’s health insurance system to cover more...

  11. NOTES
    (pp. 163-180)
  12. INDEX
    (pp. 181-193)
  13. Back Matter
    (pp. 194-194)