Organizing State and Local Health Departments for Public Health Preparedness

Organizing State and Local Health Departments for Public Health Preparedness

Jeffrey Wasserman
Peter Jacobson
Nicole Lurie
Christopher Nelson
Karen Ricci
Molly Shea
James Zazzali
Martha I. Nelson
Copyright Date: 2006
Published by: RAND Corporation
Pages: 120
https://www.jstor.org/stable/10.7249/tr318dhhs
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  • Book Info
    Organizing State and Local Health Departments for Public Health Preparedness
    Book Description:

    Explains the factors influencing the particular ways in which state and local public health systems are organized, how the various types of relationships that exist between state and local public health departments have been arrived at, and, most important, the consequences of such structures and relationships for emergency preparedness.

    eISBN: 978-0-8330-6004-4
    Subjects: Health Sciences, Political Science, Sociology

Table of Contents

  1. Front Matter
    (pp. i-ii)
  2. PREFACE
    (pp. iii-iv)
  3. Table of Contents
    (pp. v-vi)
  4. FIGURES
    (pp. vii-viii)
  5. TABLES
    (pp. ix-x)
  6. SUMMARY
    (pp. xi-xx)
  7. ACKNOWLEDGMENTS
    (pp. xxi-xxii)
  8. CHAPTER ONE. INTRODUCTION
    (pp. 1-6)

    After years of neglect, the U.S. public health system is at a crossroads. Accustomed to living in relative anonymity, public health officials have been thrust into the limelight as the nation collectively confronts a wide range of new and dangerous threats to its well-being, especially bioterrorism and, more recently, natural disasters. The public health system provides multiple services, with the overarching goal of improving population health, including population-based services (i.e., environmental health services, screening, disease surveillance, and emergency preparedness) and individualized health services (including clinics for uninsured patients and maternal and child health care). Bypublic health system, we are...

  9. CHAPTER TWO. ANALYTIC APPROACH
    (pp. 7-22)

    We used qualitative and quantitative research techniques to address the questions posed in Chapter One. Our study methodology consists of three integrated tasks.

    First, we used multivariate statistical techniques to model the effects of various organizational structural characteristics on public health preparedness.

    Second, we conducted a series of comparative case studies to determine how and why state and local health departments have chosen to organize their public health preparedness work - specifically: how governmental officials at all levels have defined their roles in enhancing public health preparedness; how those roles have changed over time; the internal and external factors affecting...

  10. CHAPTER THREE. RESULTS
    (pp. 23-58)

    In this chapter, we present the findings from our multivariate analysis, case studies, and literature review on alternative governance structures and strategies, respectively.

    As noted above, theories of organization suggest that centralization might be desirable when, among other things, there is a need for a comprehensive perspective on a task or problem, economies of scale can be achieved, and the task at hand is relatively routine. However, given that preparedness involves a wide variety of tasks - each with potentially different organizational requirements - we might expect that centralization would not have much of an effect when all of these...

  11. CHAPTER FOUR. SUMMARY AND CONCLUSIONS
    (pp. 59-66)

    This analysis employed various data sources and analytic methods with an eye toward identifying relationships between public health department organizational structures and preparedness outcomes. Our hope was that we could use the data sources and methods to triangulate on a clear set of recommendations regarding how public health systems should be restructured to increase their effectiveness. However, as is often the case, reality is more complicated than we would like, and judging from our analysis, we are not able to recommend any wholesale restructuring of the public health system to better meet preparedness goals and objectives. However, a clear set...

  12. APPENDIX A. CDC PROGRESS REPORT INDICATORS (2004)
    (pp. 67-90)
  13. APPENDIX B. PUBLIC HEALTH LABORATORIES’ SURVEY QUESTIONS USED IN ANALYSIS (FIELDED BY ASSOCIATION OF PUBLIC HEALTH LABORATORIES [APHL])
    (pp. 91-92)
  14. APPENDIX C. ROBUST REGRESSION WITH CENTRALIZATION-REGIONALIZATION INTERACTIONS
    (pp. 93-94)
  15. REFERENCES
    (pp. 95-98)