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Quantifying Disaster Impacts on Local Public Health Agency’s Leadership, Staffing, and Provision of Essential Public Health Services

Published online by Cambridge University Press:  16 August 2021

Lauren A. Clay Open the ORCID record for Lauren A. Clay [Opens in a new window] ,
Kahler W. Stone Open the ORCID record for Kahler W. Stone [Opens in a new window]  and
Jennifer A. Horney Open the ORCID record for Jennifer A. Horney [Opens in a new window]
Lauren A. Clay
Affiliation:
Department of Health Administration and Public Health, D’Youville College, Buffalo, NY, USA
Kahler W. Stone
Affiliation:
Department of Health and Human Performance, Middle Tennessee State University, Murfreesboro, TN, USA
Jennifer A. Horney*
Affiliation:
Department of Epidemiology, University of Delaware, Newark, DE, USA
*
Corresponding author: Jennifer A. Horney, Email: [email protected].
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Abstract

Objective:

The objective of this study is to assess the impact that natural disaster response has on local health departments’ (LHD) ability to continue to provide essential public health services.

Methods:

A web-based survey was sent to all North Carolina Local Health Directors. The survey asked respondents to report on LHD functioning following Hurricanes Florence (2018) and Dorian (2019).

Results:

After Hurricane Florence, the positions who most frequently had regular duties postponed or interrupted were leadership (15 of 48; 31.3%), and professional staff (e.g., nursing and epidemiology: 11 of 48; 22.9%). Staffing shelters for all phases – from disaster response through long-term recovery – was identified as a burden by LHDs, particularly for nursing staff. Approximately 66.6% of LHD jurisdictions opened an Emergency Operations Center (EOC) or activated Incident Command System in response to both hurricanes. If an EOC was activated, the LHD was statistically, significantly more likely to report that normal duties had been interrupted across every domain assessed.

Conclusions:

The ability of LHDs to perform regular activities and provide essential public health services is impacted by their obligations to support disaster response. Better metrics are needed to measure the impacts to estimate indirect public health impacts of disasters.

Keywords

local public healthessential servicesnatural disaster
Type
Original Research
Information
Disaster Medicine and Public Health Preparedness , Volume 16 , Issue 4 , August 2022 , pp. 1552 - 1557
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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References

Gossip, K, Gouda, H, Lee, YY, et al. Monitoring and evaluation of disaster response efforts undertaken by local health departments: a rapid realist review. BMC Health Serv Res. 2017;17(1):450.CrossRefGoogle ScholarPubMed
Potter, MA, Schuh, RG, Pomer, B, Stebbins, S. The adaptive response metric: Toward an all-hazards tool for planning, decision support, and after-action analytics. J Public Health Manag Pract. 2013;19 Suppl 2:S49-S54.Google ScholarPubMed
Schoch-Spana, M, Sell, TK, Morhard, R. Local health department capacity for community engagement and its implications for disaster resilience. Biosecur Bioterror. 2013;11(2):118-129.Google ScholarPubMed
Centers for Disease Control and Prevention. The 10 Essential Public Health Services: An Overview; 2014. https://www.cdc.gov/publichealthgateway/publichealthservices/pdf/essential-phs.pdf. Accessed July 10, 2020.Google Scholar
Abramson, D, Stehling-Ariza, T, Garfield, R, Redlener, I. Prevalence and predictors of mental health distress post-Katrina: Findings from the Gulf coast child and family health study. Disaster Med Public Health Prep. 2008;2(2):77-86.CrossRefGoogle ScholarPubMed
Bell, SA, Horowitz, J, Iwashyna, TJ. Health outcomes after disaster for older adults with chronic disease: A systematic review. Gerontologist. 2020;60(7):e535-e547.CrossRefGoogle ScholarPubMed
Bourque, LB, Siegel, JM, Kano, M, Wood, MM. Weathering the storm: The impact of hurricanes on physical and mental health. Disasters and Disaster Relief, Ann Am Acad Pol Soc Sci. 2006;604(1):129-151.Google Scholar
Du, W, FitzGerald, GJ, Clark, M, Hou, XY. Health impacts of floods. Prehosp Disaster Med. 2010;25(3):265-272.CrossRefGoogle ScholarPubMed
Goldmann, E, Galea, S. Mental health consequences of disasters. Annu Rev Public Health. 2014;35:169-183.CrossRefGoogle ScholarPubMed
Federal Emergency Management Agency. Disaster Declarations by Year. https://www.fema.gov/disasters/year/2019. Accessed July 10, 2020.Google Scholar
National Association of County and City Health Officials. Directory of Local Health Departments. https://www.naccho.org/membership/lhd-directory. Accessed July 10, 2020.Google Scholar
Rivera-Rodriguez, E. Role of the nurse during disaster preparedness: A systematic literature review and application to public health nurses. Walden Dissertations and Doctoral Studies. 4250; 2017. https://scholarworks.waldenu.edu/cgi/viewcontent.cgi?article=5353&context=dissertations.Google Scholar
McDavid, K, Cruz, M. Environmental health shelter assessments: Using tools to protect occupants after disasters. J Environ Health. 2019;82(5):32-33.Google Scholar
Malilay, J, Heumann, M, Perrotta, D, et al. The role of applied epidemiology methods in the disaster management cycle. Am J Public Health. 2014;104(11):2092-2102.CrossRefGoogle ScholarPubMed
Landesman, LY, Burke, RV. Public health management of disasters: the practice guide. 4th edition. Washington, DC: American Public Health Association; 2011.Google Scholar
Schuh, RG, Eichelberger, RT, Stebbins, S, et al. Developing a measure of local agency adaptation to emergencies: A metric. Eval Program Plann. 2012;35(4):473-480.CrossRefGoogle ScholarPubMed
National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Population Health and Public Health Practice; Board on Health Sciences Policy; Committee on Evidence-Based Practices for Public Health Emergency Preparedness and Response; Downey A, Brown L, Calonge N, editors. Evidence-Based Practice for Public Health Emergency Preparedness and Response. Washington (DC): National Academies Press (US); 2020 Jul 14. Available from: https://www.ncbi.nlm.nih.gov/books/NBK563990/.Google Scholar
Stoto, MA, Nelson, C. Measuring and assessing public health emergency preparedness: A methodological primer. SSRN Electronic Journal. 2012 Sep. doi: 10.2139/ssrn.2886349.CrossRefGoogle Scholar
Schuh, RG, Basque, M, Potter, MA. The effects of funding change and reorganization on patterns of emergency response in a local health agency. Public Health Rep. 2014;129 Suppl 4:166-172.Google Scholar
Asch, SM, Stoto, M, Mendes, M, et al. A review of instruments assessing public health preparedness. Public Health Rep. 2005;120(5):532-542.CrossRefGoogle ScholarPubMed
Nelson, C, Lurie, N, Wasserman, J, Zakowski, S. Conceptualizing and defining public health emergency preparedness. Am J Public Health. 2007;97 Suppl 1:S9-S11.CrossRefGoogle ScholarPubMed
Federal Emergency Management Agency. North Carolina Hurricane Florence (DR-4393). https://www.fema.gov/disaster/4393. Accessed July 10, 2020.Google Scholar
North Carolina Office of the Governor. Executive Order No. 51: Declaration of State of Emergency. https://governor.nc.gov/documents/executive-order-no-51-declaration-state-emergency. Accessed February 3, 2021.Google Scholar
Federal Emergency Management Agency. North Carolina Hurricane Dorian (DR-4465). https://www.fema.gov/disaster/4465. Accessed July 10, 2020.Google Scholar
Federal Emergency Management Agency. Individual Assistance Program and Policy Guide; March 2019. https://www.fema.gov/sites/default/files/2020-07/fema_individual-assistance-program-policy-guide_2019.pdf. Accessed December 2, 2020.Google Scholar
Phillippi, SW, Beiter, K, Thomas, CL, et al. Medicaid utilization before and after a natural disaster in the 2016 Baton Rouge-Area Flood. Am J Public Health. 2019;109(S4):S316-S321.Google ScholarPubMed
Sharp, MJ, Sun, M, Ledneva, T, Lauper, U, Pantea, C, Lin, S. Effect of Hurricane Sandy on health care services utilization under Medicaid. Disaster Med Public Health Prep. 2016;10(3):472-484.CrossRefGoogle Scholar
Rosenheim, N, Grabich, S, Horney, JA. Disaster impacts on cost and utilization of Medicare. BMC Health Serv Res. 2018;18(1):89.CrossRefGoogle ScholarPubMed
Gould, DW, Teich, JL, Pemberton, MR, Pierannunzi, C, Larson, S. Behavioral health in the gulf coast region following the Deepwater Horizon oil spill: Findings from 2 federal surveys. J Behav Health Serv Res. 2015;42(1):6-22.Google Scholar
Zotti, ME, Williams, AM, Wako, E. Post-disaster health indicators for pregnant and postpartum women and infants. Matern Child Health J. 2015;19(6):1179-1188.CrossRefGoogle ScholarPubMed
Gessner, BD, Kaslow, D, Louis, J, et al. Estimating the full public health value of vaccination. Vaccine. 2017;35(46):6255-6263.Google ScholarPubMed
Lee, P, Hedberg, CW. Understanding the Relationships Between Inspection Results and Risk of Foodborne Illness in Restaurants. Foodborne Pathog Dis. 2016;13(10):582-586.Google ScholarPubMed
Wisniewski, JM, Jacinto, C, Yeager, VA, Castrucci, B, Chapple-McGruder, T, Gould, E. Opportunities to improve employee satisfaction within state and local public health agencies. J Public Health Manag Pract. 2019;25(5):440-447.Google ScholarPubMed
National Association of County and City Health Officials. Changes in local health department workforce and finance capacity since 2008. May 2020. https://www.naccho.org/uploads/downloadable-resources/2019-Profile-Workforce-and-Finance-Capacity_final-May-2020.pdf. Accessed December 2, 2020.Google Scholar
Association of State and Territorial Health Officials. New data on state health agencies show shrinking workforce and decreased funding leading up to covid-19 pandemic. September 2020. https://www.astho.org/Press-Room/New-Data-on-State-Health-Agencies-Shows-Shrinking-Workforce-and-Decreased-Funding-Leading-up-to-the-COVID-19-Pandemic/09-24-20/. Accessed December 2, 2020.Google Scholar
North Carolina Division of Emergency Management. North Carolina Emergency Operations Plan. December 2017. https://files.nc.gov/ncdps/documents/files/Divisions/EM/EOP/North%20Carolina%20Emergency%20Operations%20Plan%20%28NCEOP%29_BASIC_2017.pdf. Accessed December 2, 2020.Google Scholar
CBS News. Coronavirus updates from March 19, 2020. March 20, 2020. https://www.cbsnews.com/live-updates/coronavirus-disease-covid-19-latest-news-2020-03-19/. Accessed July 12, 2020.Google Scholar
Wilson, RT, Troisi, CL, Gary-Webb, TL. 2020. A deficit of more than 250000 public health workers is no way to fight COVID-19. https://www.statnews.com/2020/04/05/deficit-public-health-workers-no-way-to-fight-covid-19/. Accessed June 25, 2020.Google Scholar
Hoffman, J, Maclean, R. 2020. Slowing of coronavirus is speeding the spread of other diseases. https://www.nytimes.com/2020/06/14/health/coronavirus-vaccines-measles.html. Accessed July 13, 2020.Google Scholar
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