Dr. B on Capitol Hill

APHA Executive Director Georges Benjamin, MD, far right, took part in a briefing on Capitol Hill in Washington, D.C., on Aug. 15. The briefing, organized by the Alliance for Health Reform, focused on public health preparedness and the nation’s readiness for disasters. Photo by APHA

In just the past year, U.S. national security has been threatened by public health emergencies including Superstorm Sandy, the Boston Marathon bombings and, recently, the Cyclospora infection outbreak. In a briefing Thursday hosted by the Alliance for Health Reform and broadcast on C-SPAN, APHA Executive Director Georges Benjamin and other health leaders dissected the question, “Are we ready for disaster?”

The answer is twofold: National preparedness is achievable, but we’re not there yet.

“This comes at an amazing time where we’re trying to get universal health care for all Americans,” Benjamin said. “But even when we achieve a well-functioning health care system of the highest quality and optimal costs, and even if every American gets a platinum level health plan — that’s the highest level plan under the Affordable Care Act — we still would need a robust public health system to protect the nation’s health.

“Too many Americans don’t take individual preparedness seriously.”

Taken from APHA’s Get Ready Campaign, Benjamin discussed the systemic responsibility to prepare for global health threats, but also empower individuals to act on their own. Currently, 44 percent of U.S. adults do not have first-aid kits, 48 percent lack emergency supplies and 52 percent have not designated a meeting place for families if they are separated during an emergency. Benjamin outlined that an effective public health system must:

  • prevent known health threats;
  • detect new and emerging health threats;
  • conduct epidemiological investigations;
  • confirm diseases through laboratory and other tests;
  • inform and engage stakeholders;
  • treat and contain disease;
  • link to support systems;
  • engage community; and
  • enhance recovery.

This support system needs federal and local support, according to Ali Khan of the Centers for Disease Control and Prevention. Khan helped develop the first-ever national plan for public health preparedness and response, complete with services such as the $4 million national stockpile of medicine and medical supplies to protect the American public from health emergencies. However, Khan called state and local health departments the “crown jewel” of CDC’s preparedness plan.

“Public health doesn’t happen at CDC,” Khan said. “Public health happens at your state and local level. That’s where the initial detection occurs; that’s where the initial response occurs.”

However, federal funding cuts have damaged the effectiveness of state and 2,700 local health departments, according to Jack Herrmann of the National Association of County and City Health Officials. From 2008-2010, health departments lost more than 44,000 jobs — and a reduced workforce directly affects a community’s preparedness system.

“Almost 60 percent of health departments cut or eliminated one public health program area as a result of federal funding cuts. In that same year, almost a quarter of the local health departments had to reduce or eliminate preparedness programs because of funding cuts,” Hermann said.