Achieving Public Health Legal Preparedness

How Dissonant Views on Public Health Law Threaten Emergency Preparedness and Response

Published in: Journal of Public Health, vol. 33, no. 3, Sep. 2011, p. 361-368

Posted on RAND.org on August 31, 2011

by Anda Botoseneanu, Helen Wu, Jeffrey Wasserman, Peter Jacobson

Read More

Access further information on this document at jpubhealth.oxfordjournals.org

This article was published outside of RAND. The full text of the article can be found at the link above.

Background: Effective management of modern public health emergencies requires the coordinated efforts of multiple agencies representing various disciplines. Organizational culture differences between public health (PH) and emergency management (EM) entities may hinder inter-agency collaboration. We examine how PH and EM differ in their approach to PH law and how such differences affect their collaboration towards PH preparedness. Methods: We conducted 144 semi-structured interviews with local and state PH and EM officials between April 2008 and November 2009. Thematic qualitative analysis in [software package] ATLAS.ti was used to extract characteristics of each agency's approach to PH legal preparedness. Results: Two conflicting approaches to the law emerge. The PH approach is characterized by perceived uncertainty regarding legal authority over preparedness planning tasks; expectation for guidance on interpretation of existing laws; and concern about individual and organizational liability. The EM approach reveals perception of broad legal authority; flexible interpretation of existing laws; and ethical concerns over infringement of individual freedoms and privacy. Conclusions: Distinct interpretations of preparedness law impede effective collaboration for PH preparedness. Clarification of legal authority mandates, designation within laws of scope of preparedness activities and guidance on interpretation of current federal and state laws are needed.

Research conducted by

This report is part of the RAND Corporation external publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.