Journal Article
Public Health Preparedness: Evolution or Revolution?
Jan 1, 2006
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The recent emphasis on emergency preparedness has created heightened expectations and raised questions about the extent to which U.S. public health systems have evolved in recent years. The federal government has invested some $5 billion since 2001 to upgrade the public health system's ability to prevent and respond to large-scale public health emergencies. However, the public health system is still recovering from years of being underresourced and often ignored by federal policymakers.
During the past three years, RAND has examined the public health infrastructure through a series of interrelated projects, including an assessment of California's public health preparedness; a study of the impact of variation in state and local relationships on preparedness; a review of quality improvement efforts; and the development and conduct of tabletop exercises (simulated public health emergencies that require participants to work together to describe how they would respond to the evolving scenario at specific points in time). All told, RAND visited 44 communities in 17 states and conducted over 30 exercises. These studies led to several conclusions about how public health preparedness is transforming public health agencies:
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