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The California's Public Health infrastructure, from the perspective of public health preparedness is characterized by high interjurisdictional variability. A combination of coordination of resources and new investment will be necessary to fill gaps. To assess gaps in California's Public Health Infrastructure, RAND reviewed extant performance measures; developed and conducted tabletop exercises in nine local health departments; and performed an economic analysis to identify the gaps in infrastructure relating to preparedness. Two of seven jurisdictions were well prepared, and one was poorly prepared. The study concludes that the level of protection afforded to California residents is uneven and recommends steps to strengthen the infrastructure.

The research described in the report was conducted by RAND Health for the California Endowment and Kaiser Permanente.

This report is part of the RAND technical report series. RAND technical reports may include research findings on a specific topic that is limited in scope or intended for a narrow audience; present discussions of the methodology employed in research; provide literature reviews, survey instruments, modeling exercises, guidelines for practitioners and research professionals, and supporting documentation; or deliver preliminary findings. All RAND reports undergo rigorous peer review to ensure that they meet high standards for research quality and objectivity.

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