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To help describe and enhance key aspects of state and local public health emergency preparedness, the U.S. Department of Health and Human Services asked RAND to study the response of state and local health departments to outbreaks of Severe Acute Respiratory Syndrome (SARS), monkeypox, West Nile virus, and hepatitis A that took place from 1999 to 2003. Public health agencies demonstrated a robust ability to implement the major components of response to a public health emergency. However, unlike some other emergency responders, they do not have command and control authority over many important resources that are needed for an optimal public health response. Researchers found that the most pervasive problem was the need for strong communication and coordination between public health and other governmental agencies involved in emergency response.

Table of Contents

  • Chapter One

    Introduction

  • Chapter Two

    Summary of Disease Outbreaks

  • Chapter Three

    Public Health Assessment

  • Chapter Four

    Just-in-Time Policy Development and Assurance

  • Chapter Five

    Coordination and Communication in Public Health

  • Chapter Six

    Communication with the Public

  • Chapter Seven

    Organizational Learning and Workforce Development

  • Chapter Eight

    Infrastructure Development

  • Chapter Nine

    Conclusions and Cross-Cutting Themes

  • Appendix A

    Methods

  • Appendix B

    West Nile Virus

  • Appendix C

    Severe Acute Respiratory Syndrome (SARS)

  • Appendix D

    Monkeypox

  • Appendix E

    Hepatitis A

The research described in the report was prepared for the Department of Health and Human Services by RAND Health, a unit of the RAND Corporation.

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