Public Health Systems and Public Health Preparedness

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Public Health Systems and Public Health
Preparedness

• Linda C. Degutis, DrPH, MSN

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Objectives

• To provide a context for understanding the
  relationship between public health and mental
  health services in preparedness planning and
  response
• To describe the role of public health and public
  health systems in disaster preparedness, response
  and recovery

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Mission of Public Health

• To promote physical and mental health and prevent
  disease, injury, and disability

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3 Core Public Health Functions

• Assessment and monitoring of the health of
  communities and populations at risk to identify
  health problems and priorities
• Formulating public policies, in collaboration
  with community and government leaders, designed
  to solve identified local and national health
  problems and priorities
• Assuring that all populations have access to
  appropriate and cost-effective care, including
  health promotion and disease prevention services,
  and evaluation of the effectiveness of that care

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10 Essential Public Health Services

• Monitor health status to identify and solve
  community health problems
• Diagnose and investigate health problems and
  health hazards in the community
• Inform, educate, and empower people about health
  issues
• Mobilize community partnerships and action to
  identify and solve health problems
• Develop policies and plans that support
  individual and community health efforts

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10 Essential Public Health Services

• Enforce laws and regulations that protect health
  and ensure safety
• Link people to needed personal health services
  and assure the provision of health care when
  otherwise unavailable
• Assure a competent public and personal health
  care workforce
• Evaluate effectiveness, accessibility, and
  quality of personal and population-based health
  services
• Research for new insights and innovative
  solutions to health problems

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Fundamental Obligation of Public Health Agencies

• Prevent epidemics and the spread of disease
• Protect against environmental hazards
• Prevent injuries
• Promote and encourage healthy behaviors and
  mental health
• Respond to disasters and assist communities in
  recovery
• Assure the quality and accessibility of health
  services

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Public Health System

• Complex network of
• People
• Systems
• Organizations
• Working in
• public (local, state, and national)
• private arenas

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From CDC (Public Health Foundation,
http//www.phf.org/infrastructure/
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Goals

• To improve health within the population
• Strive to enhance the effectiveness with which
  health knowledge and technologies are applied to
  address the health issues of individuals and
  populations
• Value equity in health strive to reduce
  disparities in health across different social,
  economic, ethnic, and cultural groups

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Characteristics of Public Health

• Primary focus on population
• Emphasis on prevention, health promotion for the
  whole community
• Employs a spectrum of interventions aimed at the
  environment, human behavior and lifestyle, and
  medical care
• Multiple professional identities with diffuse
  public image
• Biologic sciences central, stimulated by major
  threats to health of populations move between
  laboratory and field

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Specific Areas of Public Health Expertise

• Risk communication
• Surveillance
• Community interface/collaboration
• Access to services
• Working with disadvantaged populations
• Environmental health

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Prevent epidemics and the spread of disease

• Monitor water and food quality
• Surveillance for emerging infectious disease
• Control disease vectors (rodents, mosquitoes)

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Protect against environmental hazards

• Monitor disposition of hazardous waste
• Monitor air and water quality
• Ensure potable water is available
• Maintain sanitation systems

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Prevent injuries

• Ensure that workers are provided with appropriate
  protective devices and clothing
• Identify injury risks for the population and
  mitigate them

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Promote and encourage healthy behaviors and
mental health

• Early intervention and referral
• Identification of persons at high risk for
  developing mental health problems
• Affected population
• Responders/volunteers
• Access to mental health services and crisis
  intervention services

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Role of Public Health in Disasters

• Engage in planning for community protection and
  response
• Respond to disasters and assist communities in
  mitigation and recovery

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Respond to disasters and assist communities in
recovery

• Ensure that essential public health services are
  available and accessible
• Rebuild services that have been lost
• Engage community in plans for service delivery

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Assure the quality and accessibility of health
services

• Develop contingency plans for providing essential
  public health services
• Develop methods to ensure access to care and
  health services
• Ensure access to care for non-disaster related
  conditions (acute and chronic)

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Haddons Matrix
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Haddons Matrix with 3rd Dimension
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Additions to Haddons Matrix Value Criteria
and Preparedness

• Community preferences
• Feasibility
• Equity
• Evaluation for
• Cost
• Effectiveness
• Freedom

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Effectiveness

• Planning and preparations
• Evacuation
• Shelter
• Maintenance of access to care
• Community health resources
• Hospitals
• Medications
• Home care
• Alternate care sites
• Distribution of resources

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Cost

• Community
• State
• Region
• Private entities

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Preferences of Affected Community

• Evacuation
• Transportation
• Shelter
• Safety
• Health care
• Link to relatives/friends/pets

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Equity

• Horizontal equity
• Vertical equity
• Equal chance of accessing services need to
  ensure that all population groups have equal
  access

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Freedom

• Protection of freedom while protecting publics
  health
• May require compromise
• Depends upon community norms/expectations

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Stigmatization

• Failure to evacuate
• Mental health problems
• Homelessness
• Poverty

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Feasibility

• Adequacy of shelters
• Plans for provision of food and water
• Evacuation plans

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Advantages of 3rd Dimension

• Brings important social and community concepts to
  the planning, intervention and recovery phases of
  a disaster
• Allows for planning and response in a way that
  takes into consideration community values and
  priorities

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So what?
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Summary

• Public health has unique skills and expertise
  that it brings to disaster planning and response.
• Because of its population-based focus, public
  health is in a position to examine the impact of
  disasters on the population as a whole, and work
  with others to incorporate the knowledge gained
  into planning for future responses.

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• Mental health is an important component of the
  communitys health
• Smooth integration of the mental health component
  of health is critical to public health
  preparedness planning and response

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The time to get to know each other is not in the
midst of a crisis, but while planning for the
health of the community
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