Center for Infectious Diseases and Emergency Readiness, School of Public Health, University of California, Berkeley, California, United States of America.
PLoS One. 2013 Nov 13;8(11):e79457. doi: 10.1371/journal.pone.0079457. eCollection 2013.
As part of their core mission, public health agencies attend to a wide range of disease and health threats, including those that require routine, acute, and emergency responses. While each incident is unique, the number and type of response activities are finite; therefore, through comparative analysis, we can learn about commonalities in the response patterns that could improve predictions and expectations regarding the resources and capabilities required to respond to future acute events. In this study, we interviewed representatives from more than 120 local health departments regarding their recent experiences with real-world acute public health incidents, such as infectious disease outbreaks, severe weather events, chemical spills, and bioterrorism threats. We collected highly structured data on key aspects of the incident and the public health response, particularly focusing on the public health activities initiated and community partners engaged in the response efforts. As a result, we are able to make comparisons across event types, create response profiles, and identify functional and structural response patterns that have import for future public health preparedness and response. Our study contributes to clarifying the complexity of public health response systems and our analysis reveals the ways in which these systems are adaptive to the character of the threat, resulting in differential activation of functions and partners based on the type of incident. Continued and rigorous examination of the experiences of health departments throughout the nation will refine our very understanding of what the public health response system is, will enable the identification of organizational and event inputs to performance, and will allow for the construction of rich, relevant, and practical models of response operations that can be employed to strengthen public health systems.
作为其核心使命的一部分，公共卫生机构应对广泛的疾病和健康威胁，包括需要常规、急性和紧急应对的威胁。虽然每个事件都是独特的，但响应活动的数量和类型是有限的；因此，通过比较分析，我们可以了解响应模式中的共性，这些共性可以提高对未来急性事件所需资源和能力的预测和预期。在这项研究中，我们采访了 120 多个地方卫生部门的代表，了解他们最近在现实世界中急性公共卫生事件中的经验，如传染病爆发、恶劣天气事件、化学品泄漏和生物恐怖主义威胁。我们收集了关于事件和公共卫生应对关键方面的高度结构化数据，特别是侧重于启动的公共卫生活动和参与应对工作的社区伙伴。因此，我们能够对不同类型的事件进行比较，创建响应概况，并确定对未来公共卫生准备和应对具有重要意义的功能和结构响应模式。我们的研究有助于澄清公共卫生应对系统的复杂性，我们的分析揭示了这些系统如何适应威胁的特征，从而根据事件类型差异化地激活功能和伙伴。对全国卫生部门的经验进行持续和严格的审查将深化我们对公共卫生应对系统的理解，使我们能够确定组织和事件对绩效的投入，并构建丰富、相关和实用的应对操作模型，以加强公共卫生系统。
