How to Improve Public Health Emergency Preparedness

Leadership, planning and training are among the ways that communities can improve their readiness for public health emergencies. Past and current public health emergencies put into stark relief the importance of preparing for the unexpected. A pair of studies recently published in the International Journal of Disaster Risk Reduction revealed that preparedness is often a key factor in mitigating the impact of large-scale infectious disease outbreaks.

Measures such as assessing risk and establishing partnerships with various stakeholders are vital to boosting public health emergency preparedness. An advanced degree in homeland security and emergency preparedness can help aspiring leaders develop the skills to take appropriate action during a crisis.

What Is Public Health Emergency Preparedness?

Public health is the science of protecting and improving the health of individuals and communities. Public health emergencies may involve outbreaks of disease or natural disasters, and they often have far-ranging and long-term impacts.

When these scenarios occur or appear likely to occur in the near future, government officials may declare public health emergencies. To fully understand what public health emergency preparedness is, it’s crucial to consider several different elements that can influence how these situations play out.

Who Is Involved in Public Health Emergency Preparedness?

Efforts to prepare for public health emergencies typically focus on providing training and tools to the following groups:

• Community members
• Businesses
• State and local officials
• Emergency responders
• Health care providers

In the case of businesses, developing an evacuation plan can protect the health of employees as they escape dangerous conditions ranging from weather emergencies to chemical spills. The U.S. Occupational Safety and Health Administration (OSHA) recommends that companies select employees to lead evacuation efforts and then make note of factors such as:

• Conditions that warrant evacuation vs. sheltering in place
• Routes for leaving the building
• Procedures for assisting building visitors
• Location of equipment, such as respirators or goggles, required for safety during evacuation

Emergency responders can prepare for a variety of scenarios related to public health emergencies, including the care of special populations. The Centers for Disease Control and Prevention (CDC), for example, outlines steps to take to ensure that infants receive proper nutrition in the event of an emergency that may disrupt their normal routines.

Special Populations and Public Health Emergency Preparedness

During public health emergencies, certain groups may face increased risks or have unique needs that require specialized support. Among these groups are:

• Evacuees who must take care of their medical needs while traveling and may face hazardous situations during cleanup after a disaster
• Children and caregivers, as children are more prone to injury and illness and require greater assistance
• Older adults who may have mobility problems or struggle with the unavailability of support services
• Pregnant women and infants, with pregnant women requiring special medical care and infants at greater risk of illness
• People with chronic illnesses who have special medical needs
• People experiencing homelessness who may distrust emergency responders and often have a higher rate of emotional trauma, according to the U.S. Department of Housing and Urban Development (HUD).
• Tribal communities whose unique cultures and traditions require sensitivity when addressing concerns during emergencies
• People with disabilities who may need help evacuating or who may be confined to their homes during an emergency

Elements of Public Health Emergency Preparedness

Federal, state and local officials must prepare for these emergencies, which pose a threat to the health and safety of families, communities and the nation. Since 9/11, the CDC has worked in concert with global health officials and state and local leaders to focus on the areas it refers to as the “Six Domains of Preparedness”:

• Biosurveillance — Monitoring and investigating health threats
• Community resilience — Preparing for emergencies and recovering after they occur
• Incident management — Coordinating emergency response
• Information management — Sharing important information so stakeholders can take appropriate action
• Countermeasures and mitigation — Delivering medical care and supplies where they’re needed
• Surge management — Preparing for expansion of services to accommodate large-scale events

Public Health Emergency Examples

One of the reasons public health emergency preparedness is so critical is that public health can be threatened by a wide range of issues, including terrorist attacks, disease outbreaks and natural disasters. Below are some examples of public health emergencies.

Natural Disasters and Weather Emergencies

Disasters and extreme weather events that can have public health implications include the following:

• Earthquakes
• Extreme heat
• Floods
• Landslides
• Lightning
• Volcanoes
• Hurricanes
• Winter weather
• Tsunamis
• Wildfires

Natural disasters and weather emergencies can contribute to a litany of public health concerns such as:

• Illness and injury
• Food and water contamination
• Mental trauma
• Cleanup safety
• Insect management

Epidemics and Pandemics

Epidemics are diseases that are widespread in a community, region or country. When a disease spreads across international borders, it can become a pandemic. The CDC reports that a pathogen can travel from a remote area to major cities on all continents in just 36 hours.

While COVID-19 is the most recent example, numerous epidemics and pandemics have broken out over the last two decades. Examples from the 21st century include:

• SARS (2002-2003) — Severe acute respiratory syndrome, a form of coronavirus, causing respiratory issues in two dozen countries
• Swine flu (2009-2010) — A strain of influenza, also known as H1N1, that spread to more than 70 countries
• MERS (2012) — Middle East respiratory syndrome, a coronavirus found in 24 countries
• Ebola (2014-2016) — An illness causing symptoms ranging from aches and pains to gastrointestinal concerns and internal bleeding, it spread to countries in Africa and Europe as well as the United States
• Zika (2015-2016) — Mosquito-borne illness that causes congenital abnormalities in infants born to infected mothers and affected individuals in 60 countries
• Monkeypox (2022) — Similar to smallpox, a disease causing rashes and flu-like symptoms that’s been reported in 75 countries

Conditions Increasing Epidemic and Pandemic Risk

Factors that can lead to a heightened risk of epidemics and pandemics include the following:

• Weak public health infrastructure
• Acts of bioterrorism
• Global travel spreading illness
• Antimicrobial resistance
• Animal-to-human contact

Terrorist Attacks

Another example of a public health emergency is a terrorist attack, which can inflict harm on the populace from conventional or chemical weapons.

The 9/11 attacks involved plane hijackings and crashes that led to mass casualties as well as illness stemming from chemical exposure. In the weeks following that event, there were also attacks involving the bioterrorism agent anthrax.

Chemical Emergencies

Accidental exposure to dangerous chemicals, such as acids and ammonia, can cause various health problems, including trouble breathing and skin damage. Contamination of clothing or pets can exacerbate these health concerns.

Radiation Accidents

The accidental release of radioactive material into the environment can cause health problems, ranging from skin discomfort to cancer. Individuals can spread their initial exposure to others through direct contact or by leaving radioactive materials on surfaces.

Importance of Public Health Emergency Preparedness and Response

No crisis in recent history underscores the importance of effective public health emergency preparedness and response more clearly than the COVID-19 pandemic.

In a recent report on public health emergency preparedness — “Ready or Not 2021: Protecting the Public’s Health Against Diseases, Disasters and Bioterrorism” — health advocacy organization Trust for America’s Health (TFAH) noted that the pandemic exposed multiple areas for improvement in U.S. readiness. These vulnerabilities reveal the consequences of being ill-prepared.

The following concerns about the nation’s COVID-19 response are among those the report identifies:

• Lack of resources — TFAH notes that the unavailability of adequate supplies of personal protective equipment (PPE) to guard against exposure to the COVID-19 virus left medical personnel and emergency responders at risk.
• Inequitable health care access — A history of inequities in providing care to all populations plagued response efforts, causing the pandemic to have a disproportionate impact on people of color and tribal communities.
• Inconsistent messaging — Unclear and contradictory instructions about COVID-19 protection and response led to confusion among public health officials — and the public — and weakened emergency response.

Effect on Community Health and Well-Being

Ensuring that a community can effectively address public health emergencies has implications for individuals’ overall health. For example, the CDC reports that by June 2020, a few months after the COVID-19 pandemic began, 41 percent of U.S. adults had postponed or avoided medical care, including urgent and emergency care.

A 2021 essay in the journal Preventing Chronic Disease reports that the impact of neglecting health care — coupled with the emotional toll of the pandemic and the struggle for underserved populations to get assistance — will affect the population’s overall health well into the future.

What Do Public Health Professionals Do?

Public health officials have various responsibilities related to preparing for emergencies and promoting population health. Following is a look at what public health professionals do:

Monitor Health Conditions

Public health officials monitor the health status of communities and larger populations — including entire countries — evaluating data to find trends in injuries, illnesses and birth outcomes. These findings help them identify issues and their underlying causes as well as potential solutions.

Investigate Health Hazards

Public health officials research the factors driving certain health trends and outcomes. Tracking variables that those affected by an illness or injury have in common can help in developing solutions that address the issues. Interviewing people who are experiencing gastrointestinal issues about what they ate, for example, can help identify a foodborne illness.

Provide Health Education

Public health professionals inform the public about existing or potential health concerns, from the hazards of smoking to updates on infectious disease outbreaks. They speak with community members and government officials, share printed materials, and post information online to alert the public about the issue and actions they can take.

Establish Community Partnerships

To help their message reach as many people as possible, public health professionals often form partnerships with other health-minded individuals and organizations. In many cases, these partnerships are with organizations that cater to high-risk populations. Public health officials educating people about COVID-19 risks, for example, could partner with organizations that help individuals with cancer, a condition that places people at a higher risk of severe COVID-19 symptoms.

Develop Health Policies and Plans

Public health professionals advocate for policies and procedures that help individuals and communities prevent and manage illness and injury. For example, public health officials help develop guidelines for workplace safety.

Enforce Health Regulations

Ensuring that individuals, businesses and communities adhere to health guidelines and regulations is another area of responsibility for public health officials. For example, they may monitor the storage of unsafe materials in work spaces, such as chemicals that could cause respiratory damage, like chlorine or ammonia.

Promote Health Care Accessibility

Public health officials develop and lead programs that help ensure equitable access to medical care. These efforts help communities’ most vulnerable populations find providers and manage travel and payment concerns.

Prepare Providers and First Responders

Keeping health care staff and first responders current on best practices and tactics is also part of public health officials’ purview — and a key component of public health emergency preparedness, as these professionals are on the front lines during an emergency. Public health officials can help prepare frontline workers by providing education on topics such as containing disease spread and responding to bioterrorism.

How Officials Are Improving Public Health Emergency Preparedness

Communities can prepare for public health emergencies such as disease outbreaks and natural disasters through a combination of planning, training and education.

Federal agencies like the CDC and the Office of Disease Prevention and Health Promotion, part of the U.S. Department of Health and Human Services, are among the leaders in public health providing guidance, resources and tools for improving public health emergency preparedness.

Through efforts like the federal Public Health Emergency Preparedness program (which partners with state and local agencies to bolster emergency preparedness and response) and the Healthy People 2030 initiative (which focuses on health promotion and equity), these agencies are working to ensure that individuals, communities, businesses, emergency responders and health care providers can effectively handle public health emergencies. Their work emphasizes the following:

Encouraging Emergency Planning

To prepare for public health emergencies, plans should be established for:

• Families to evacuate
• Schools to assist students
• Individuals to access prescriptions and documents
• Individuals and businesses to access power and other assistance
• Health care professionals to store equipment
• Medical personnel to have a single point of command
• Emergency personnel to mobilize staff and dispense medication and supplies

Ensuring Emergency Training

First responders and medical personnel should have training on handling disease outbreaks, while public officials should be equipped to detect and respond to potential threats. Individuals and businesses should understand how to dispose of clothing and other materials with chemical or radiation contamination.

Fostering Preparedness Teamwork

Public health officials can help bolster blood donations, which are often vital after an emergency. Individuals and businesses can also prepare to assist others by learning CPR and how to use automated external defibrillators (AEDs).

Educating Community Members

Some key actions can help educate the public about preparing for and responding to public health emergencies, such as:

• Improving medical testing and reporting
• Expanding communication about how to respond to environmental and health emergencies
• Encouraging news stories that provide information about emergency preparedness, management and response

Prepare Your Community for Public Health Emergencies

Effective public health emergency preparedness can pay dividends, strengthening a community’s response when a crisis occurs and aiding in recovery afterward. With effective planning, training and education, public health leaders and community members can help ensure that people are safe and can get the assistance they need right away.

Virginia Commonwealth University’s online Master of Arts program in Homeland Security and Emergency Preparedness can prepare students to support and lead their communities during crisis scenarios. The program provides a holistic examination of a wide range of issues, including threat assessment, policymaking and leadership.

Explore how the program can help you lead your community to readiness for public health emergencies.