Term of Award
Spring 2017
Degree Name
Doctor of Public Health (Dr.P.H.)
Document Type and Release Option
Dissertation (restricted to Georgia Southern)
Copyright Statement / License for Reuse
This work is licensed under a Creative Commons Attribution 4.0 License.
Department
Jiann-Ping Hsu College of Public Health
Committee Chair
James Stephens
Committee Member 1
Gulzar Shah
Committee Member 2
Hani Samawi
Abstract
ABSTRACT
Background: Disasters precipitate the need for public health organizations to be prepared for an emergency, both at the state and local level. Public health district preparedness is a significant concern considering its impact on the safety and welfare of the citizens and communities they serve. Currently, there are limited surveillance systems to assess the preparedness level of these entities that are required to comply with state regulations that govern how they should respond when faced with dangerous hazards. The purpose of this research is to identify whether significant relationships exist between public health districts and their assessment of their level of preparedness to recommend additional training or educational instruction to improve disaster readiness.
Methods: Data was collected from all eighteen public health districts in the State of Georgia through the GREaT Hazard Vulnerability Assessment System and included the fiscal years 2011 through 2014. Secondary analysis of the data was performed using the correlation coefficient method and bootstrapping at the 95% confidence interval level.
Results: There were no statistically significant relationships (p-values of 0.113; 0.185; 0.878>0.05) found between the overall risk assessment scores and what the public health districts identified as their top first, second and third most vulnerable hazard. There was a statistically significant linear relationship (p-value of 0.000
Conclusion: Findings show that those health districts in mostly rural areas were less vulnerable to disasters and those in mostly urban areas were more vulnerable to disasters listed in the top three hazard categories. Also, the public health districts with the lower number of hospital beds were at greater risk for disasters identified in the top three hazard categories.
Recommended Citation
REFERENCES Ablah, E., Konda, K.S., Konda, K., Melbourne, M., Ingoglia, J.N., & Gebbie, K.M. (2010). Emergency Preparedness Training and Response Among Community Health Centers and Local Health Departments: Results from a Multi-State Survey. Journal of Community Health, 35, 285-293. Adger, W. N. (2006). “Vulnerability.” In Special Issue: Resilience, Vulnerability, and Adaptation: A Cross-Cutting Theme of the International Human Dimensions Programme on Global Environmental Change. Edited by Marco A. Janssen and Elinor Ostrom. Global Environmental Change 16.3: 268–281. American Hospital Association (AHA). (2001). Public Health System’s Capacity to Respond to Bioterrorism. Committee on Government Reform: Subcommittee on Technology and Procurement Policy. Chicago, IL: AHA. Allen, H., & Katz, R. (2010). Demography and Public Health Emergency Preparedness: Making the Connection. Population Research and Policy Review, 29(4), 527-539. Altevogt, B.M., Pope, A.N., Hill, M.N. & Shine, K.I (Editors). (2008). Research Priorities in Emergency Preparedness and Response for Public Health Systems: A Letter Report. The National Academy of Sciences, 1-41. Asch, S.M., Stoto, M., Mendes, M., Valdez, R.B., Gallagher, M.E., Halverson, P. & Lurie, N. (2005). A Review of Instruments Assessing Public Health Preparedness. Public Health Reports, 120, 532-542. Bauer, K.W. (2004). Conducting Longitudinal Studies. New Directions for Institutional Research, 121, 75-90. Bayleyegn, T.M., Schnall, A.H., Ballou, S.G., Zane, D.F., Burrer, S.L., Noe, R.S., & Wolkin, A.F. (2015). Use of Community Assessments for Public Health Emergency Response (CASPERS) to Rapidly Assess Public Health Issues---United States, 2003-2012. Prehospital and Disaster Medicine, 30(4), 1-8. Blumenstock, J., Bakker, G., & Jarris, P.E. (2014). Measuring Preparedness: The National Health Security Preparedness Index. Journal of Public Health Management and Practice, 20(3), 361-363. Buehler, J.W., Whitney, E.A., & Berkelman, R.L. (2006). Business and Public Health Collaboration for Emergency Preparedness in Georgia: A Case Study. Bio Medical Central Public Health, 6(285), 1-13. Burton, I., Kates, R.W., & White, G.F. (1993). The Environment as Hazard. (2nd ed). New York and London: Guilford. Centers for Disease Control and Prevention [CDC]. (2015). Office of Public Health Preparedness and Response (OPHPR): Emergency Preparedness and Response homepage. Retrieved from https://www.emergency.cdc.gov/. Centers for Disease Control and Prevention [CDC]. (2008). Emergency Preparedness and Response homepage. Retrieved from https://emergency.cdc.gov/. Centers for Disease Control and Prevention [CDC] Public Health Emergency Preparedness Cooperative Agreement. (2011). Budget Period 11 (BP11): Performance Measures Specifications and Implementation Guidance. Retrieved from http://www.cdc.gov/phpr/documents/CDC_PHEP_BP11_Performance_Measures_Guidance_2011_1109_FINAL.PDF. Centers for Disease Control and Prevention [CDC]. (2012). Public Health Preparedness Capabilities: National Standards for State and Local Planning. Retrieved from http://www.cdc.gov/phpr/capabilities/. Cheng, H.G., & Phillips, M.R. (2014). Secondary Analysis of Existing Data: Opportunities and Implementation. Shanghai Archives of Psychiatry, 26(6), 371-375. Childers, W., Alperin, M., & Miner, K.R. (2005). Emergency Preparedness in Georgia: An Assessment of Public Health Training Needs [Commentary]. American Journal of Public Health, 36(5), 287-294. Chretien, J.P., Tomich, N.E., Gaydos, J.C., & Kelley, P.W. (2009). Real-Time Public Health Surveillance for Emergency Preparedness. American Journal of Public Health, 99(8), 1360-1363. Christian, M.D., Kollek, D., & Schwartz, B. (2005). Emergency Preparedness: What Every Health Care Worker Needs to Know. Journal of the Canadian Association of Emergency Physicians, 7(5), 330-337. Clements, B.W. (2009). Disasters and Public Health Planning and Response. Jordan Hill, Oxford: Butterworth-Heinemann (Elsevier). Creswell, J.W. (2008). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches, 3rd Edition. Thousand Oaks, CA: Sage. Creswell, J.W., & Plano Clark, V.L. (2007). Designing and Conducting Mixed Methods Research. Thousand Oaks, CA: Sage. Cutter, S.L. (1996). Vulnerability to Environmental Hazards. Progress in Human Geography, 20(4), 529-539. Dorn, B.C., Savoia, E., Testa, M.A., Stoto, M.A., & Marcus, L.J. (2007). Development of a Survey Instrument to Measure Connectivity to Evaluate National Public Health Preparedness and Response Performance. Public Health Reports, 122, 329-338. Eshghi, K. & Larson, R.C. (2008). Disasters: Lessons from the Past 105 Years. Disaster Prevention and Management, 17(1), 62-82. Faulkner, B. (2001). Towards a Framework for Tourism Disaster Management. Tourism Management, 22, 135-147. Fox, M.A., & Latashaw, M. (2013). State Public Health Laboratory Biomonitoring Programs: Implementation and Early Accomplishments. Journal of Environmental Health, 75(6), 90-94. Gamboa-Maldonado, T., Hopp Marshak, H., Sinclair, R., Montgomery, S., & Dyjack, D.T. (2012). Building Capacity for Community Disaster Preparedness: A Call for Collaboration between Public Environmental Health and Emergency Preparedness and Response Programs. Journal of Environmental Health, 75(2), 24-29. Gebbie, K.M., & Qureshi, K. (2002). Emergency and Disaster Preparedness. American Journal of Nursing, 102(1), 46-51. Gebbie, K., & Merrill, J. (2002). Public Health Worker Competencies for Emergency Response. Journal of Public Health Management Practice, 8(3), 73-81. Georgia Department of Community Health [GDCH]. (2009). Public Health Districts. Retrieved from https://dph.georgia.gov/public-health-districts. Georgia Emergency Management Agency [GEMA]. (n.d.). Georgia Gov. Retrieved from https://georgia.gov/agencies/georgia-emergency-management-agency. Georgia Hazard Mitigation Strategy: Standard and Enhanced Plan (2014). Retrieved from www.gema.ga.gov/Mitigation/Documents/Planning/2014%20GHMS.pdf. Gibson, P.J., Theadore, F., & Jellison, J.B. (2012). The Common Ground Preparedness Framework: A Comprehensive Description of Public Health Emergency Preparedness. American Journal of Public Health, 102(4), 633-642. Glanz, K., Rimer, B.K., Viswanath, K. (Eds.) (2008). Health behavior and Health Education: Theory, Research, and Practice (4th ed.). San Francisco, CA: John Wiley & Sons. Goodman, R.A., Posid, J.M., & Popovic, T. (2012). Investigations of Selected Historically Important Syndromic Outbreaks: Impact and Lessons Learned for Public Health Preparedness and Response. American Journal of Public Health, 102(6), 1079-1090. Gursky, E. (2004). Hometown Hospitals: The Weakest Link? Bioterrorism Readiness in America’s Rural Hospitals. Washington, DC: National Defense University, Center for Technology and National Security Policy. Hunter, J.C., Yang, J.E., Crawley, A.W., Biesiadecki, L., & Aragon, T.J. (2013). Public Health Response Systems In-Action: Learning from Local Health Departments’ Experiences with Acute and Emergency Incidents. Public Library of Science (PLOS) ONE, 8(1), 1-13. Hunter, J.C., Yang, J.E., Petrie, M., & Aragon, T.J. (2012). Integrating a Framework for Conducting Public Health Systems Research into Statewide Operations-Based Exercises to Improve Emergency Preparedness. Bio Medical Central Public Health, 12(680), 1-10. Hyogo Framework for Action (HFA) 2005-2015: Building the Resilience of Nations and Communities to Disasters (2007). United Nations International Strategy for Disaster Reduction (UNISDR). Kasperson, J. X., & Kasperson, R.E. (eds). (2001). Global Environmental Risk. London: Earthscan. Katz, A., Staiti, A.B., & McKenzie, K.L. (2006). Responding To the Known: Communities and Public Health Preparedness. Health Affairs, 25(4), 946-957. Khan, A.S. (2011). Public Health Preparedness and Response in the USA since 9/11: A National Health Security Imperative. Lancet, 378, 953-956. Lechat, M.F. (1979). Disasters and Public Health. Bulletin of the World Health Organization, 57(1), 11-17. Ledlow, G. (2011). The GREaT Assessment System: A Public Health Preparedness Hazard Vulnerability Assessment System User's Manual. Ledlow, G., Jones, W., & Johnson, J (Eds.). (2005). Community Preparedness and Response to Terrorism: Governmental Collaboration and the Community Model (Vols. 1-3). Westport, CT: Praeger Publishers. Logue, J.N. (2006). The Public Health Response to Disasters in the 21st Century: Reflections on Hurricane Katrina. Journal of Environmental Health, 69(2), 9-13. Lotstein, D., Seid, M., Ricci, K., Leuschner, K., Margolis, P., & Lurie, N. (2008). Using Quality Improvement Methods To Improve Public Health Emergency Preparedness: PREPARE for Pandemic Influenza. Health Affairs, w334-w339. Lumpkin, J.R., Miller, Y.K., Inglesby, T., Links, J.M., Schwartz, A.T., Slemp, C.C., Burhans, R.L., Blumenstock, J., & Khan, A.S. (2013). The Importance of Establishing a National Health Security Preparedness Index (NHSPI). Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 11(1), 81-87. Lurie, N., Wasserman, J., & Nelson, C.D. (2006). Public Health Preparedness: Evolution or Revolution? Health Affairs, 25(4), 935-945. McCabe, O. L., Perry, C., Azur, M., Taylor, H.G., Gwon, H., Mosley, A., Semon, N., & Links, J.M. (2013). Guided Preparedness Planning with Lay Communities: Enhancing Capacity of Rural Emergency Response Through a Systems-Based Partnership. Prehospital and Disaster Medicine, 28(1), 8-15. Michigan Model for Health [MMH]. (2011). What is Emergency Preparedness? Retrieved from http://www.emc.cmich.edu. Mileti, D.S. (1999). Disasters by Design: A Reassessment of Natural Hazards in the United States. Natural Hazards and Disasters. Washington, DC: Joseph Henry. Moore, M. (2012). The Global Dimensions of Public Health Preparedness and Implications for US Action: Commentary. American Journal of Public Health, 102(6), e1-e7. Morse, S. S. (2007). Global Preparedness for Public Health Emergencies. Journal of Public Health Policy, 28(2), 196-200. National Center for Biotechnology Information [NCBI], U.S. National Library of Medicine. (2008). Variables for Data Extraction from Randomized Controlled Trials: Validity of Risk of Bias: Data Extraction Guide. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK92294/. Nelson, C., Lurie, N., Wasserman, J., & Zakowski, S. (2007a). Conceptualizing and Defining Public Health Emergency Preparedness [Editorial]. American Journal of Public Health, 97(1), S9-S11. Nelson, C., Lurie, N., Wasserman, J., & Zakowski, S. (2007b). Assessing Public Health Emergency Preparedness: Concepts, Tools, and Challenges. Annual Review of Public Health, 28, 1-18. Nelson, C., Willis, H.H., Chan, E.W., Shelton, S.R., & Parker, A.M. (2010). Federal Initiative Increases Community Preparedness for Public Health Emergencies. Health Affairs, 29(12), 2286-2293. Nunn, S. (2002). The Future of Public Health Preparedness. The Journal of Law, Medicine, & Ethics, 30(3), 202-209. Plough, A., Fielding, J.E., Chandra, A., Williams, M., Eisenman, D., Wells, K.B., Law, G.Y., Fogelman, S., & Magana, A. (2013). Building Community Disaster Resilience: Perspectives from a Large Urban County Department of Public Health. American Journal of Public Health, 103(7), 1190-1197. Powell, K. (2014). Top 10 Deadliest U.S. Natural Disasters. The Worst Storms and Environmental Disasters in U.S. History. Retrieved from http://genealogy.about.com/od/historic_disasters/tp/deadliest_us.htm. Public Health Preparedness Capabilities: National Standards for State and Local Planning. https://www.cdc.gov/phpr/capabilities/dslr_capabilities_july.pdf. Public Health Preparedness [PHP]: Strengthening the Nation’s Emergency Response State by State. (2010). A Report on CDC-Funded Preparedness and Response Activities in 50 States, 4 Cities, and 8 U.S. Insular Areas. Retrieved from https://www.cdc.gov/phpr/publications/2010/phprep_report_2010.pdf. Ready Georgia [RG]: Prepare, Plan, Stay Informed. (n.d.). Georgia Disaster History. Retrieved from https://ready.ga.gov/be-informed/. Ready or Not Issue Report [RNIR]. (2010). Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism. Robert Wood Johnson Foundation. Retrieved from http://healthyamericans.org/assets/files/TFAH2010ReadyorNot%20FINAL.pdf. Ready or Not Issue Report [RNIR]. (2012). Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism. Robert Wood Johnson Foundation. Retrieved from http://healthyamericans.org/assets/files/TFAH2012ReadyorNot08.pdf. Roberts, C.M. (2010). The Dissertation Journey: A Practical and Comprehensive Guide to Planning, Writing, and Defending Your Dissertation, 2nd ed. Thousand Oaks, CA: SAGE Publishing. Savoia, E., Preston, J., & Biddinger, P.D. (2013). A Consensus Process on the Use of Exercises and After Action Reports to Assess and Improve Public Health Emergency Preparedness and Response. Prehospital and Disaster Medicine, 28(3), 305-308. Schur, C.L., Berk, M.L., & Mueller, C.D. (2004). Perspectives of Rural Hospitals on Bioterrorism Preparedness Planning (W Series, No. 4). Bethesda, MD: NORC Walsh Center for Rural Health Analysis. Sendai Framework for Disaster Risk Reduction (SFDRR) 2015-2030. The United Nations Office for Disaster Risk Reduction (UNISDR). Geneva, Switzerland. Shrestha, S.S., Swerdlow, D.L., Borse, R.H., Prabhu, V.S., Finelli, L., Atkins, C.Y., Owusu- Edusei, K., Bell, B., Mead, P.S., Biggerstaff, M., Brammer, L., Davidson, H., Jernigan, D., Jhung, M.A., Kamimoto, L.A., Merlin, T.L., Nowell, M., Redd, S.C., Reed, C., Schuchat, A., & Meltzer, M.I. (2011). Estimating the Burden of 2009 Pandemic Influenza A (H1N1) in the United States (April 2009-April 2010). Clinical Infectious Diseases, 52(1), S75-S82. Song, M. & Jung, K. (2015). Filling the Gap between Disaster Preparedness and Response Networks of Urban Emergency Management: Following the 2013 Seoul Floods. Journal of Emergency Management, 13(4), 327-338. The Human Cost of Weather Related Disasters (HCWRD) 1995-2015. The United Nations Office for Disaster Risk Reduction (UNISDR). Centre for Research on the Epidemiology of Disasters (CRED). Treat, K.N., Williams, J.M., Furbee, P.M., Manley, W.G., Russell, F.K., & Stamper, C.D. Jr. (2001). Hospital Preparedness for Weapons of Mass Destruction Incidents: An Initial Assessment. Annals of Emergency Medicine 38(5):562–565. United Nations, International Strategy for Disaster Reduction (ISDR). (2007). Hyogo Framework for Action 2005-2015: Building the Resilience of Nations and Communities to Disasters. United States Government Accountability Office: [GAO Report]-04-360R. (2002). HHS Bioterrorism Preparedness Programs: States Reported Progress but Fell Short of Program Goals for 2002. Report to the Committee on Energy and Commerce, House of Representatives. Retrieved from http://www.gao.gov. United States Government Accountability Office: [GAO Report]-13-278. (2013). National Preparedness: Improvements Needed for Measuring Awardee Performance in Meeting Medical and Public Health Preparedness Goals. Report to the Committee on Energy and Commerce, House of Representatives. Retrieved from http://www.gao.gov. United States Department of Health and Human Services [DHHS], Centers for Disease Control and Prevention. (2011). Public Health Preparedness Capabilities: National Standards for State and Local Planning. Retrieved from http://www.cdc.gov/phpr/capabilities/DSLR_capabilities_July.pdf. United States Department of Health and Human Services [DHHS]. (2014). 2013-2014 National Snapshot of Public Health Preparedness. Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention (CDC). Retrieved from http://www.cdc.gov/phpr/pubs-links/2013/documents/2013_Preparedness_Report.pdf. United States Department of Homeland Security [DHS]. (2008). National Response Framework, 1-82. Retrieved from http://www.fema.gov/pdf/emergency/nrf/nrf-core.pdf. Uzun Jacobson, E., Inglesby, T., Khan, A.S., Rajotte, J.C., Burhans, R.L., Slemp, C.C., & Links, J.M. (2014). Design of the National Health Security Preparedness Index (NHSPI). Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science, 12 (3), 122-131. Vielot, N.A., & Horney, J.A. (2014). Can Merging the Roles of Public Health Preparedness and Emergency Management Increase the Efficiency and Effectiveness of Emergency Planning and Response? International Journal of Environmental Research and Public Health, 11, 2911-2921. Wright, K.S., Thomas, M.W., Durham, D.P., Jackson, L.M., Porth, L.L., & Buxton, M. (2010). A Public Health Academic-Practice Partnership to Develop Capacity for Exercise Evaluation and Improvement Planning. Public Health Reports, 125(5), 107-116. United Nations Office for Disaster Risk Reduction (UNISDR). (2015). The Human Costs of Weather Related Disasters 1995-2015: 20-Year Review Shows 90% of Disasters are Weather-related: US, China, India, Philippines and Indonesia Record the Most.
Research Data and Supplementary Material
Yes