The recent release of the National Health Security Preparedness Index, a comprehensive snapshot of the nation’s readiness for large-scale emergencies, provides necessary context to the current moment and can be used for ongoing relief efforts. In short, more data on every state’s level of emergency preparedness can help create a better integrated and more equitable public health system for the long-term.

The Index illustrates disparate preparedness levels across the country, driven by long-standing geographic and historical inequities. It shows a 32-percent gap in overall health security levels between the highest performing state and the lowest. Researchers from the Colorado School of Public Health and the University of Kentucky note that states with higher health security levels experienced significantly lower COVID-19 deaths in the opening year of the pandemic. Where a person lives should not dictate if, or for how long, they live.

Leading with a public health response will be key to an equitable long-term recovery, but other sectors and systems must follow suit. This rings particularly true as many public health officials find themselves continuing to serve on the frontlines of care – conducting contact tracing, testing, vaccinations, and more – while also being asked to rebuild and improve the public health and emergency response infrastructure in their communities. To reduce inequities in protection, leaders in healthcare, government, and business can use the up-to-date data from the Index to determine how to best tailor relief for the communities that need it most. For example, the Index includes state- and county-level medical staffing data that can inform where manpower and fiscal resources should be directed to shore up current workforce shortages. Simply put, the geographic, racial, and socioeconomic disparities uncovered by the Index demand to be taken into greater account. In theory many of us know that these disparities persist but it’s difficult to pinpoint exactly where they are occurring. The Index empowers public health and emergency preparedness professionals to do just that.

Establishing a robust, permanent emergency preparedness infrastructure is vital and will help ensure the country is prepared for future crises like the next pandemic or natural disaster. Climate-related disasters are expected to increase in the years ahead while the link between climate change and health grows. Now is the time to be proactive in taking on these pressing issues and preparing for the future.

The federal government appears prepared to continue directing relief to states and municipalities while deferring to local officials to pave the path forward for a healthier and more secure future. Local leaders from all backgrounds can seize the opportunity to pair the influx of federal investments with evidence-based data included in the Index to improve population health and advance health equity. Data is an incredibly valuable tool that should inform smart, targeted investments in both the short- and long-term. This Index is a helpful starting point.

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Alonzo Plough, PhD, MPH is the chief science officer and vice president, Research-Evaluation-Learning at the Robert Wood Johnson Foundation. He is a national leader in public health and emergency preparedness, previously working as director of public health in Boston and Seattle-King County.

The post Data on Emergency Preparedness Can Improve Public Health Response in Every State appeared first on NHSPI.

The more troubling news from the 2021 Index release is that large differences in health security levels persist across states and communities, with the lowest levels of health security found in geographic areas with the highest levels of social and economic vulnerability. By producing the Index annually since 2013, we can clearly see that health security levels have improved at an uneven pace across the United States in recent years. As a result, large segments of the country are left under-protected and vulnerable to health and economic burdens triggered by COVID-19.

The 2021 release of the Index provides an important window into the consequences of failing to achieve a more equitable health security system across the United States. In earlier releases of the Index—prior to the COVID-19 pandemic—it was difficult to see the clear connections between health security levels and health outcomes as they varied across the country. Now, in the midst of the pandemic, the 2021 Index release clearly demonstrates that areas with lower health security levels experienced significantly higher mortality due to COVID-19. These results document how inequities in health security contribute to inequities in health outcomes within the context of a large-scale health emergency.

Most importantly, results from the 2021 release of the Index demonstrate that gaps and inequities in health security are amenable to solutions. Every state achieved improvements in health security levels in at least one domain over the past eight years and most states also bolstered their overall health security levels. For example, Louisiana achieved one of the largest gains in health security of any state in 2020 despite serving many residents with high levels of social and economic vulnerability and despite confronting simultaneous health emergencies. If all states achieve sustained rates of improvement observed in Louisiana, the nation as a whole can eliminate geographic inequities and reach a strong national health security level of at least 9.0 in as few as five years.

This year’s Index results show that inequities in health security are not inevitable. A uniformly high-functioning system is within reach by targeting additional resources and assistance to places that experience the lowest health security levels and by supporting meaningful approaches to regional coordination and cross-sector collaboration.

We hope the 2021 release of the Index can inform these types of improvements as the United States continues to recover from the pandemic. Please spend some time with the 2021 Key Findings report for a deeper dive into health security patterns and trends observed across the country. For a summary of the health security patterns in your specific area, take a look at the state profile for your individual state.  We invite you to conduct your own analyses of health security measures by downloading the Health Security Data Explorer. For ideas on using the Index data to mobilize change in your community, see the Innovator’s Guide to the National Health Security Preparedness Index and other resources on the Index website.

Glen P. Mays PhD, MPH is the chair and a professor in the Department of Health Systems, Management and Policy in the Colorado School of Public Health at CU Anschutz. His research examines delivery and financing systems for health services, with a focus on estimating their effects on population health and economic efficiency.

The post Health Security Levels in 2021 Show that Inequities are Large, Persistent but Solvable appeared first on NHSPI.

In this interview, RWJF’s Alonzo Plough, PhD, MPH, and the National Health Security Preparedness Index’s (NHSPI) National Program Office Director Glen Mays, PhD, MPH, discuss ways NHSPI can be used to guide change, the role geographic differences play in preparedness levels, how the COVID-19 pandemic has exposed health inequities and much more.

This interview has been edited for clarity and length.

Glen Mays: From your perspective, why is preparedness important to building and creating a culture of health across the United States?

Alonzo Plough: Preparedness is at the core of building a Culture of Health and health equity—one that ensures everybody, regardless of neighborhood or income group, has a good and fair opportunity for a healthy life, particularly when you have a disaster like the coronavirus pandemic.

We know that no individual, community, organization or initiative can change the trajectory of America’s health alone. This remains true for preparing states and the nation for emergencies. The Index is a way for us to convey what it means to be prepared and the kind of connectivity between sectors required for national preparedness. We’re all in this together.

Glen: The Index lets us focus on specific states and understand how preparedness capabilities vary across the country and change over time. How can that information about geographic variation and differences in protections be used to help us respond to new and emerging threats?

Alonzo: There are many important regional nuances and context-specific factors that have different health security implications across states and regions.

We’ve seen this play out during the COVID-19 pandemic—even the difference in broadband access from region-to-region tells us the kind of things we have to do to achieve the fairness in outcomes and resilience that’s at the core of what we try to do and monitor with the Index. In an urban area with 5G service emerging, for instance, parents at home trying to take care of their kids and keep them schooled will have reasonable broadband access. Those in rural areas likely don’t have this same access, which can really affect the family’s ability to shelter in place and be safe during the pandemic.

Glen: We’ve got a number of measures in the Index that relate to populations and population groups that typically are disproportionately affected by large scale hazards and emergencies like the COVID-19 pandemic. How can we best use this tool as an instrument for improving health equity and closing gaps in health across the country?

Alonzo: Given the data right now, I think it’s fair to say we have a ways to go as a nation, but I think the Index will play a very important role in our learning as to how we improve from this baseline of our COVID-19 response.

I think some of the things that we’re measuring in the Index help us understand areas that we really need to improve, particularly around vulnerable populations. The Index has been very sensitive in trying to understand those contexts, how they vary regionally, and what policies are needed to promote equity so that your state, your neighborhood, or your income bracket doesn’t determine whether you’re going to have a resilient outcome in a disaster.

With COVID-19, for instance, we know that in spite of the good work we are trying to do, there are  tragic inequities in the outcomes we are seeing among different populations, such African Americans and Latinos, isolated elders in nursing homes, and incarcerated populations, to name a few. The Index can help us prioritize these populations and their unique needs and risks as we formulate equitable solutions like distribution of vaccines, therapeutics, and other health interventions.

Alonzo Plough, PhD, MPH, is the vice president of Research-Evaluation-Learning and chief science officer at the Robert Wood Johnson Foundation. Glen Mays, PhD, MPH, is the director of the NHSPI Program Office and chair of the Department of Health, Management, and Policy at the Colorado School of Public Health.

The post How Preparedness Builds a Culture of Health and Health Equity appeared first on NHSPI.

What Can Be Learned from Updated Results?

Results from the 2020 release of the Index show that national health security capabilities continue to gain strength, but at a rate that has slowed down over time. Most states experienced improvements in health security levels over the past year, but at widely varying levels. Large geographic differences in preparedness remain, and these differences have grown larger over time in selected domains. Jurisdictions are responding to a growing array of risks and hazards by stretching constrained human, financial, and technological resources and making difficult trade-offs.

How can states and communities use this updated information? Coronavirus transmissions appear to be leveling off in a growing number of U.S. regions, giving these areas some breathing room and a chance to take stock of their capabilities and needs. With a large set of 130 measures, the Index allows users to identify strengths and weaknesses across a broad range of sectors and capabilities.

As new resources become available through federal coronavirus aid packages, the Index can help emergency preparedness stakeholders identify where vulnerabilities exist and where reinforcements are most urgently needed. Users can quickly identify leading states in each domain of preparedness and in regions across the United States, allowing for peer networking and cross-jurisdictional learning to occur.

What Can Findings Tell Us About COVID-19 Response?

The Index includes many measures that are directly relevant to coronavirus response efforts, including measures of laboratory testing capabilities, epidemiologist staffing, hospital surge capacity, nursing home infection control, household broadband access, and employer-provided paid time off. Effective responses to COVID-19 require coordination of resources across a broad range of public and private sectors. The Index integrates data from a broad range of sectors to offer a comprehensive view of preparedness.

Figure: Higher Scores on the 2020 Health Security Index Are Associated with Significantly Lower Risk-adjusted County COVID-19 Mortality Rates

Note: point estimates with 95% confidence intervals are shown as horizontal lines.  Estimates are derived from risk-adjusted mortality regression models using generalized estimating equations. 

To gain additional perspectives on pandemic response, Index results can be linked with emerging state and local data on COVID-19 (see figure). To date, states with higher health security levels have experienced significantly lower risk-adjusted COVID-19 deaths per 100,000 population – an encouraging trend that can be monitored over time. The figure above shows how county-level risk-adjusted mortality rates change in response to a one point increase in Index scores. These results can help stakeholders craft targeted responses for regions that face higher mortality risks combined with lower preparedness levels.

What Index Changes Were Introduced in 2020?

The Index measurement set and methodology remain virtually unchanged from last year. We introduced one new measure into the Index based on recommendations from the field: a measure of nursing home compliance with federal standards for infection control. This addition appears particularly relevant to the COVID-19 pandemic, given the heightened infection rates observed in long-term care facilities across the United States.

One notable change to our dissemination process this year is the rethinking of the “Index preview period” used in previous years to give emergency preparedness stakeholders an early look at the results and a structured process to provide feedback. To avoid placing additional demands on these officials during the COVID-19 response and to provide information as quickly as possible to the field, we are releasing the results directly to the field without holding a full review and comment period. One downside of this minimally invasive approach, of course, is that we have fewer opportunities to screen for possible errors in the many data sources used in the Index. Such errors have been rare in previous releases of the Index, but they occasionally do occur in some data sources, particularly those that rely on self-reported information from agencies and facilities. For this reason, we invite Index users to ask questions and provide feedback on an ongoing basis at any time that is convenient by sending an email to our research team at systemsforaction@ucdenver.edu. If we identify the need to correct any data source based on this feedback, we will release corrections as soon as possible on the Index website.

We hope you find useful information and new insight about the geography and dynamics of health security in this latest release of the Index. We look forward to incorporating the lessons learned from current health security experiences into future releases of the Index.

Glen P. Mays PhD, MPH is the chair and a professor in the Department of Health Systems, Management and Policy in the Colorado School of Public Health at CU Anschutz. His research examines delivery and financing systems for health services, with a focus on estimating their effects on population health and economic efficiency.

The post Health Security Levels in 2020: Navigating the Pandemic & Preparing for New Uncertainties appeared first on NHSPI.

This session will feature real-world, on-the-ground examples of how the Index is being used as a force of engagement, activation and improvement.  In pulling this event together, I am extremely fortunate to be joined by Dara Lieberman, MPP, of the Trust for America’s Health, and Darrell Small, CEM, an emergency management professional who works closely with the federal Community Preparedness Initiative in sites across the U.S.  Dara and Darrell have a wealth of experience on how to engage community and policy stakeholders in the work of preparedness, and how to use metrics as powerful levers in this task.

Along the way, I will foreshadow some of the new data and metrics that will be released later this spring as part of the 2019 release of the National Health Security Preparedness Index, coming in May.

The Index measures health security capabilities from a broad, multi-sector perspective, so it includes and extends beyond the public health sector to reach medical care, emergency management, transportation, schools, employers, civil engineers, public utilities and others.  But who plays the part of mobilizing, coordinating, and assessing these collective actions in preparedness? Who makes strategic use of data to drive the system as a whole forward?

Our Learning Session at the Preparedness Summit will be held on Thursday, March 28, 3:30-5 p.m., in Room 220 of the St Louis Convention Center Complex.  If you can’t make the Summit this year, look for our Index team at other meetings this spring and summer, including the AcademyHealth Annual Research Meeting, the National Environmental Health Association Meeting, the Natural Hazards Research and Applications Workshop, and more to come.

Glen P. Mays PhD, MPH is the chair and a professor in the Department of Health Systems, Management and Policy in the Colorado School of Public Health at CU Anschutz. His research examines delivery and financing systems for health services, with a focus on estimating their effects on population health and economic efficiency.

The post Beyond the Numbers: Strategic Uses of the Index to Engage Communities and Shape Policies appeared first on NHSPI.

So, can you identify the most heavily questioned and hotly contested element of the National Health Security Preparedness Index? Believe it or not, it is the set of measures that indicate what public health laboratories do.

Heterogeneity and Controversy in Lab Testing

The controversy stems from the concept of assurance. And it flows from the many different ways that public health responsibilities get divvied up across state governments.

In most states, multiple laboratories exist, operated by different state agencies.  Public health laboratories are often organized within state health agencies, but sometimes they are organized as independent state institutions or as part of state university systems.  Environmental laboratories are often located within state environmental protection agencies, which may or may not fall under the umbrella of a health-related super agency.  Agricultural laboratories are found within state agriculture agencies.  And of course there are clinical labs located within state hospitals, crime labs located within state law enforcement agencies, and medical examiner’s labs located somewhere in this mix.  Which lab is responsible for testing food samples for pathogens?  Which lab tests air, soil or other environmental samples for harmful substances like lead? Which lab tests public drinking water sources, private wells, or recreational bodies of water?  Which lab tests the white powder found in an office building?

Political dynamics add to the controversies surrounding heterogeneity in laboratory structure. Environmental and agricultural labs conduct testing largely in support of the regulatory enforcement duties carried out by their parent agencies. Some of the tests performed by public health labs also fulfill regulatory purposes, but these labs typically have a broader surveillance mission and a wider scope of responsibilities.  Concerns about industry capture and political interference in testing exist, and examples that fuel these concerns are not hard to find.

Figure 1: State public health laboratory roles in testing for hazards in air, 2016

Source: Association of Public Health Laboratories, 2016

The Solution: Assurance

Long ago, laboratory experts at CDC and at state public health laboratories recognized the problems that can arise when testing capabilities exist in one agency but interpretation and response capabilities reside in other corners of state government.  Information does not always flow seamlessly through government bureaucracies.  The legal authority to act and the scientific knowledge about what to do are distributed unevenly across agencies.  This situation can cause delays in responding effectively to hazards detected through laboratory testing.  And delays can have serious human and economic consequences.

The solution devised by CDC and its state laboratory partners at APHL involve two key ingredients:

1. Recognize that public health testing and reporting capabilities are carried out by a multi-agency system of laboratories in most states.
2. Recommend that a state’s designated public health laboratory take responsibility for ensuring that all necessary health-related testing and reporting capabilities exist somewhere within the state’s laboratory system and are implemented effectively. The laboratory can carry out this assurance function either by directly providing necessary testing and reporting activities itself OR by confirming that another laboratory somewhere within the state system provides these activities effectively.

This “provide or assure” recommendation for state public health laboratories forms the basis of CDC’s and APHL’s Comprehensive Public Health Laboratory System definition and its Core Functions and Capabilities of State Public Health Laboratories framework. Moreover, this recommendation is formalized in the federal Healthy People 2020 health objectives for the nation.

How Does the Index Measure Laboratory Capabilities?

The National Health Security Preparedness Index follows the recommendations of CDC and APHL when measuring public health laboratory capabilities.  In fact, we use a series of measures constructed from periodic surveys that APHL fields with state public health laboratory administrators.  The measures in this series indicate whether or not the state public health laboratory “provides or assures” testing of water, air, soil, and human samples for specific pathogens and hazards.  A state receives credit for having a specified capability if the public health laboratory directly performs the test, OR if it assures that another laboratory entity performs the test.

Figure 2: State public health laboratory roles in testing public drinking water systems, 2016

Source: Association of Public Health Laboratories, 2016

The controversy arises in states where a certain type of test is performed by an environmental or agricultural laboratory, but there is no assurance function performed by the public health laboratory.  In these cases, the capability to test for a certain hazard exists. But the capability to assure that the testing and reporting function is carried out effectively does not exist within the public health laboratory. Such states do not comply with the CDC/APHL recommendation.  By following the CDC/APHL recommendations, the Index measures the assurance capability rather than the testing capability alone.

And as you can imagine, some states don’t agree with this way of measuring laboratory capabilities.

Figure 3: State public health laboratory roles in testing hazardous waste, 2016

Source: Association of Public Health Laboratories, 2016

Testing vs. Assurance: Are We Measuring the Right Stuff?

The CDC/APHL “provide or assure” recommendation for public health laboratory testing reflects the consensus opinion of experts and experienced laboratory professionals at the dawn of the 21^st century.  As a recommendation based more on experience than on rigorous scientific evidence, it should remain open to continued evaluation, critical analysis, and revisions over time.  The Index continues to monitor the scientific and professional literature on this topic, and we stand ready to update our measurement approaches as professional norms and standards evolve.

One issue in need of clarification involves how the assurance function should be defined and carried out by public health laboratories across the U.S.  The APHL surveys used in constructing the Index rely on information that is self-reported by individual laboratory administrators.  The surveys provide little guidance about what is meant by “assurance” and how laboratories should carry out this function in cases where they do not directly perform the testing.  Consequently, it is left up to the interpretation of individual administrators as to whether or not their laboratory carries out the assurance function.

Figure 4: State public health laboratory roles in testing for hazards in soil, 2016

Source: Association of Public Health Laboratories, 2016

Is assurance really all that important? Isn’t it enough to know that testing exists somewhere within the state bureaucracy?

Clearly some people think so.  But in the absence of clear scientific evidence, the Index relies upon well-reasoned professional recommendations like those from CDC and APHL.

It is not very difficult to find real-world examples that support the underlying logic of the “provide or assure” recommendation.  As one example, Arizona’s environmental laboratory has responsibility for testing the safety of public drinking water systems, but it does not have the legal authority to notify the public of potential hazards.  As a consequence, residents of one community waited years to learn that their drinking water supply had seriously elevated levels of uranium contamination from a defunct mine.  The Flint water crisis provides another recent example of the problems posed by organizational complexity in lab testing and response.  In that case, Michigan’s environmental agency held responsibility for overseeing testing of Flint’s drinking water system, but the state’s public health agency had responsibility for monitoring test results for reportable diseases like Legionnaires’.  Delays in connecting the dots between water test results and disease surveillance enabled the hazards in Flint to persist and grow unchecked.

We hope the Index will stimulate further dialogue, discussion, and debate about these important issues in health security.  Publicly accessible data, rigorous analysis, and critical thinking lead the way to a clearer understanding of actions that can strengthen health protections for everyone.

The post Just Making Sure? Laboratory Capabilities and National Health Security appeared first on NHSPI.

But thinking about these crucial elements often comes too late, after a tragedy has already shattered infrastructure and destroyed lives. In Colorado we want to make sure we don’t end up looking back at an ‘unexpected’ crisis and discussing what we could have done better—we want to prepare our public health system for those challenges today with the right resources and the right data.

What’s more, true health security goes beyond just guarding against natural disasters. For example, figures from this year’s statewide flu report show that Coloradans are ending up in the hospital at higher rates than usual, which suggests that this flu strain may be particularly dangerous for seniors. But by using the National Health Security Preparedness Index—a measure of our state and national capacity to prepare for, respond to, and recover from emergencies that pose health risks in the United States—we don’t have to guess what we need to do to craft a strong response to everyday issues like flu outbreaks. The Colorado Department of Public Health and Environment (CDPHE) is using data from the Index to set goals and strategies, and start talking to and working with potential allies outside of the public health world.

Of course, getting out of our silos and working in concert with state healthcare systems, community planners, and other government agencies is not an easy task. All of these organizations are often dealing with their own overstretched budgets to meet their own priorities and goals, so it can be difficult to ask more of them. But ultimately, each of these groups will have to tackle the next health security challenge, and a coordinated response is better for all Coloradans.

Our department can make that case by looking at measures within the Index that are beyond our traditional wheelhouse to find shared priorities. For example, we know that the number of physicians serving a given population is crucial to how well we can respond to and recover from an emergency, but Colorado is falling behind. Our local hospital and physician associations likely already know that we have physician shortages, but we can use this information for better planning and preparation.

Every state has its share of destructive natural disasters and horrific man-made tragedies, we just don’t know when or where they will strike. That doesn’t mean we should wait until the aftermath before developing a response. We need to act now to build an agile public health system, but we can only do that if we have the blueprints. With so many things that can go wrong, getting to true preparedness can be an incredibly difficult, often fuzzy process. That’s why it’s crucial that we have the right resources to do this work, including active Coloradans that participate in organizations like local Medical Reserve Corps and National Voluntary Organizations Active in Disaster. We know what it takes to be prepared for the worst-case scenario, and it’s never too early to start.

Dane Matthew, MAEd, MMAS, is the director of the Office of Emergency Preparedness and Response at the Colorado Department of Public Health & Environment.  Since June of 2016, he has led the state’s public health and medical emergency preparedness and response program.  He is ensuring all 64 counties and the nine regional healthcare coalitions in Colorado are prepared to respond to and recover from incidents adversely impacting health and the environment. Matthew’s experience as a military officer, combined with the skills he developed while a firefighter and executive director of a Colorado Special District, make him a skilled strategic planner, leader, and consensus builder. He continues to grow his knowledge of public health and medical EPR and propel Colorado’s program forward to ensure the state is prepared for when someday is today.

The post Let’s Use Data to be Ready for the Next Unpredictable Emergency appeared first on NHSPI.

The Colorado Department of Public Health and Environment (CDPHE) was tops in our recent Innovator Challenge for using the National Health Security Preparedness Index to stimulate intra- and multi-sectorial communication, collaboration, and action to improve health security. The Index team spoke with Dane Matthew, director of Colorado’s Office of Emergency Response, about how the Index is helping the department meet its goals. Below is a snapshot of the conversation.

INDEX TEAM: How did improving Colorado’s health security and preparedness become a priority and how did you translate this into action?

MATTHEW: One of the goals in our strategic plan is to prepare and respond to emerging issues, but assessing readiness and preparedness is a pretty nebulous thing. There are so many factors. The National Health Security Preparedness Index has done that hard work and given us a sense of where we stand and where we can improve.

We decided that to use the Index, we have to figure out how to improve our score—so we formed an internal team to dig into the data and measures to understand where we were successful, where we could make improvements, and where there are missing data that we know exists somewhere. From there, we set goals and benchmarks using the Index measures and weaved them into our implementation plan and our overall strategic plan.

You mention homing in on missing data. Can you tell us what data you are working to collect?

First, we had to identify exactly where there were missing data to understand why. When we looked more closely at the data, we found measures where data were labeled “missing” that CDPHE could add. We realized that the “missing data” could be due to reporting data in a way that was not captured in the Index, potentially lowering our overall score. For example, the number of epidemiologists per 100,000 people was a low-scoring item for us, but we realized this is a measure in Colorado that is collected by the state’s Department of Labor, even though it’s a public health profession. In this case, we just needed to find out where the data are to report accurately. We now know that we have a high number of epidemiologists in the state and our score has improved.

How does this fit into the future goals of the department?

A future step for us will be to look outside of the department. We know some of the measures are beyond public health’s direct control. For example, one measure is the number of doctors per 100,000 people. Now we are thinking, “How can we encourage our local hospital associations to improve this score?” Understanding where the data come from is helping us understand what specific improvements can be made and which community partners we need to speak with.

What are the top preparedness activities in Colorado that you’re looking to improve?

We are very focused on improving a number of preparedness efforts in the state, specifically improving syndromic surveillance capabilities and sharing the generated data. Currently, we do not maintain this information at the state level, only within the Denver metro area. We are working to provide this at the local level across the state to prevent and respond to emerging threats.

Another area to improve, and this ties back into our conversations with community partners, is the number of pediatricians in the state. We are looking to partner with our local hospital associations and other health care stakeholders to improve our pediatrics capabilities—for day-to-day health and well-being, and in the event of a disaster.

What is one of the barriers to preparedness?

One challenge that I’ve been concerned about is the philosophy that just because you don’t have major events requiring massive evacuations on a continual basis, that doesn’t mean you don’t need to prepare for smaller, more localized events. When a community has something happen, we are pretty good about making sure we have a much improved response the next time something similar happens. But it’s easy to lose sight of the need to continually prepare, especially if we haven’t experienced any major emergencies or disasters for a period of time.

What advice would you give to other states using the Index?

Measuring preparedness is incredibly difficult, but the Index is a foundational piece. You can use the Index to better understand your state and departments and begin crucial conversations. Having a tool to help you articulate your readiness is important. I would urge my health security and preparedness peers to utilize the Index and dig into the data and ask, “Did that score equate to a better response or not? Are there small changes that can make a big difference?” Start with the low-hanging fruit and focus on making incremental change.

Dane Matthew, MAEd, MMAS, is the director of the Office of Emergency Preparedness and Response at the Colorado Department of Public Health & Environment.  Since June of 2016, he has led the state’s public health and medical emergency preparedness and response program.  He is ensuring all 64 counties and the nine regional healthcare coalitions in Colorado are prepared to respond to and recover from incidents adversely impacting health and the environment. Matthew’s experience as a military officer, combined with the skills he developed while a firefighter and executive director of a Colorado Special District, make him a skilled strategic planner, leader, and consensus builder. He continues to grow his knowledge of public health and medical EPR and propel Colorado’s program forward to ensure the state is prepared for when someday is today.

The post Expert Q&A: Using the Index in Colorado appeared first on NHSPI.

The Colorado Department of Public Health and Environment (CDPHE) is exemplary in its use of Index data to communicate the importance of preparedness across government agencies and with community stakeholders. The CDPHE team leverages Index data to establish priorities, identify gaps, and galvanize support for community wide preparedness across Colorado.

The CDPHE used Index data to create preparedness goals, and incorporated the data into its Implementation Plan and overall Strategic Plan. Through an analysis of the measures and data sources, the CDPHE is targeting areas of improvement within the department and identifying measures where more data are needed from community partners, such as hospitals, businesses, and school districts.

We asked Dane Matthew, director of CDPHE’s Office of Emergency Preparedness and Response, how the Index was helpful to his agency’s work, and he said, “Measuring preparedness is extremely difficult because there are a number of factors, but you can’t improve what you haven’t measured. The Index has done the hard work for us. We know where we need to improve and have a starting point to build upon.”

Seeing this practical application of the Index is exciting and we are eager to follow CDPHE’s progress as the staff apply it to their work. Stay tuned for blog updates to learn more about how CDPHE is integrating measures into their strategic goals in our upcoming interview with Dane Matthew.

Glen P. Mays PhD, MPH is the Scutchfield Endowed Professor of Health Services and Systems Research at the University of Kentucky College of Public Health. His research examines delivery and financing systems for health services, with a focus on estimating their effects on population health and economic efficiency.

The post Colorado Rises to the Challenge as the Preparedness Index Innovator for 2017 appeared first on NHSPI.

Results from the National Health Security Preparedness Index clearly demonstrate that health security is not simply a governmental responsibility.  Individual businesses and the private sector at large contribute to many of the health security measures that comprise the Index, such as by offering paid time off and telecommuting options for employees, promoting vaccination coverage in the workforce, supporting workers who train and volunteer for their local Medical Reserve Corps, and participating in emergency planning and exercises organized by regional healthcare coalitions and networks.

Panelists shared key insights for both health and business stakeholders as they consider strategies for strengthening health security and preparedness activities, including:

• The importance of leveraging the supply chain to prepare for events by collaborating on contingency plans to avoid large-scale business disruptions;
• Increasing awareness about the need for preparedness plans among the business community, especially for small businesses with little influence over suppliers;
• How business can foster social cohesion—often business owners work closely in the community and will need to rise above competition to recover from an adverse event;
• Businesses as a catalyst for volunteerism in their workforce; and
• Harnessing technology to plan, respond, and recover, for both large and small companies.

We also know health security and preparedness require cross-sector collaboration and a multipronged approach, and we were pleased that our participants joined from a variety of backgrounds. A plurality came from governmental public health, with significant representation from the private sector and academia.

Figure: Webinar attendees

The diversity of our attendees led to questions on a wide-range of topics, including:

• Global pandemics are arguably the only catastrophic threat that can simultaneously hit a business’s employees, customers, and suppliers worldwide. Do you think most corporate CEOs are fully aware of the risk and adequately engaged in ensuring that all parts of the house (business continuity, HR, medical services) are resourced and supported? Are most companies doing drills?
• As a Public Health Emergency Preparedness Coordinator through a Health Department, where should the line be drawn between helping private businesses to prepare vs. just working towards community preparedness?
• How do you handle the moral hazard aspect of private markets, like healthcare, that may see these regional treatment facilities as the primary source for handling high-consequence pathogens and therefore cut down on preparedness and training?

Panelists mentioned the following resources during the discussion:

• National Health Security Preparedness Index measures
• Intel CSR Report highlighting preparedness efforts
• Global Health Security Agenda: Private Sector Roundtable backgrounder

We are excited to continue engaging stakeholders from many different backgrounds and improving health security and preparedness in all communities. Follow the conversation on Twitter @NHSPIndex and stay tuned for more webinars on the role we all can play in health security.

Glen P. Mays PhD, MPH is the chair and a professor in the Department of Health Systems, Management and Policy in the Colorado School of Public Health at CU Anschutz. His research examines delivery and financing systems for health services, with a focus on estimating their effects on population health and economic efficiency.

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