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**New**
Public Health Preparedness in a Reforming Health
System Serena Vinter* Dara Alpert Lieberman** Jeffrey Levi***
INTRODUCTION
The 2009–2010 H1N1 novel influenza A pandemic revealed serious underlying
gaps in our nation’s ability to
respond to public health emergencies. H1N1 is the latest in a string of public health crises Americans have faced
inthe past decade, which have included
a nationwide food-borne disease outbreak in
June and July of 2008, natural disasters like the California wildfires in August 2007 and Hurricanes Katrina and Rita in 2005, and man-made disasters including the terror attacks of September 11, 2001 and the anthrax
mailings in October of the same year.
These public health emergencies have tested our nation’s ability to respond to threats.Health officials and emergency planners define a public
health emergencyas any event that has
the potential to overwhelm a jurisdiction’s ability to handle the resulting health consequences.
To strengthen our nation’s ability to respond to public health emergencies, we must reexamine the role of the U.S. public health system. Regardless of the recent
passage of health reform legislation
(the Patient Protection and Affordable Care Act, the health delivery and public health systems are continually modernizing, and we must take advantage of opportunities to build prevention, preparedness,and response into our nation’s public health and health
care systems.
A cornerstone of public health emergency preparedness is
community resilience: the notion that
healthy, well-connected communities are better prepared
to both weather public health emergencies and recover from their aftermath. As detailed in the new U.S. National Health Security Strategy, public health emergency preparedness is built on a foundation
of community resilience—healthy
individuals,families, and communities with access to health care and with the knowledge and resources to know what to do to care for themselves and others in both routine and emergency situations. .
. .Community resilience is not possible
without strong and sustainable public
health, health care, and emergency response systems. This level of community resilience requires a public health system that canprotect us from threats to our health and prevent disease. A prepared system
must have the workforce, technology,
and equipment to detect emerging pathogens,
respond to disease outbreaks like H1N1, respond to natural disasters and acts of terrorism, protect our food and water supplies, immunize ourpopulation, help prevent disease, and communicate and work with at-riskpopulations.
Comprehensive health reform presents a rare opportunity to furtherstrengthen our nation. However, even with health reform, there are still majorgaps in our public health preparedness. Addressing these
underlying weaknesses in our health
system will not be easy or cheap, but failure to address
these concerns could prove extremely costly.
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