Moving toward a measurement model for public health preparedness

More than 40 billion dollars have been spent on public health preparedness since 2001. The Centers for Disease Control and Prevention (CDC) receives approximately 1.5 billion dollars in annual appropriations for preparedness and emergency response. CDC awards almost half of those funds to state and local governments through the Public Health Emergency Preparedness Cooperative Agreement. As a result of the Pandemic and All Hazards Preparedness Act, which called for the development of a National Health Security Strategy, and the current budget climate, there is a renewed focus on assessing the impact of the investment in public health preparedness. Building on an effort to inventory CDC's preparedness and response measures, and building CDC's preparedness strategic planning efforts, the authors have developed a flexible framework for measuring and evaluating public health preparedness programs. Drawing from public policy and evaluation literature, the framework was developed by conducting a review of the public health preparedness literature; creating a logic model of public health preparedness that assumes the national health security goals of preparedness and resiliency; categorizing measures collected during the inventory of CDC preparedness and response capability and capacity measures; and, aligning the measures to the five CDC preparedness objectives and other national preparedness strategies. This presentation describes the proposed framework, proposes methods for testing and refining the framework, and highlights applications. Findings include a need to move toward a consistent, agreed upon set of preparedness measures and CDC should consider integrating the measurement of public health preparedness programs at all levels of government.