142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Challenging structural foundations: How well do buildings, health systems, and public health pearls of wisdom hold up against hurricanes and other disasters?

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 11:30 AM - 11:50 AM

Benita Panigrahi, MD, MS , National Center for Disaster Preparedness, Columbia University, New York, NY
Thomas Chandler, PhD , National Center for Disaster Preparedness, Columbia University, New York, NY
Jonathan Sury, MPH, CPH , Columbia University, New York, NY
David M. Abramson, PhD MPH , National Center for Disaster Preparedness, Columbia University, New York, NY
This study aims to explore how public health leaders set priorities based on the accumulation of didactic training and experiential knowledge and to what extent changes in the local context may influence the evolution of these priorities. The National Center for Disaster Preparedness (NCDP) at Columbia University has developed strong collaborative partnerships with regional public health practice partners, including Nassau County Department of Public Health. Changes in local context were demonstrated by considering public health priorities of a single county health department at three distinct time periods which temporally varied around regionally significant natural disasters: (1) before any recent storms (Hurricane Ivan in 1999), (2) immediately after a mild storm (Tropical Storm Irene in 2011), and (3) after major category 3 hurricane (Hurricane Sandy in 2012). Investigators used a longitudinal qualitative interview approach to explore the public health decision making and to provide insights into how the public-health priority setting used by ten senior leadership staff who had over 250 years of combined experience in the local health department. Thematic content from initial pre-disaster interviews conducted as part of a previous study, was used to generate 10 key pearls of public health wisdom for the health department.  Content from interviews conducted in the two post-disaster timeframes were each analyzed for thematic content around public health decision-making and priority setting in the setting of the disasters and were compared to the pre-disaster circumstance. The findings were used to generate a modified public health pearls-framework, and highlight the dynamic influence of the local context that must be considered when setting public health priorities.

Learning Areas:

Administration, management, leadership
Conduct evaluation related to programs, research, and other areas of practice
Program planning
Public health administration or related administration
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
Evaluate the generalizability of the public health pearls based on the learner's experiences Identify health department priorities and decisions within and outside of the context of a disaster. Analyze local contextual factors that influence alignment of public health priorities and decisions making within the learners’ purview. Design a plan for a health division to address decision making and priority setting in critical, rapidly changing circumstances. Demonstrate collaborative approaches that may be used to efficiently develop a versatile and integrated health department plan used for decision making and priority setting by all divisions.

Keyword(s): Disasters, Public Health Administration

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the lead analyst on a number of projects sponsored by federally funded grants and non-profit agencies aimed at improving health systems efficiency in international settings. As a postdoctoral research scientist at NCDP, I am involved with a CDC-sponsored grant focused on evaluating the Health Systems Response in the NYC metro area following the Hurricane Sandy disaster. My scientific interests have been informed by my clinical experiences as a physician in county hospitals.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.