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-- FEMA releases three national frameworks in support of National Preparedness Goal --
Last week, the Federal Emergency Management Agency took another step forward to achieving their National Preparedness Goal through the release of three National Planning Frameworks: National Prevention Framework, National Mitigation Framework, & the 2nd Edition of the National Response Framework. Combined with two other frameworks, these documents address each of the five preparedness mission areas identified in President Policy Directive-8. The only remaining framework to be addressed is the National Prevention Framework.
In combination, these resources serve to create a more resilient nation with a whole community-focus. Furthermore, FEMA emphasizes the value of both a responsive workforce and population prepared to endure and respond to all-hazards events.
Summarized below are the guiding themes or principles for each framework.
National Prevention Framework: Avoiding, preventing, or stopping a threatened or actual act of terrorism
National Mitigation Framework: Encouraging a culture of preparedness with a focus on risk, resilience, and mitigation with a whole community approach
National Response Framework, 2nd Ed.: Discussing how the whole community can collaborate together and what role response plays in national preparedness
As a Center with a focus on more resilient communities, NCDMPH values FEMA’s whole-community approach. The resourcefulness of the entire community is indispensable, as was seen recently after the Boston bombings. By engaging with the entire Nation, the frameworks set the standard for future conversation about national resiliency in the face of all-hazards events.
May 7, 2013
-- NCDMPH authors featured in latest addition of DMPHP --
The National Center for Disaster Medicine and Public Health’s Acting Director Dr. Kenneth W. Schor and Education Coordinator Dr. Brian Altman recently published an article in the February 2013 edition of Disaster Medicine and Public Health Preparedness "Proposals for Aligning Disaster Health Competency Models" (2013; 7: 8-12) provides suggestions for standardizing and aligning the building blocks of disaster health competency models. Drs. Schor and Altman suggest that uniformity across competency frameworks will facilitate comparison between different models.
"We wrote this paper because our efforts to date demonstrated the need to standardize the reporting of competencies related to disasters," Dr. Schor said. "Most importantly, we wanted to provide a broader context for competencies to highlight the importance of assessing and evaluating the competencies beyond just providing a list."
The article recommends that competency builders use the article’s reinterpretation of the research, development, test, and evaluation construct (RDT&E) when producing their competency sets. In addition, Drs. Schor and Altman encourage developers to consider content in at least 4 key areas: disaster-type domain, systems domain, clinical domain, and public health domain. Finally, the article advises competency model designers to constantly consider the challenges of the disaster work environment when creating their model.
"Competency models have a key role in the education and training of disaster health professionals," said Dr. Altman. "In writing this paper, we thought not only of competency model developers but also those who implement these models."
For further information and access to the abstract: "Proposals for Aligning Disaster Health Competency Models"
April 24, 2013
-- SAMHSA presents webcast on behavioral health response to mass violence --
The Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Technical Assistance Center (DTAC) recently presented a disaster behavioral health webcast dedicated to support and response during a mass casualty incident. The content focused on identifying common behavioral health reactions to mass casualty events seen in both survivors and responders.
The presentation emphasized that intentional mass violence incidents tend to cause more distress because survivors struggle with understanding why the attack occurred. This tension often results in higher rates of psychological effects overall.
One factor that determines how people will react to mass violence is their exposure to the event. Presenters referenced the population exposure model (Tucker et al., 1999: Wright, Ursano, and Bartone, 1990) as a useful tool when responding to mass violence. The model dictates that the severity of psychological response increases as an individual comes closer to the epicenter of the violence. The model can serve as a map to guide responders to individuals who have the most direct exposure to the event. SAMHSA’s Mental Health Response to Mass Violence and Terrorism offers more information on mental health interventions.
Responders also suffer psychologically when responding to mass violence. Specifically, responders can suffer from compassion fatigue, secondary traumatic stress or vicarious trauma, and burnout. SAMHSA has a self-care tip sheet for emergency and disaster response workers that can assist with managing and reacting to stress. USU's Center for the Study of Traumatic Stress (CSTS) also offers a wealth of resources on disaster mental health.
Team leaders can help mitigate by ensuring members are supporting each other and encouraging self-care when needed. Presenters advised that response exercises should include a focus on strategies for managing a psychologically difficult and emotional experience. By openly communicating with fellow responders, team mates are building trust and increasing the team’s resilience and ability to respond.
Thank you to SAMHSA and CSTS for providing valuable educational resources to facilitate behavioral health focused response. Readers can find additional psychosocial resources related to mass violence in our "Resilience through Learning" series.
April 9, 2013
-- The Centers for Disease Control and Prevention monitoring the avian flu outbreak in China --
The Centers for Disease Control and Prevention is currently monitoring the outbreaks of avian influenza virus H7N9 in China. Although avian flu outbreaks have occurred in the past, health officials are concerned because H7N9 is usually carried by birds that do not display any outward symptoms.
The Centers for Disease Control and Prevention offered the following guidance for Americans traveling or living in China:
The CDC continues to monitor the situation. The National Center encourages readers to follow the latest guidance and reports issued from the CDC's Health Alert Network.
April 2, 2013
-- National Center Celebrates National Public Health Week --
The National Center is a proud partner of the American Public Health Association's National Public Health Week (April 1-7, 2013). This year's theme is "Public Health is ROI (Return on Investment): Save Lives, Save Money." NPHW includes daily themes during the week, events in your community, and opportunities to interact online with public health leaders.
The National Center explored where the NPHW daily themes intersect with all-hazards preparedness, education and training. NCDMPH encourages participants to read the content listed below and consider how to apply the resources in their home, community and workplace.
NPHW emphasizes the importance of emergency preparedness as part of this daily theme. In addition, they encourage spreading the importance of preparedness in the community. The Centers for Disease Control and Prevention offers a variety of educational resources to guide individuals on creating a detailed emergency plan. Families and individuals should also prepare for reacting to a disaster after it strikes. For example, Superstorm Sandy revealed the importance of knowing when to shelter in place and how to react to flood damage.
NPHW provides an extensive list of actions to create a healthier and safer environment for children at school. Children remain a vulnerable population during a disaster and school faculty may have to respond to children's unique needs if an event occurs during the school day. The National Child Traumatic Stress Network has multiple resources to enable schools to respond to children after a traumatic incident. In addition, the National Center's "Tracking and Reunification of Children in Disasters: A Lesson and Reference for Health Professionals" can assist schools with its guidance on how to reunite children with their parent or guardian.
In addition to providing a safe workplace for their employees, employers can also make their business more resilient during and after an all-hazards event. Agility Recovery and the U.S. Small Business Administration provide resources for businesses with their website Prepare My Business. Last year, Prepare My Business presented a webinar on "Top 10 Mistakes Made During a Disaster." Employers and business owners can utilize both of these resources to create a safer and more resilient working environment.
The National Center encourages its stakeholders to take part in National Public Health Week and join NCDMPH for Wednesday's NPHW Twitter chat. Continue to follow @NCDMPH on Twitter this week for the latest resources related to NPHW.
March 28, 2013
-- Private-public partnerships & vulnerable populations discussed at VEMEC 2013 --
Earlier this week, the National Center for Disaster Medicine and Public Health attended the first two days of the Fourth Annual Advancing & Redefining Communities for Emergency Management Conference (ARC). Formally known as the Comprehensive Emergency Management Program Evaluation and Research Conference, ARC was held in collaboration with the Veterans Emergency Management Evaluation Center and co-sponsored by the Georgetown School of Nursing and Health Studies. This year's theme was "Redefining Community & Bringing Partners Together" which planning committee chair Dr. Aram Dobalian believes "recognizes the important role that all organizations across the community must play in preparing for, responding to, and recovering from a disaster."
The two-day event included a combination of poster sessions, panels and keynote speakers. An enduring theme throughout the event was the importance of partnerships that bridge across the public-private sector. The panel "Public-Private Partnership in Disaster Response: Turning Challenges into Opportunities" discussed in part the Maryland Emergency Management Agency's relationships with various private partners which resulted in a stronger response to communities in need during and after Hurricane Irene. Education remains a key part of this relationship, since both MEMA and the private entities continuously learn about the resources and capabilities of the other.
Additionally, ARC addressed the needs of vulnerable populations with the session, "Building Resilience to Address Access and Functional Needs: A Multidisciplinary Perspective to Inclusive Disaster Planning and Policy."The panel included representatives from the U.S. Department of Transportation, Natural Hazards Center, Center for Integrated Emergency Preparedness, and the Substance Abuse and Mental Health Services Administration. The panel included a discussion on the importance of addressing the needs of children and youth during and after an all-hazards event. The National Center continues to work in this critical area by developing a pediatric disaster health curriculum for the disaster health workforce.
ARC 2013 concluded with the HHS/ASPR co-sponsored workshop, "Incorporating Homeless Population into Disaster Preparedness, Planning, and Response" which considered the unique needs of the homeless during and after a disaster. The National Center applauds ARC 2013 and VEMEC for addressing this need and for the inclusion of a session focused on the training of community-based organizations and NGOs for responding to the needs of the homeless.
NCDMPH looks forward to the new collaborations from ARC 2013 and encourages attendees to share their learning at the National Center's "Learning in Disaster Health: A Continuing Education Workshop."
March 14, 2013
-- Pandemic All-Hazards Preparedness Reauthorization Act --
On March 13th, President Obama signed the much anticipated five year Pandemic All-Hazards Preparedness Reauthorization Act (PAHPRA) which was originally created after Katrina to bolster the Nation's public health preparedness and foster the development of chemical, biological, radioactive, and nuclear (CBRN) medical countermeasures. PAHPRA also stipulates the creation of a new National Advisory Committee on Children and Disasters which would work until September 2018. The funding for PAHPRA will not be finalized until the President submits a FY 2014 budget.
The National Center for Disaster Medicine and Public Health commends Congress and President Obama for the passage of this significant piece of legislation. In addition to strengthening medical countermeasures and amending the Public Health Service Act, PAHPRA identifies new areas of educating and training for the disaster health workforce.
The following aspects of PAHPRA can inform or compliment the work of the National Center:
The National Center looks forward to the reauthorization's increased impact on national preparedness and resiliency. NCDMPH will continue to monitor the impact of PAHPRA and provide the latest updates regarding education and training.
For more information about PAHPRA and other documents that support the NCDMPH's work, please visit the Documents & Directives section of the website.
March 5, 2013
-- Competency Resources release coincides with Severe Weather Preparedness Week --
The National Center announces the release of their "Resources for Core Competencies in Disaster Health" which links resources to each of the 11 core competencies published in Disaster Medicine and Public Health Preparedness 2012 article, "Core Competencies for Disaster Medicine and Public Health." This article arose via an interdisciplinary collaboration funded by the Terrorism Injuries Information Dissemination & Exchange (TIIDE) program of the CDC and spearheaded by the American Medical Associations (AMA) Center for Public Health Preparedness and Disaster Response (CPHPDR) in partnership with NCDMPH. The article is available for free on the DMPHP website.
"Resources for Core Competencies in Disaster Health" provides suggested external materials that align with the 11 core competencies identified in the aforementioned article. These resources can be used for training and educating all health professionals for disasters and public health emergencies. Resources are paired with the appropriate core competency and some resources align with several different competencies.
Although this resource is applicable for any event, its release coincides with "Be a Force of Nature: National Severe Weather Preparedness Week." This week is a joint effort by FEMA and the National Oceanic and Atmospheric Administration (NOAA) to encourage preparedness and planning in the event of severe weather. In addition to the emphasis on preparedness, NOAA and FEMA ask participants to use their influence on social networks to promote weather preparedness whether via blogging, Twitter, or Facebook.
Participants can fortify the resources provided by NOAA and FEMA by perusing NCDMPH's competency resources. Several of the competencies address personal preparedness and participants can find the resources that best meet their needs during their knowledge search. In addition, trainers and educators can use the competencies to design lessons that focus on severe weather.
The National Center thanks FEMA and NOAA for fostering communities of resilience by holding events like National Severe Weather Preparedness Week. NCDMPH will be taking part by providing various resources over the week via its Twitter account, @NCDMPH.
February 28, 2013
-- Reuniting Children in Disaster included in HHS Learning Management System --
Last November, the National Center released its first pediatric learning object "Tracking and Reunification of Children in Disasters: A Lesson and Reference for Health Professionals." This online lesson is applicable to a wide range of health workers and continuing education credit is currently available for 12 professions. During the lesson, learners will analyze general steps for responding to an unaccompanied child at a disaster scene. The lesson includes a reference card that provides guidance on how to respond to a child as well as key contacts to reach during an all-hazards event.
As of this week, this lesson is now included in the Department of Health and Human Services National
Disaster Medical System's Learning Management System, Responder E-Learn. Through the Center's Federal advisory board, the Federal Education and Training Interagency Group, a representative of HHS requested that Reuniting Children in Disaster be placed in the NDMS Responder E-Learn.
The Center and Responder e-Learn have a similar mission: the development and propagation of disaster health education and training. Available to 7,000 to 8,000 learners, Responder e-Learn uses a curriculum that combines medical, public health, preparedness and response education. HHS designed the LMS to improve and expand the skills and competencies of Federal responders. The course content of Responder e-Learn is based "upon capabilities needed to fulfill operational missions and anticipated response requirement." As an online lesson that addresses the needs of children in an all-hazards event, Reuniting Children in Disasters aligns with the Responder e-Learn course content.
When a trainee logs into Responder E-Learn, they can find the lesson and are redirected to the National Center website. If you are a NDMS employee and utilize Responder e-Learn, follow these steps to find the lesson.
Reuniting Children in Disasters is also available directly on the Center's website.
The National Center extends its gratitude to HHS and NDMS for including Reuniting Children in Disasters in Responder e-Learn. Through key strategic interagency partnerships such as these, the Center can better prepare the nation to respond to all-hazards events.
February 21, 2013
-- Avoiding carbon monoxide poisoning in the wake of winter storms --
An immense winter storm is barreling across western New Mexico to southwestern Virginia, a distance of more than 1600 miles, bringing with it freezing rain, thunderstorms and an estimated foot of snow. The extreme weather system has brought snow to the deserts of Arizona, New Mexico and Southern California. Over 60 million people are in the storm's path. As schools and workplaces close, citizens in the storm's path need to be prepared for a deathly threat in their own home: Carbon Monoxide poisoning.
The February winter storm in the Northeast brought in its wake tragic cases of preventable Carbon Monoxide poisoning. In Boston several people died in cars with blocked tailpipes. The Boston Police Department responded to these deaths by releasing a public safety advisory regarding Carbon Monoxide poisoning. But CO deaths are not limited to cars. In January, a man in Connecticut died in his home due to Carbon Monoxide poisoning from a propane heater.
Fortunately, Carbon Monoxide poisoning is preventable by following safety measures. The Centers for Disease Control offers the following tips:
City managers and response organizations can use the CDC's Carbon Monoxide poisoning public service announcements to alert citizens of CO risk after a storm. In terms of training resources, the National Hazardous Materials Fusion Center offers training packages for Carbon Monoxide release. The CDC also offers a Carbon Monoxide Prevention Clinical Education training designed to improve treatment of CO poisoning.
The NCDMPH extends its gratitude to all the members of the disaster health workforce responding to the winter storm. Keep up with NCDMPH on Twitter at @NCDMPH for the latest news about winter storm safety.
February 14, 2013
-- NCDMPH observes training for John Hopkins Medicine's Suburban Hospital --
As a center dedicated to the education and training of the disaster health workforce, NCDMPH supports its staff attending and observing professionally led trainings and exercisees. At the invitation of the National Library of Medicine's Disaster Information Management Research Center, Dr. Brian Altman, education coordinator, and Robin Lowe, webmaster, recently observed a training for John Hopkins Medicine's Suburban Hospital staff.
Suburban Hospital is a member of the Bethesda Hospitals' Emergency Preparedness Partnership (BHEPP) which consists of four major healthcare institutions in Bethesda, MD that respond collaboratively to all-hazards events. NLM DIMRC works with BHEPP on two projects. The first program is focused on building a resilient communications system. For the second program, NLM DIMRC assists BHEPP on reinforcing the Hospital Incident Command System. On January 31st, NLM DIMRC conducted a training exercise at Suburban Hospital to practice HICS using Second Life, a virtual and adaptable world.
"Second Life added pseudo-realism," Robin said. "Although they can't race back and forth on the hospital floor, they can still respond within the application to incidents happening in the virtual hospital."
According to Robin, the trainers used Hurricane Sandy as the basis for the exercise. They used issues that occurred at various hospitals during the hurricane, including electricity loss. Robin noted most of the participants also used their iPhones and iPads during the training.
The training involved an initial preparation of the facilitators along with a briefing for the observers. The participants then received a briefing before the exercise and concluded with an after-action discussion. However, Dr. Altman noted there was an aspect of the training not immediately apparent. The day before the training, the participants had an introduction to the Second Life platform. Altman noted that the experience of the training would have changed if the trainees never received this initial introduction.
The National Center thanks NLM DIMRC and Suburban Hospital for the privilege to observe the training.
"We appreciate the opportunity to be more aware of this type of exercise and how it can be used in the disaster health education and training milieu," Dr. Altman said.
Victor Cid, Senior Computer Scientist at NLM DIMRC will present on the collaboration with BHEPP in further detail in February's Disaster Information Specialist program meeting on Thursday 14th at 1:30 PM. You can join this meeting here.
February 6, 2013
-- SAMHSA releases education resources for disaster behavioral response programs --
In the wake of a disaster, survivors may feel overwhelmed for many reasons, whether because they are temporarily displaced or have lost loved ones. Coping with the immediate aftermath might cause anxiety, especially for survivors of previous trauma and those with pre-existing conditions. This stress affects the recovery of a community in the long term, which highlights the importance of mitigating the effects during and after a disaster. Whether Federal or community-based, organizations in the field face substantial challenges when addressing behavioral health issues in a recovering community.
The Substance Abuse and Mental Health Services Administration, the creators of the Disaster Distress Helpline, recently released the Disaster Response Template Toolkit. This compilation of resources includes a variety of customizable multimedia materials (brochures, flyers, tip sheets, wallet cards, post cards, and audio). These materials aim to strengthen a disaster response or behavioral health program. SAMHSA emphasizes the importance of avoiding complicated or technical language and encourages programs to stick to a short, concise message when communicating with survivors. Each resource comes with an example from the field to assist programs in customizing the templates.
SAMHSA also provides advice on creating blogs, websites, public service announcements and using social networks for community outreach. SAMHSA highlights RI HOPE and Project Iowa as models of effective Facebook pages that focus on long-term behavioral health recovery. For Public Service Announcements, SAMHSA recommends plain language tailored to the community along with the contact information for your organization. A valuable tool when creating these messages is SAMHSA's Languages Other Than English resource, which can assist programs that work in multi-lingual communities.
The National Center for Disaster Medicine and Public Health commends SAMHSA for creating this dynamic list of resources. NCDMPH also extends their gratitude towards all organizations dedicated to the long-term recovery of post-disaster communities. To learn more about behavioral health and disasters, visit SAMHSA's webpage dedicated to disaster response.
January 28, 2013
-- Organizations dedicated to teaching children about disaster preparedness --
The National Center for Disaster Medicine and Public Health recently released "Tracking and Reunification of Children in Disasters: A Lesson and Reference for Health Professionals." This learning object focuses on reuniting an unaccompanied child in a disaster. Children and adolescents are a vulnerable population with specific needs in an all-hazards event, which is why NCDMPH and other organizations produce training materials focusing on their needs. These resources are typically aimed at disaster health workers responding to children, versus resources targeted for an adolescent audience.
Plan International and FEMA's Ready Kids programs address this gap by engaging with children and adolescents directly in their materials. FEMA and Plan International take different approaches, both in terms of content and audience. Each organization creates child-accessible teaching documents that cover basic and complex principles of disaster preparedness. By teaching children disaster preparedness concepts early and directly, FEMA and Plan International strengthen the resiliency of domestic and international youth.
Plan International, an organization dedicated to the human rights of children, adapted Intergovernmental Panel on Climate Change's Special Report: Managing the Risks of Extreme Events and Disasters to Advance Climate Change Adaption for a youth audience. The resulting "Climate Extreme: How Young People Can Respond to Disasters in a Changing World" covers the basics of climate change, its relation to natural disaster, and disaster planning. Each section begins with an outline of content and a list of topic words with definition. The report does not shy away from weightier topics, like gender disparity in disaster, community vulnerability and climate change related causalities. Although aimed for children in developing countries, the documents content is applicable to a general population.
FEMA's Ready Kids' activity book discusses the basics of disaster planning, such as assembling an emergency kit or packing a bag in case of evacuation. Laid out in a comic book format, the activity book introduces readers to Rex, the Ready Kids mountain lion mascot, to learn about disaster preparedness. Between each section introducing a new preparedness topic are coloring pages and a crossword puzzle.
As an organization interested in the special needs of all ages and populations, the National Center commends the efforts of FEMA and Plan International. By familiarizing children with climate change and disaster planning, these organizations contribute to a global culture of preparedness.
January 15, 2013
-- 2012-2013 flu strain at epidemic levels --
The 2012-2013 flu season has hit the United States remarkably hard this winter, with elevated levels of influenza arriving a month earlier than usual. On January 11, 2013 the Centers for Disease Control declared the current flu season an epidemic, emphasizing all individuals 6 months of age and older to get vaccinated. New York state and Boston, MA declared public health emergencies within several days of each other and 42/50 states have reported cases of the flu. Sadly, at least 20 child deaths have been reported this season.
There are simple preventive measures that can decelerate the spread of flu. The most effective method of preventing infection or reducing flu symptoms is getting the flu vaccine. The CDC recently reported that the estimated flu vaccine effectiveness (VE) for the current vaccine is 62%. But even a moderate effectiveness can reduce flu symptoms, time lost from work, and use of antibiotic treatments. Some pharmacies may be running low on their supply, but HealthMap Vaccine Finder can assist you in finding a vaccine near you. It takes an estimated two weeks for the vaccine to be effective.
In addition to receiving the vaccines, there are other ways to prevent infection. Frequent hand washing, keeping your hands away from your mouth, and avoiding people who show symptoms of the flu are effective. Symptoms can include: fever, sore throat, aches, fatigue, and muscle soreness. If you have a fever, avoid going to work or school for at least 24 hours or until the fever breaks.
Hospitals are seeing an increase in patients with the flu. Massachusetts General Hospital sees 40-80 patients with flu-like symptoms daily and Children's Hospital and Clinics of Minnesota opened a 12-bed unit for patients with respiratory illness. The CDC developed an influenza app for healthcare professionals which has the latest recommendations and updates.
The National Center recognizes the extra stress a flu epidemic places on our public health workforce and facilities and thanks them for their continued hard work in treating the Nation's ill. We will be keeping track of all the latest flu coverage on Twitter @NCDMPH.
January 8, 2013
-- Do 1 Thing launches free program to increase disaster preparedness and community resiliency --
Do 1 Thing, a non-profit dedicated to building strong communities recently launched an online program to increase individual's disaster preparedness skills and familiarity with local emergency resources. Run by a variety of different professionals, Do 1 Thing's program is designed to gradually increase community resiliency through individual action.
The online program introduces preparedness concepts gradually instead of overwhelming an individual with a long list of complicated tasks. Rather, each month the program provides a new preparedness tip that is applicable for a broad audience.
Taking part in the program is simple. A potential user visits do1thing.com and signs up to receive reminders about their monthly tasks. Each of the 12 Things comes with a list of three sub-tasks, fact sheets and a short video that describes or highlights the task for that month. The sub-tasks include comment boxes where a user can enter details about what they did to accomplish the task. These comments are then saved for the user's use in the future.
Do 1 Thing's approach is based on research from some of its creative founders, Ronda Oberlin, Erika Mahoney and Rachelle Wood. Their research discovered that people generally find the process of emergency preparedness daunting due to the number of steps involved. Instead of processing multiple tasks at once, individuals end up not preparing at all. Do 1 Thing allows individuals to approach each topic at their own pace since each month's content is already on the website.
The National Center for Disaster Medicine and Public Health is encouraged to see innovative approaches to improving community preparedness and resiliency. We look forward to more inventive programs from Do 1 Thing.
January 2, 2013
-- Ready or Not? Trust for America's Health releases emergency preparedness report --
In December, Trust for America's Health, with support from the Robert Wood Johnson Foundation, released Ready or Not? Protecting the Public from Disease, Disasters, and Bioterrorism . This annual report analyzes the Nation's gaps and achievements in public health emergency preparedness. The report also provides policy makers information on how public health preparedness programs enact policy and spend tax dollars. Ready or Not? concludes with recommendations for strengthening public health preparedness in 2013 and beyond.
The report largely focuses on the level of preparedness in all 50 states and the District of Columbia. TFAH approached this analysis by creating 10 indicators addressing various preparedness concerns and a range of all-hazards events. The report assigns annual ratings to each state based on their achievement of an indicator. The highest score achieved by any state was 8 (Maryland, Mississippi, North Carolina, Vermont, Wisconsin) and the lowest score was 3 (Kansas, Montana).
Ready or Not? revealed multiple notable findings through their state-by-state analysis. A few of those findings include:
TFAH's report provides a timely and relevant picture in the wake of several all-hazards events that challenged the Nation's disaster preparedness and response. Released after the devastation of Hurricane Sandy, the report contains a section on public health risks post-Hurricane and the response to the damage. Other 2012 events covered include the tuberculosis, West Nile, and fungal meningitis outbreaks
Ready or Not includes several key recommendations for improving national preparedness, such as "Improving Community Resilience: Helping Communities Cope and Recover by Setting Up Better Ongoing Support." This recommendation emphasizes that community resilience is "inextricably linked to the underlying health of that community and the basic, ongoing capabilities of that community's public health department or region." TFAH urges federal agencies involved with emergency response to prioritize strengthening community resilience. According to the report, building and refining relationships between public health departments and local communities is one method of heightening community resilience.
The National Center for Disaster Medicine and Public Health applauds TFAH for their consequential document and hopes Ready or Not? contributes to a more resilient 2013.