Managing Disasters at the County Level: A Focus on Public Health

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Healthcare professionals in hazmat suits practice decontaminating a simulated patient inside a training tent.

In order to remain healthy, vibrant and safe, America’s counties must continue to strengthen their resiliency by building leadership capacity to better identify and manage risk. In 2017, there were 16 disaster events across the U.S. that resulted in losses exceeding $1 billion, including: 8 severe storms, 3 tropical cyclones, 2 floods, an extreme drought, a freeze and a major wildfire. In total, these events resulted in significant fatalities and economic losses: 362 people died, double the disaster-related death toll from last year; and over $306 billion in total damage was caused, $265 billion of which is attributed to Hurricanes Harvey, Irma and Maria. In total, 813 counties were declared major disasters at least once by the federal government in 2017.

Disasters like these have a profound impact on the long-term public health of a community. It is critically important for county health departments to coordinate closely with their local offices of emergency management, as well as federal and state partners, to develop emergency and recovery plans that ensure the delivery of public health and medical services during a disaster. There are numerous factors for which county public health departments should plan, including but not limited to: lack of access to local hospitals; hospital and other first responder staff working overtime and/or unable to make it into work; lost or destroyed medications; food and pharmaceutical shortages; water and/or sewage treatment plants losing power or discharging untreated sewage; and the acute vulnerability of certain residents. Low income, disabled, elderly, immigrant, and chronically ill populations tend to be most adversely affected in disaster situations. They are typically the most impacted when access to critical treatment (dialysis, breathing machines, etc.) is lost, the most stressed during evacuation and temporary relocation, and most underprepared due lack of resources (insurance, mobility, alternative shelter, etc.). It is important for counties to understand those compounding effects.

During the disaster recovery process, counties should prioritize managing basic health and safety concerns. In the short term, the most pressing concerns for county health departments are the prevention of potential injury and mortality due to a range of challenges, including: antibiotic resistant staph infections; flesh-eating bacteria; infection due to exposure to raw sewage or contaminated water; exposure to mold and mildew; increased mosquitos; and respiratory infections. In the long term, the major concern is to ensure the positive mental health of residents. Disasters and their associated aftereffects often lead to greater prevalence of post-traumatic stress disorder, higher risk of alcohol and substance use and depression due to the loss of life and property and the challenge of coping with injuries sustained during the event.

This publication serves as a best practices guide for county leaders to better understand the intersections of public health protection and emergency management. The case studies included within spotlight counties whose public health departments have both taken a proactive approach to emergency management and have dealt with a high volume of disaster declarations over the past decade.


Read the full publication on NACo’s website at the link below:

 Managing Disasters at the County Level: A Focus on Public Health

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