|Resham Patel, MPH, Program Analyst, Public Health Preparedness, NACCHO and Bill Belknap, Public Information Officer, Hennepin County Public Health|
The Hollywood sensation, Contagion, may have delivered some fundamental public health messaging within its two hours of fear-laced entertainment; however, in many ways the film missed the opportunity to acknowledge the pivotal roles played by state and local health departments (LHDs) in real-life disease outbreaks and other emergencies.
Although the Centers for Disease Control and Prevention (CDC) was fairly accurately portrayed as playing a critical role in leading the epidemiological investigation in Contagion, it seems that the rest of the public health community was misrepresented. While much of the movie’s action was set in the Minneapolis/St. Paul metropolitan area, the state health department’s outbreak response was shown as simplistic—and local public health was absent. This was more than just a missed opportunity to show the essential role all LHDs play in public health preparedness and response—this was a missed opportunity to feature a highly recognized agency: Hennepin County’s Human Services and Public Health Department (HSPHD), the largest LHD in the seven county Minneapolis-St. Paul metropolitan area and the state of Minnesota.
The 2010 National Health Security Strategy emphasizes that government agencies and their non-governmental partners, at all levels, are essential to effective public health response. NACCHO’s Project Public Health Ready (PPHR) Program, a competency-based training and recognition program that assesses preparedness and assists LHDs to respond to emergencies, supports achievement of this strategy by helping to build local public health preparedness capacity and capability through a continuous quality improvement model.
Hennepin HSPHD attained PPHR recognition in 2005 and re-recognition in 2010. It was also the lead agency of one of NACCHO’s first Advanced Practice Centers (APC)—one that developed a variety of innovative environmental health emergency preparedness training materials now available to LHDs nationwide. In 2009, Hennepin HSPHD was chosen to serve as one of 19 local Public Health Accreditation Board (PHAB) beta test sites; in 2012, it will begin the official PHAB process.
“These kinds of recognition and accreditation can motivate and measure our emergency preparedness progress, but they’re certainly not our focus,” says Susan Palchick, PhD., manager of HSPHD’s Public Health Protection Group. “In the end, the only measure that really matters is how well we respond when real emergencies happen.”
Hennepin HSPHD employs approximately 2,800 public health and diversified human services professionals. Today, after almost a decade of planning and training, the vast majority of these folks now stand ready to be mobilized in coordinated response roles when public health emergencies happen in Hennepin County. A core group of about 20 public health emergency preparedness professionals support these ongoing efforts for the department.
Thanks to these preparedness efforts, when measles broke out among homeless and other under-vaccinated populations in Minneapolis this past spring, Hennepin HSPHD was ready to lead a case contact investigation and outbreak mitigation spanning four months, that limited the outbreak to just 23 confirmed cases. Mitigation tactics included targeted mass immunizations of those most at-risk and isolation and quarantine of those ill or exposed to measles. The response fully engaged HSPHD’s epidemiology, healthcare for the homeless, immunization services, incident management, and public information staff, supported by case specimen testing at the Minnesota Department of Health laboratory and close coordination with local hospitals that treated case patients.
Similarly, when a tornado tore through Minneapolis late this summer, HSPHD played a key role in supporting the city of Minneapolis and its efforts to coordinate essential human services for thousands of residents displaced from their homes. Four years ago, when the Minneapolis I-35W bridge collapsed into the Mississippi River, HSPHD helped coordinate and staff an information and counseling center for victims’ family members. A year earlier, when polio cases surfaced among recently resettled East African refugees, HSPHD rapidly organized and operated a mass immunization and case contact investigation effort that kept the disease from spreading.
“These and other real-life responses are just a sample of the vital roles that state and local health departments play in responding to public health emergencies in communities, nationwide, all the time,” notes Palchick. “We might all be preparing for the ‘big one,’ but we’re proving and improving our preparedness with ‘small ones’ in the meantime.”
Contagion has put the spotlight on the importance of public health preparedness in the safety and well-being of our global community. Now, it is up to preparedness colleagues nationwide to take the next step and highlight the significant role that we all—local, state, federal, and non-governmental partners— perform in achieving our common purpose: to prevent, prepare for, respond to, and recover from public health emergencies.