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Self-reported Preparedness to Respond to Mass Fatality Incidents in 38 State Health Departments
Jacqueline Merrill1, Qi Zhi, Robyn R Gershon
1Columbia University Medical Center, New York, New York (Dr Merrill); and Department of Biostatistics and Epidemiology (Dr Gershon), Phillip R. Lee Institute for Health Policy Studies (Ms Zhi), University of California, San Francisco California.
Context:
Public health departments play an important role in the preparation and response to mass fatality incidents (MFIs).
Objective:
To describe MFI response capabilities of US state health departments.
Design:
The data are part of a multisector cross-sectional study aimed at 5 sectors that comprise the US mass fatality infrastructure. Data were collected over a 6-week period via a self-administered, anonymous Web-based survey.
Setting:
In 2014, a link to the survey was distributed via e-mail to health departments in 50 states and the District of Columbia.
Participants:
State health department representatives responsible for their state's MFI plans.
Measures:
Preparedness was assessed using 3 newly developed metrics: organizational capabilities (n = 19 items); operational capabilities (n = 19 items); and resource-sharing capabilities (n = 13 items).
Results:
Response rate was 75% (n = 38). Among 38 responses, 37 rated their workplace moderately or well prepared; 45% reported MFI training, but only 30% reported training on MFI with hazardous contaminants; 58% estimated high levels of staff willingness to respond, but that dropped to 40% if MFIs involved hazardous contaminants; and 84% reported a need for more training. On average, 76% of operational capabilities were present. Resource sharing was most prevalent with state Office of Emergency Management but less evident with faith-based organizations and agencies within the medical examiner sector.
Conclusion:
Overall response capability was adequate, with gaps found in capabilities where public health shares responsibility with other sectors. Collaborative training with other sectors is critical to ensure optimal response to future MFIs, but recent funding cuts in public health preparedness may adversely impact this critical preparedness element. In order for the sector to effectively meet its public health MFI responsibilities as delineated in the National Response Framework, resources to support training and other elements of preparedness must be maintained.
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