Health communications ailing

County, city and metropolitan health departments, normally at the forefront of providing information about emerging health issues to the public, may lack effective plans and communications to deal with bioterrorism, according to findings by a national public health association.

Only about 20 percent of local public health agencies said they have a comprehensive strategy in place regarding emergency preparedness and bioterrorism, according to the results of a recent survey conducted by the National Association of County and City Health Officials (NACCHO), which serves the 3,000 or so local health departments nationwide. Another 56 percent of local agencies said response plans were being developed, and 24 percent said they didn't have one.

According to the findings, many agencies cited failure of communication tools such as pagers, cell phones, e-mail and faxes, as well as lack of or poor communication from state and federal agencies, in the aftermath of the Sept. 11 attacks.

Tom Milne, NACCHO's executive director, said that part of the problem stemmed from the phone service outages and overloaded communications circuits along the East Coast. This, he said, affected agencies from other states that were trying to communicate with, for example, the Centers for Disease Control and Prevention in Atlanta.

He also said that information passed from the federal government to the states was not, in a few cases, trickling down to local agencies. But he said "that's been fixed."

However, Milne added that a substantial number of local health agencies do not have the hardware and software to adequately communicate with other governments or receive information in a timely manner. About 10 percent — or 300 departments — do not have e-mail, and he estimated that about 40 percent lack high-speed Internet access "to gain access to important Web sites with important information for breaking news.

"I don't think we're ill-prepared. I think we're underprepared," said Milne, who added that 70 percent of local agencies serve populations of 50,000 or fewer people.

One solution is the Health Alert Network, a CDC initiative to develop a nationwide system for communications and information access as well as a distance-learning education tool. Milne said all 50 states have received some funding for improved Internet access and health alert broadcast capacity through the program, which just ended its second year.

Milne said there is a concerted national effort to secure substantial funds to build up the state and local public health infrastructure and ensure that technical expertise, such as lab work, is addressed and financed properly.

He also said local public health agencies are "well engaged in their community" to develop or boost their emergency preparedness and bioterrorism plans. Since the terrorist attacks, he said NACCHO ( has stepped up its efforts to collect data from health departments and share it with others.


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