Rachel Nonkin Avchen

Impact of Postcensal Versus Intercensal Population Estimates on Prevalence of Selected Developmental Disabilities—Metropolitan Atlanta, Georgia, 1991–1996

Prevalence estimates often use U.S. Census Bureau estimates of the population as denominator data. Postcensal estimates are population estimates produced following a decennial census. Intercensal estimates are surrounded by 2 census years and supersede postcensal estimates. In this report we describe prevalence estimates in Atlanta for mental retardation, cerebral palsy, and hearing and vision loss for 8 year olds from 1991-1994 and 1996. We used calculations of postcensal and intercensal population estimates. Intercensal population data were consistently higher than postcensal data, and prevalence estimates for developmental disabilities were lower using intercensal population data. This discrepancy varied by race and ethnicity. Comparison of population estimates, particularly at state and local levels, should be considered to assess meaningful differences in published prevalence estimates using intercensal data.

Monitoring of Persons with Risk for Exposure to Ebola Virus - United States, November 3, 2014-December 27, 2015.

During November 3, 2014-December 27, 2015, CDC implemented guidance on movement and monitoring of persons in the United States with potential exposure to Ebola virus (Ebola) (1). Monitoring was concluded in December 2015. After CDC modified the guidance for monitoring travelers from Guinea (the last country for which monitoring of travelers was recommended) in late December 2015, jurisdictional reports were no longer collected by CDC. This report documents the number of persons monitored as part of the effort to isolate, test, and, if necessary, treat symptomatic travelers and other persons in the United States who had risk for exposure to Ebola during the period the guidance was in effect. Sixty jurisdictions, including all 50 states, two local jurisdictions, and eight territories and freely associated states, reported a total of 29,789 persons monitored, with >99% completing 21-day monitoring with no loss to follow-up exceeding 48 hours. No confirmed cases of imported Ebola were reported once monitoring was initiated. This landmark public health response demonstrates the robust infrastructure and sustained monitoring capacity of local, state, and territorial health authorities in the United States as a part of a response to an international public health emergency.

Progress in Public Health Emergency Preparedness—United States, 2001–2016

Objectives To evaluate the Public Health Emergency Preparedness (PHEP) programs progress toward meeting public health preparedness capability standards in state, local, and territorial health departments. Methods All 62 PHEP awardees completed the Centers for Disease Control and Preventions self-administered PHEP Impact Assessment as part of program review measuring public health preparedness capability before September 11, 2001 (9/11), and in 2014. We collected additional self-reported capability self-assessments from 2016. We analyzed trends in congressional funding for public health preparedness from 2001 to 2016. Results Before 9/11, most PHEP awardees reported limited preparedness capabilities, but considerable progress was reported by 2016. The number of jurisdictions reporting established capability functions within the countermeasures and mitigation domain had the largest increase, almost 200%, by 2014. However, more than 20% of jurisdictions still reported underdeveloped coordination between the health system and public health agencies in 2016. Challenges and barriers to building PHEP capabilities included lack of trained personnel, plans, and sustained resources. Conclusions Considerable progress in public health preparedness capability was observed from before 9/11 to 2016. Support, sustainment, and advancement of public health preparedness capability is critical to ensure a strong public health infrastructure.

Improvements in State and Local Planning for Mass Dispensing of Medical Countermeasures: The Technical Assistance Review Program, United States, 2007–2014

Objectives To evaluate and describe outcomes of state and local medical countermeasure preparedness planning, which is critical to ensure rapid distribution and dispensing of a broad spectrum of life-saving medical assets during a public health emergency. Methods We used 2007 to 2014 state and local data collected from the Centers for Disease Control and Preventions Technical Assistance Review. We calculated descriptive statistics from 50 states and 72 local Cities Readiness Initiative jurisdictions that participated in the Technical Assistance Review annually. Results From 2007 to 2014, the average overall Technical Assistance Review score increased by 13% for states and 41% for Cities Readiness Initiative jurisdictions. In 2014, nearly half of states achieved the maximum possible overall score (100), and 94% of local Cities Readiness Initiative jurisdictions achieved a score of 90 or more. Conclusions Despite challenges, effective and timely medical countermeasure distribution and dispensing is possible with appropriate planning, staff, and resources. However, vigilance in training, exercising, and improving plans from lessons learned in a sustained, coordinated way is critical to ensure continued public health preparedness success.

From Anthrax to Zika: Fifteen Years of Public Health Emergency Preparedness

An introduction is presented in which the authors discuss various reports within the journal on topics including public health emergency preparedness in the twenty-first century, competencies in biosurveillance, and funding from the U.S. Centers for Disease Control and Prevention.

Performance of Point of Dispensing Setup Drills for Distribution of Medical Countermeasures: United States and Territories, 2012–2016

Objectives To describe results of points of dispensing (POD) medical countermeasure drill performance among local jurisdictions. Methods To compare POD setup times for each year, we calculated descriptive statistics of annual jurisdictional POD setup data submitted by over 400 local jurisdictions across 50 states and 8 US territories to a Centers for Disease Control and Prevention (CDC) program monitoring database from July 2012 to June 2016. Results In data collected from July 2012 to June 2015, fewer than 5% of PODs required more than 240 minutes to set up, although the proportion increased from July 2015 to June 2016 to almost 12%. From July 2012 to June 2016, more than 60% of PODs were set up in less than 90 minutes, with 60 minutes as the median setup time during the period. Conclusions Our results yield evidence of national progress for response to a mass medical emergency. Technical assistance may be required to aid certain jurisdictions for improvement. Public Health Implications The results of this study may inform future target times for performance on POD setup activities and highlight jurisdictions in need of technical assistance.

Public Health Emergencies: Unpacking Medical Countermeasures Management for Preparedness and Response Introduction and Contents of the Volume

An introduction is presented in which the authors discuss various reports within the journal on topics including the distribution and dispensing of medical countermeasures in American public health emergencies, the U.S. Strategic National Stockpile, and just-in-time training for medical personnel.

Medical Countermeasures: Mission, Method, and Management

An introduction is presented in which the authors discuss various reports within the journal on topics including best practices and innovation in the provision of medical countermeasures (MCMs) for large-scale public health emergencies, influenza pandemic treatments, and health care coalitions.

Evolution of Public Health Emergency Management From Preparedness to Response and Recovery: Introduction and Contents of the Volume

An introduction is presented in which the authors discuss various reports within the issue on topics including public health and emergency preparedness programs in the wake of the September 11, 2001 terrorist attacks in America, biosurveillance, and disaster-related community resilience.

Public Health Impact: Metropolitan Atlanta Developmental Disabilities Surveillance Program**

Publisher Summary This chapter describes the establishment and ongoing implementation of Metropolitan Atlanta Developmental Disabilities Study (MADDS) and Metropolitan Atlanta Developmental Disabilities Surveillance Program (MADDSP) that are used a public health framework for understanding developmental disabilities. To providing ongoing estimates of prevalence that are useful for policy, prevention, and intervention planning, MADDSP facilitates epidemiologic studies to investigate risk and other factors associated with developmental disabilities. The chapter demonstrates the utility of MADDS and MADDSP data to address important public health issues. Such activities help in identifying gaps and help develop future research and policy priorities.