Study calls for public health preparedness standards

The federal government should implement clear national standards for public health preparedness, according to a report released Thursday by the Century Foundation's Working Group on Bioterrorism Preparedness.

The report, Breathing Easier?, called on the federal government to establish "a baseline set of performance goals and measures." The Century Foundation conducts public policy research and analyses.

In recent years, public health advocates have been calling for more direction and leadership from the federal government, despite a massive jump in congressional funding for biological defense programs after the 9/11 terrorist attacks.

Local public health departments are using the funding in different ways, and the ability to detect and handle a biological attack varies greatly across the country. In December, the Trust for America's Health concluded that the country is still unprepared to handle a biological terrorism attack.

The Century Foundation report did not find that the nation's biological defenses are severely lacking-but it did warn that the government risks wasting scarce resources if funding is not matched by stringent standards.

"Without such goals and defined standards, there is no assurance that the federal money is well spent and a basic level of preparedness for all communities is achieved," the report found. Members of the working group also cited "a real lack of standards and leadership coming from the feds" and a dispersal of responsibility for setting standards.

"We don't know what constitutes real preparedness," said Leif Haase, a Century Foundation fellow and the report's author, at a luncheon Thursday in Washington.

Ed Thompson, the chief of Public Health Practice at the Centers for Disease Control and Prevention in Atlanta, said the nation's public health system had made great strides since 2001. He acknowledged, however, that a better system of national standards would help federal officials determine how money should be allocated. He cited the need for clear, measurable benchmarks that allow public health officials to "determine, objectively, whether we are meeting them or not."

Georges Benjamin, executive director of the American Public Health Association, said there is a huge disparity in the ability, size and focus of public health departments across the country. He said that some have only two staff members, while others have large departments to handle biological defense preparation.

"If you've seen one public health department, then you've seen one public health department," Benjamin said. He said federal officials need to "figure out some of the fundamental capabilities you need to have in a public health department."