In May 2015, with support from the Center for Disease Control (CDC), NACCHO developed and distributed the first annual Preparedness Profile assessment to local health departments (LHDs). Amidst continuous cuts to preparedness funding, NACCHO has interviewed members who have anecdotally reported that decreases in funding have led to decreases in staffing, trainings, exercises, travel and supplies. This assessment sought to gather information about preparedness trends and emerging issues at the local level. Findings from this assessment provide a better understanding of the overall state of personnel and practices at LHDs that could have implications for preparedness programs. Furthermore, results from this assessment can help to inform preparedness priorities at the national level and influence NACCHO’s preparedness activities.

The Preparedness Profile assessment was distributed to a statistically representative sample of 730 preparedness coordinators. Preparedness coordinators are individuals previously identified by LHDs as having a primary or significant responsibility for leading or coordinating an LHD’s disaster/emergency preparedness planning and response activities.

The survey was distributed online via Qualtrics Survey Software and stratified by jurisdiction population size. Large LHDs (population 500,000+) were oversampled, and results were weighted to adjust for both oversampling and non-response. Preparedness coordinators were asked to respond to 24 close- and open-ended questions ranging from topics around preparedness staffing, training, partnerships, activities, and hazards and emerging threats. Assessment questions were developed by NACCHO based on feedback from LHD preparedness workgroups, the Assistant Secretary for Preparedness and Response (ASPR), and the CDC. A total of 345 preparedness coordinators completed the survey for a response rate of 47%. It should be noted that because of the sampling methodology, these results are only representative of LHDs with a designated preparedness coordinator.

Key highlights from this assessment include:

• Regardless of jurisdiction size, over a quarter of preparedness coordinators have spent a total of five years or less in this role
• Over half of the preparedness coordinators within large jurisdictions spend all of their time on job duties related to preparedness, while 60% of preparedness coordinators in smaller jurisdictions spend less than half their time on preparedness related duties
• Nearly a quarter of LHDs have reported a decrease in staffing over the last two years; large LHDs have seen the most decrease (36%)
• Most LHDs engage volunteer groups (e.g., Medical Reserve Corps [MRC] and other) in preparedness activities such as community preparedness, training, exercises/drills, and incident response
• Most LHDs (75%) reported being a member of a regional healthcare coalition and participation was similar across jurisdiction size
• Most LHDs reported their activities increased or stayed the same on topics related to the PHEP capabilities (e.g., surveillance, emergency information and public warning, MCM dispensing)

LHDs reported the largest decreases in activities related to volunteer management and responder equipment maintenance.

Findings from this report provide a foundation for future public health initiatives. This annual assessment represents a significant contribution by preparedness coordinators to the knowledge base of local public health preparedness. Through this research, NACCHO will continue to educate, advocate, and promote the work of LHDs towards ensuring the health, safety and resilience of their communities.

View the full report and check out the supplemental infographic.