Disasters have the potential for negative long-lasting repercussions on the environment and environmental health services (e.g., food, water, shelter, sanitation and hygiene, and vector control) of affected areas (Miller, 2006; World Health Organization, 2011). Partnerships among local public environmental health (EH), emergency preparedness and response (EPR) programs, and the communities they serve have great potential to build community environmental health emergency preparedness (EHEP) capacity because of the expertise of the first two groups in protecting the public's health from harmful elements in the environment (Berg, 2004; Elderidge & Tenkate, 2006; Forsting, 2004; Miller, 2006) and their ability to coordinate efforts with first responders during response activities (Dyjack, Case, Marlow, Soret, & Montgomery, 2007; Miller, 2006). Our study goal was to explore the capacity of EH and EPR programs to facilitate participatory relationships between themselves and with the community members they serve and to assess past levels of community emergency preparedness outreach (Abbot, 2002; Berg, 2004; Blessman et al., 2007; Elderidge & Tenkate, 2006; Miller, 2006). We posit that this is best done using community-based participatory research (CBPR) methodologies to foster the reciprocal transfer of knowledge and skills that may lead to system-wide disaster resilience (National Academy of Sciences, 2010).
Public Health Emergency Preparedness--It Is Everyone's Responsibility
Traditionally, public health departments and agencies are responsible for protecting the food supply, safeguarding against infectious diseases, and ensuring safe and healthful living conditions (American Public Health Association, National Center for Environmental Health, & Centers for Disease Control and Prevention [CDC], 2001; CDC Foundation, 2001; Goldman & Coussens, 2007). In response to domestic incidents such as the 9/11 terrorist attacks and subsequent anthrax attacks, Congress enacted the 2002 Public Health Security and Bioterrorism Act, thereby clearly articulating the role of public health in emergency and disaster preparedness (Brand, Kerby, Elledge, Johnson, & Magas, 2006; Gebbie & Qureshi, 2002; Qureshi et al., 2004). The act authorized funding for the Public Health Emergency Preparedness (PHEP) cooperative agreement to support preparedness nationwide in state, local, tribal, and territorial public health departments. The intent was to build the capacity and capability of public health departments to effectively respond to the public health consequences of terrorist threats; infectious disease outbreaks; natural disasters; and biological, chemical, nuclear, and radiological emergencies (CDC, 2011a; Field Costich & Scutchfield, 2004).
More than a decade later our nation has recovered from the events of 2001, and public health systems are stronger, but as citizens we continue to experience sudden natural and human-made disasters. Lessons learned from notable domestic and international disaster situations emphasize the urgent need to be prepared to prevent, respond to, and rapidly recover from constant public health threats. While responsibility begins at the local level, public health preparedness requires a concerted effort, involving every level of government, the private sector, nongovernmental organizations, and individuals. Responsibility for the preparedness of the nation's communities lies not only with governmental agencies but also with active, engaged, and mobilized community residents, businesses, and nongovernmental organizations (Goldman & Coussens, 2007; Henestra, Kovacs, McBean, & Sweeting, 2004). Nelson and co-authors (2007) define public health preparedness as
[T]he capability of the public health and health-care systems, communities, and individuals to prevent, protect against, quickly respond to, and recover from health …