Assessing Public Health Preparedness in Alberta Using a Systems-Level Approach
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Recent international and national events such as the SARS outbreak in 2002–2003, the rising incidence of West Nile Virus, and the increasing threat of a pandemic influenza outbreak have brought critical attention to the Canadian public health system and how prepared the system is to respond to various types of contemporary public health threats. The effective coordination of all agencies at metropolitan, regional, provincial, and federal levels is essential to the management of public health emergencies. The level of inter-organizational coordination and preparedness of public health and emergency preparedness organizations throughout Alberta was investigated. An online organizational questionnaire provided a census of organizations involved in public health preparedness, and information on the structure of inter-organizational relations in Alberta and the state of public health preparedness from the perspective of organizational members. The primary goal was to use the information provided by individual agencies to help improve how policymakers and public health and emergency management officials plan and organize for public health threats and emergencies. Major findings are as follows: i) organizational characteristics including organizational training opportunities, size, and jurisdiction are associated with different dimensions of organizational-level preparedness in Alberta, ii) perceived organizational connectivity serves as a proxy measure of formal ties objectively reported by organizations with respect to pandemic influenza preparedness, iii) higher jurisdictional organizations display greater degrees of interconnectedness on average, and iv) organizational connectivity moderates the association of perceived public health preparedness with an organization’s objective level of preparedness, independent of jurisdictional level. The true test of public health preparedness is in how the system responds to an actual crisis. Since public health emergencies are rare, there is an absence of province-wide data in this regard; however, this work has measured organizational-level perceptions of public health preparedness as a proxy for actual preparedness. It is critical that organizations have a written emergency response plan which is tested in practice through exercises or in a real situation to observe jurisdictional and organizational ability to execute an appropriate response and assess communication and resource flow among organizations.