Investment, managerial capacity, and bias in public health preparedness

Authors

  • James R. Langabeer II, MBA, EdD
  • Jami L. DelliFraine, MHA, PhD
  • Sandra Tyson, MA
  • Jamie M. Emert, BS
  • John Herbold, MPH, DVM, PhD

DOI:

https://doi.org/10.5055/ajdm.2009.0032

Keywords:

public health preparedness, managerial capacity, bioterrorism, investment

Abstract

Objective: Nearly $7 billion has been invested through national cooperative funding since 2002 to strengthen state and local response capacity. Yet, very little outcome evidence exists to analyze funding effectiveness. The objective of this research is to analyze the relationship between investment (funding) and capacity (readiness) for public health preparedness (PHP). The aim of the authors is to use a management framework to evaluate capacity, and to explore the “immediacy bias” impact on investment stability.
Design: This study employs a longitudinal study design, incorporating survey research of the entire population of 68 health departments in the state ofTexas.
Methods: The authors assessed the investment– capacity relationship through several statistical methods. The authors created a structural measure of managerial capacity through principal components analysis, factorizing 10 independent variables and augment this with a perceived readiness level reported from PHP managers. The authors then employ analysis of variance, correlation analyses, and other descriptive statistics.
Results: There has been a 539 percent coefficient of variation in funding at the local level between the years 2004 and 2008, and a 63 percent reduction in total resources since the peak of funding, using paired sample data. Results suggest that investment is positively associated with readiness and managerial capacity in local health departments. The authors also find that investment was related to greater community collaboration, higher adoption of Incident Command System (ICS) structure, and more frequent operational drills and exercises.
Conclusions: Greater investment is associated with higher levels of capacity and readiness. The authors conclude from this that investment should be stabilized and continued, and not be influenced by historical cognitive biases.

Author Biographies

James R. Langabeer II, MBA, EdD

Associate Professor of Management, Center for Biosecurity and Public Health Preparedness, University of Texas School of Public Health (UTSPH), Houston, Texas.

Jami L. DelliFraine, MHA, PhD

Assistant Professor of Management, Center for Biosecurity and Public Health Preparedness, University of Texas School of Public Health (UTSPH), Houston, Texas.

Sandra Tyson, MA

Program Manager, Center for Biosecurity and Public Health Preparedness, University of Texas School of Public Health (UTSPH), Houston, Texas.

Jamie M. Emert, BS

Graduate Assistant, Center for Biosecurity and Public Health Preparedness, University of Texas School of Public Health (UTSPH), Houston, Texas.

John Herbold, MPH, DVM, PhD

Director, Center for Biosecurity and Public Health Preparedness, University of Texas School of Public Health (UTSPH), Houston, Texas.

References

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Published

07/01/2009

How to Cite

Langabeer II, MBA, EdD, J. R., J. L. DelliFraine, MHA, PhD, S. Tyson, MA, J. M. Emert, BS, and J. Herbold, MPH, DVM, PhD. “Investment, Managerial Capacity, and Bias in Public Health Preparedness”. American Journal of Disaster Medicine, vol. 4, no. 4, July 2009, pp. 207-15, doi:10.5055/ajdm.2009.0032.

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Section

Articles