Strategies for Strengthening the Resilience of Public Health Systems for Pandemics, Disasters, and Other Emergencies

OBJECTIVE

The aim of this study was to identify and prioritize strategies for strengthening public health system resilience for pandemics, disasters, and other emergencies using a scorecard approach.

METHODS

The United Nations Public Health System Resilience Scorecard (Scorecard) was applied across 5 workshops in Slovenia, Turkey, and the United States of America. The workshops focused on participants reviewing and discussing 23 questions/indicators. A Likert type scale was used for scoring with zero being the lowest and 5 the highest. The workshop scores were analyzed and discussed by participants to prioritize areas of need and develop resilience strategies. Data from all workshops were aggregated, analyzed, and interpreted to develop priorities representative of participating locations.

RESULTS

Eight themes emerged representing the need for better integration of public health and disaster management systems. These include: assessing community disease burden; embedding long-term recovery groups in emergency systems; exploring mental health care needs; examining ecosystem risks; evaluating reserve funds; identifying what crisis communication strategies worked well; providing non-medical services; and reviewing resilience of existing facilities, alternate care sites, and institutions.

CONCLUSIONS

The Scorecard is an effective tool for establishing baseline resilience and prioritizing actions. The strategies identified reflect areas in most need for investment to improve public health system resilience.

Objective measurement of personality variables in epidemic neuromyasthenia patients

The psychological symptoms of patients diagnosed as having epidemic neuromyasthenia were investigated using the Minnesota Multiphasic Personality Inventory, the Social Readjustment Rating Scale, the Mehrabian Achieving Tendency Scale for Females, a personal data questionnaire, and a subjective anxiety rating. Twenty-five women with epidemic neuromyasthenia were compared with 25 women who were not ill. Multivariate analysis using the Hotelling T-test on the group data indicated that the patient and non-patient groups differed significantly (P less than 0.001) in respect of psychological characteristics. Stress as a possible predisposing factor in the illness was supported (P less than 0.001). The data do not support the concept of epidemic neuromyasthenia as being 'mass hysteria' as mentioned by McEvedy and Beard, but rather seem to support the suggestion that diagnosis can be made by use of a combination of logical, objective medical and physiological measures. The use of biofeedback as a possible treatment is also proposed.

Bender-Gestalt emotional indicators and acting-out behavior in young children

This study was designed to investigate the relationship between 15 emotional indicators on the Bender-Gestalt Test and acting-out behavior in young children. The subjects were 93 children ranging in age from five to 12 years. Each was administered the Bender. A measure of each subject's overt acting-out behavior was then obtained by having teachers rate each student on a Behavioral Rating Scale. Subjects' records were then divided into groups on the basis of both sex and age. Results indicated that neither the total number of Bender indicators nor any of the individual Bender indicators were correlated significantly with total scores on the rating scale. Use of the Bender as a projective device to measure acting-out behavior was seriously questioned.