Intergovernmental finance and the bioterrorism program: Is federal funding enough to create local health department activity?

Emergency preparedness has been at the forefront of local and state health department agendas since the emergence of West Nile in 1999 and the events of surrounding September 11, 2001. The Centers for Disease Control and Prevention has made a concerted effort in supporting local health department’s preparedness efforts with both funding and guidance. Without funding many local health departments are unable to adequately prepare their agency and surrounding community for a possible attack. Using the 1997, 2005, and 2008 National Association of County and City Health Officials Profiles we studied the effect of emergency preparedness leadership on preparedness activity, emergency preparedness leadership on bioterrorism preparedness funding, and emergency preparedness funding on leadership. Results indicate that the employment of an emergency preparedness coordinator is directly and positively related to emergency preparedness activity scores. Agencies employing an emergency preparedness coordinator are more likely to engage in numerous activities throughout the year to ensure that their department is prepared to handle such an event. Secondly, it was found that agencies with an emergency preparedness coordinator are more likely to attain greater funds in future years. Results indicate that having an emergency preparedness coordinator does not influence current emergency preparedness funding. Finally, although our results indicate that preparedness funds do not influence the employment of an emergency preparedness coordinator, we are unable to confirm the validity of this result as confounding factors are likely to have affected our findings