Role of Local Public Health in Disaster Recovery: Successes and Challenges after Hurricanes Irene and Sandy

Background: Local public health agencies are the hub of the public health emergency preparedness system. These agencies play a frontline role throughout the disaster life cycle, including the long-term recovery. As disaster health training is not currently a requirement of most degree-granting programs, nor is it consistently provided by local public health agencies, little is known about the capacity of the local public health workforce to lead and participate in disaster recovery activities. Methods: Semi-structured interviews were conducted among leaders in the health and safety sectors in five locations affected by either Hurricane Irene or Superstorm Sandy. Salient themes were identified using a mixed-methods approach of analysis. Results: Local public health agencies are responsible for a wide variety of activities through the response and recovery phases of a major disaster. While many roles were planned for, others were unanticipated and required staff and resources beyond the capacity of the department. The local public health agency workforce is also comprised of professionals with diverse educational backgrounds, but few received training in the core competencies of disaster health. Systematic, bureaucratic, and political obstacles to effective workforce participation in recovery were also uncovered. Conclusion: Locally-led recovery begins with empowered individuals. The successes and challenges uncovered in this study highlight the opportunities for improved training of local public health agency workers in regards to their potential role in the long-term community recovery. It also identifies policy changes that may improve the ability public health practitioners to meaningfully lead in long-term recovery activities.