Report: Rural America Vulnerable to Bioterrorism and Natural Disaster Threats

A new report indicates that inadequate emergency response systems in rural areas need strengthening if they're going to meet public health emergencies such as natural disasters or bioterrorism attacks.

The Harvard School of Public Health Center for Public Health Preparedness, in collaboration with the Maine Department of Health and Human Services, and four other schools of public health, has released its latest independent report highlighting rural preparedness challenges and concerns. The schools are University of Pittsburgh Centers for Rural Health Practice and Public Health Preparedness, Texas A&M University School of Rural Public Health, University of Minnesota and

University of North Carolina School of Public Health.

"Preparing for Public Health Emergencies: Meeting the Challenges in Rural Americ"a presents information and recommendations resulting from a conference that was held in St. Paul, Minn., Sept. 27 - 28, 2004. The session brought together more than 80 public health preparedness leaders from multiple states to identify important yet unique barriers facing rural public health preparedness and the strategies to overcome those barriers.

The report presents recommendations based on the unique preparedness concerns facing rural America. Specifically:

  • Contrary to the opinion of many, rural America is indeed vulnerable to bioterrorism and other serious public health emergency threats such as storms and other natural disasters, and must be adequately prepared to protect its citizens;
  • Public health and health care systems in rural America need to be strengthened to meet the challenges of these threats;
  • Policy makers at the federal, state and local levels need to make sure that rural America has the financial and human resources required to achieve an adequate state of readiness; and,
  • Public health and health care leaders in rural areas need to work together to assure that emergency preparedness is achieved in a cost-effective manner.

Paul Campbell, Harvard School of Public Health (HSPH) faculty member, and Joshua Frances, research assistant and co-investigator of the report, are leaders in rural preparedness at HSPH's Center for Public Health Preparedness and helped organize the conference. Michael Meit, director of the University of Pittsburgh's Center for Rural Health Practice, was also an author of the report.

"The conference did not focus exclusively upon bioterrorism," said Campbell. "Participants from across the country emphasized that we need to be prepared for the full range of public health emergencies, including weather events such as ice storms and hurricanes, and emerging diseases like SARS that do not result from terrorist actions."

Campbell said the issue of financing of preparations for potential bioterrorist attacks"has forced us to confront the inadequacy of our public health defenses in rural areas of this country. A strong national defense requires that we address our weakest links wherever they are."

Frances noted that rural areas in the United States bring with them unique challenges that are much different than their urban counterparts. "Though many perceive rural areas to be just farmland, plains and dense forest, much of the nation's water supply, food supply and critical industries (power plants and water treatment facilities) are located in rural areas. They pose a unique challenge to protection from terrorism and public health emergencies," he added.

The report, "Preparing for Public Health Emergencies: Meeting the Challenges in Rural America," can be viewed at

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