Today is the eighth anniversary of Hurricane Katrina, one of the deadliest and most expensive natural disasters in U.S. history. Close to 2,000 people died during the worst of the storm and in the flooding that followed.

Since then, local, state, national and private disaster preparedness efforts have been increasingly improved. States reeling from the impact of last year’s Super Storm Sandy on the East Coast, for example, were able to rely on some of those improvements. They included more and better trained disaster management assistance teams from other states, as well as both commercial and government social media tools that helped professionals communicate among themselves and with the public to share safety and recovery instructions.

“By every measure our nation is dramatically better prepared for public health threats than they were,” said Ali Khan, MD, MPH, Director, Office of Public Health Preparedness and Response at the U.S. Centers for Disease Control and Prevention (CDC), at a Congressional briefing last week on the topic. It was hosted by the Alliance for Health Reform and the Robert Wood Johnson Foundation. In a conversation with NewPublicHealth this week, Khan ticked off some recent advances in disaster preparedness:

Congressionally appropriated funds for the U.S. Department of Health and Human Services to allow all states to improve their public health and health care preparedness and response capabilities.

• Response activities now coordinated through state-of-the-art emergency operations center at CDC and centers at almost all state public health departments.
• Health departments use the National Incident Management System, allowing for structured collaboration across responding agencies.
• More than 150 laboratories in the United States now belong to CDC’s Laboratory Response Network and can test for biological agents with the addition of regional chemical laboratories.
• The National Disaster Medical System now includes 49 Disaster Medical Assistance Teams, ten Disaster Mortuary Response Teams and five National Veterinary Response Teams, as well as other specialized units to provide medical-response surge during disasters and emergencies through on-scene medical care, patient transport and definitive care in participating hospitals.
• The Strategic National Stockpile was authorized and expanded, ensuring the availability of key medical supplies. All states have plans to receive, distribute and dispense these assets. Development of new medical countermeasures under the Biomedical Advanced Research and Development Authority (BARDA) includes new drugs and diagnostics. BARDA has delivered nine new medical countermeasures to the Strategic National Stockpile (SNS) in the last six years.

NewPublicHealth has been conducting a series of interviews with health directors impacted by weather disasters this year. Last month marked the official start of hurricane season in the Atlantic. We recently spoke with Mary O’Dowd, health commissioner of New Jersey, which is continuing its recovery and rebuilding after Hurricane Sandy last fall.

>>Read our interview with Oklahoma Health Commissioner Terry Cline on the tornadoes that struck Oklahoma this summer.

NewPublicHealth: How far along are you in the recovery process?

Mary O’Dowd: One of the things that we’ve learned is that recovery takes years not months when you’re dealing with a disaster of the proportion that Superstorm Sandy was for New Jersey. I would say that we’ve made significant progress. Some communities have very little signs of Sandy left, others are still working to rebuild a significant amount of their property and they’re still in the process of demolition of damaged buildings and properties. Great strides have been made, much progress has already occurred, but there still is a lot of work yet to be done.

NPH: What are some of the public health endeavors you’re still engaged in for the response?

In several recent and upcoming posts, NewPublicHealth is connecting with communities that have faced severe weather disasters in the last year. New York City, for example, is continuing to regroup and rebuild after Hurricane Sandy struck the region eight months ago. The city, and its health department, recently announced several initiatives aimed at “building back better” while supporting residents still facing housing as well as mental health problems since the storm last October. Some examples are detailed below.

• The New York City Building Resiliency Task Force, an expert panel convened after Hurricane Sandy to help strengthen buildings and building standards, recently issued a report with recommendations for buildings and homes of all sizes in the city. The report recommends establishing backup power in the event that primary networks fail; protecting water supplies and stabilizing interior temperatures if residents need to shelter in place. ”Making our city’s buildings more resilient to coastal flooding and other climate hazards is a challenge that requires collaboration among government, designers, engineers, and building owners, among others,” said City Planning Commissioner Amanda M. Burden. “The Task Force's work exemplifies the kind of innovation and cooperation necessary to prepare our city for a changing climate.”  To create the report, the Task Force convened over 200 volunteer experts in architecture, engineering, construction, building codes and real estate.

USPSTF Recommends HIV Screening for All Americans 15-65
The U.S. Preventive Services Task Force (USPSTF) now recommends that all Americans ages 15 to 65 be screened for HIV, according to new guidelines appearing in the Annals of Internal Medicine. USPSTF’s previous 2005 guidelines recommended screening for only those people categorized as high-risk. The U.S. Centers for Disease Control and Prevention already recommends this course of action. "We do hope the fact that the guidelines are all very similar will provide an impetus for people to offer screening because it is a very critical public-health problem,” said task force member Douglas Owens, MD, a medical professor at Stanford University. Experts noted that the change will likely mean that testing will be covered as a preventive service under the Affordable Care Act. Read more on HIV/AIDS.

HUD’s $1.83B Plan Will Help Rebuild New Jersey, Prepare for Future Disasters
The U.S. Department of Housing and Urban Development’s (HUD) $1.83 billion New Jersey disaster recovery plan will help residents continue to recover from the damage caused by Hurricane Sandy and better prepare for future extreme weather events. “This infusion of federal funding will help New Jersey continue to recover from Superstorm Sandy and ensure that our state is rebuilt stronger and better prepared for future storms,” said Senator Frank Lautenberg (D-NJ). “Families that are rebuilding their homes, small businesses that are getting back on their feet, and communities that are repairing damaged public infrastructure will all benefit from this federal grant program.” The plan is funded through HUD’s Community Development Block Grant Program. The infrastructure restoration efforts will including elevating some homes to guard against future flooding. Read more on Hurricane Sandy.

Early Obesity Dramatically Increases Men’s Risk of Poor Health, Death
Obesity in the early 20’s can dramatically increased a man’s chance of suffering from serious health problems or even dying by the age of 55, according to a new study in the journal BMJ Open. A study tracking Danish men found that approximately half of the participants who were obese at the age of 22 had developed diabetes, developed high blood pressure, had a heart attack, had a stroke, or experienced blood clots or died by age 55. Men of a normal weight at age 22 saw only a 20 percent risk of developing these problems by age 55. Each unit increase in body mass index raised the risk of heart attack by 5 percent; high blood pressure and clots by 10 percent; and diabetes by 20 percent. In the United States approximately 35.7 percent of adults and 17 percent of children are obese, according to the U. S. Centers for Disease Control and Prevention. Read more on obesity.

Survey: Many Americans Still Unaware of or Confused About the Affordable Care Act
Signup for the Affordable Care Act (ACA) Health Insurance Marketplace begins in October, but a new poll from the Kaiser Family Foundation finds that many Americans are still confused about the law, which will require virtually all Americans to sign up for health insurance coverage that will take effect January 1, 2014.

Key poll findings include:

• More than 40 percent of Americans aren’t aware that the ACA is the law of the land.
• Of those who aren’t aware that the ACA is now law, 12 percent think the law was repealed by Congress and 7 percent think the law was overturned by the Supreme Court.
• About half of the respondents said they did not have enough information about the health reform law to understand how it will impact their family.

The poll findings also showed that people who are currently uninsured and those in low-income households were the most likely groups to say they did not understand how the ACA benefits them and their families. Read more on access to health care.

Hurricane Sandy devastated much of the Atlantic coastal region—particularly New Jersey, where public health and other agencies from across the state came together to prepare for and respond to the extreme weather event. Ocean County alone saw more than 250 public health department employees working day and night to help the county’s 576,000 residents.

As part of its coverage on the public health response to Hurricane Sandy, the Robert Wood Johnson Foundation created a series of videos featuring public health officials and those touched by the disaster.

>> Go here to read more about Hurricane Sandy and watched the RWJF video "Unwavering: Public Health's Dedication in the Wake of Hurricane Sandy."

In this video, Christopher Rinn, Assistant Commissioner of the Division of Public Health Infrastructure, Laboratories and Emergency Preparedness for the New Jersey Department of Health, describes how the public health department led the response to Hurricane Sandy by collaborating across acute care hospitals, EMS agencies, local health departments, home healthcare agencies, private sector partners and other sectors of the community.

At this month’s Public Health Preparedness Summit, John Lumpkin, MD, MPH, senior vice president and the director of the Health Care Group at the Robert Wood Johnson Foundation, presented about the National Health Security Preparedness Index. The Index, when completed, will be a single annual measure of health security and preparedness at the national and state levels. The Index will help inform decisions about how to prioritize investments and continual quality improvement of public health preparedness, and will also identify and highlight strengths and novel approaches. With input from many stakeholders, the Association of State and Territorial Health Officials, in partnership with the Centers for Disease Control and Prevention, is coordinating development of the Index.

Prior to joining the Foundation in 2003, Dr. Lumpkin served as director of the Illinois Department of Public Health for 12 years. In an interview at the Summit, Dr. Lumpkin described how the Index will help improve the quality of public health preparedness. He also shared his insights from his first-hand experience in coordinating a sustained response to public health emergencies that extends well beyond the initial response.

NPH: In the aftermath of a disaster such as Hurricane Sandy, how can public health agencies balance their focus on immediate needs such as shelter, food and emergency services, with longer-term challenges such as mental health, housing solutions and resilience?

Dr. John Lumpkin: While the immediate impact of homes being destroyed, people being forced to relocate and lives being lost, is devastating—there is also an ongoing public health impact of a disaster such as Hurricane Sandy, which is tremendous.

>>Watch a video on the ongoing public health response to Hurricane Sandy.

The sea communities of New York and New Jersey were the hardest hit by Hurricane Sandy. Ocean County, N.J., was especially devasted. It was there that more than 250 public health department employees provided medical care, shelter and more to approximately 576,000 residents.

These numbers are tremendous in scope—but they're more than just numbers. It's not every day that we get the opportunity to see the results of successful public health policies firsthand. But when we do get the chance to step into a person's life and witness how they were personally affected by a public healh crisis, it can make the case for careful preparedness planning even stronger.

In this video Tom Cioppa, an Ocean County resident, relives the heavy rain and harsh winds brought by Hurricane Sandy. Images of upturned cars and demolished two-story houses illustrate the storm’s destruction and its life-changing effects.

While the effects of Hurricane Sandy were felt up and down the east coast, the sea communities of New York and New Jersey were the hardest hit. Ocean County, N.J. saw more than 250 public health department employees working day and night to help the county’s 576,000 residents—providing medical care, shelter, clean water and even a safe place for pets.

As part of its coverage on the public health response to Hurricane Sandy, the Robert Wood Johnson Foundation created a series of videos featuring public health officials and those touched by the disaster.

>> Go here to read more about Hurricane Sandy and watched the RWJF video "Unwavering: Public Health's Dedication in the Wake of Hurricane Sandy."

In this first video, Daniel Regenye, Coordinator for the Ocean County Health Department, describes how the state of emergency brought government agencies, non-profit organizations and for-profit organizations together to meet the needs of the community in new ways. Medical needs shelters opened their doors for 24-hour-a-day service for weeks following the storm, with staff members showing incredible dedication by prioritizing the community over their own needs.

Clear, effective communication before and during a major natural disaster plays a major role in saving lives. In this video, Leslie Terjesen, Public Information Officer for the Ocean County Health Department, describes how the department shared information regarding flood preparedness; food and water safety; and keeping medical devices and equipment safe was shared in creative ways given power outages across the county.

Read more of our coverage of Hurricane Sandy.

"When the day comes that we’re not able to respond in the way that we think we should, that there will be a price to pay."

The U.S. Centers for Disease Control and Prevention and the National Association of County and City Health Officials (NACCHO) are among the partners hosting this week’s 2013 Public Health Preparedness Summit, which provides a national forum for public health and health care professionals, emergency managers, and other leaders to collaborate, learn, and share best practices—especially as budget cuts threaten strides that have been made to better prepare communities for disasters.

Conferences sessions include presentations on catastrophic preparedness, community resilience, biosurveillance, volunteer management, mass prophylaxis, public health law, and crisis standards of care.

NewPublicHealth will be on the ground at the Preparedness Summit in Atlanta this week covering sessions, exploring new tools at the conference expo and talking with plenary speakers and other leaders. Follow the conversation on Twitter at #PHPS13 and follow our coverage here.

In advance of the conference NewPublicHealth spoke with Jack Herrmann, senior advisor for public health preparedness at NACCHO.

NewPublicHealth: How do disasters that happen during the course of the year—such as Superstorm Sandy and the past year’s mass shootings in Colorado and Connecticut—impact the sessions at the Summit?

Jack Herrmann: Unfortunately over the last number of years we’ve always had some kind of event that we’ve had to focus on during the summit, some disaster that has occurred, so this year really is not unique. Last year we also had hurricanes and major tornadoes, and so we found ourselves having to rally around major disasters and pointing out how poignant the Preparedness Summit is because of the events that unfolded. This year, the Aurora shooting, the Newtown shooting, Hurricane Sandy and other events that have occurred really define why we all come together each year for this summit.

It is an opportunity to reflect back and remember how important it is for us to be able to prepare for events every day. I suspect many of the people who have sat in the audience never expected a disaster to occur in their community. So, it is a lesson for all of us in that we never know when disaster is going to strike and that it’s critically important that we’re always on our toes and looking for ways that we can enhance and build the preparedness efforts across our communities and across our nation.

Hurricane Sandy devastated much of the East Coast last fall, with sea communities in New York and New Jersey such as Ocean County bearing a disproportionate share of the damage. In Ocean County alone, 40,000 buildings were damaged by the storm’s monstrous gusts and floodwaters and the county suffered nearly half the damage recorded throughout New Jersey, according to the Federal Emergency Management Agency.

>>A new video produced by the Robert Wood Johnson Foundation about the public health response to Hurricane Sandy features health department officials including Dan Regenye, coordinator of the Ocean County Public Health Department, and New Jersey Health Commissioner Mary O’Dowd. Watch the video:

For more than a week after the storm ended, more than 250 employees of the public health department worked day and night to help the county’s 576,000 residents. The county provided medical needs sheltering for more than 1,000 residents, three times the number expected. And many shelters that housed displaced residents were also able to shelter their pets­–a critical need for many people who might not have evacuated otherwise.

This week at the annual Public Health Preparedness Summit hosted by the Centers for Disease Control and Prevention and the National Association of County and City Health Officials, the Ocean County Health Department will present a poster on response to and recovery from disaster. Follow NewPublicHealth coverage of the conference and other preparedness news.

In advance of the conference, NewPublicHealth spoke with Dan Regenye.

NewPublicHealth: How is your community doing?

Dan Regenye: I think it’s going to take a long time for total recovery to happen, and the reality is that it’s never going to be what it was. Some things will be better, some things will be worse. Our residents are dealing with their own personal issues and circumstances on a case-by-case basis. I think it’s the navigation part that’s so difficult for so many people between all the different agencies—local, state and federal—and private organizations. They need to look at FEMA (Federal Emergency Management Agency) maps and have to interact with insurers, contractors and others. It’s challenging.

NPH: What is the health department’s role in the recovery?