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Improve the Nation’s ability to prevent, prepare for, respond to, and recover from a major health incident.


Preparedness involves Government agencies, nongovernmental organizations, the private sector, communities, and individuals working together to improve the Nation’s ability to prevent, prepare for, respond to, and recover from a major health incident. The Healthy People 2020 objectives for preparedness are based on a set of national priorities articulated in the National Health Security Strategy of the United States of America (NHSS). The overarching goals of NHSS are to build community resilience and to strengthen and sustain health and emergency response systems.

To reach these goals, NHSS identifies the following objectives for urgent, focused attention:

  • Foster informed, empowered individuals and communities.
  • Develop and maintain the workforce needed for national health security.
  • Ensure situational awareness.
  • Foster integrated, scalable health care delivery systems.
  • Ensure timely and effective communications.
  • Promote an effective countermeasure enterprise.
  • Ensure prevention or mitigation of environmental and other emerging threats to health.
  • Incorporate postincident health recovery into planning and response.
  • Work with cross-border and global partners to enhance national, continental, and global health security.
  • Ensure that all systems that support national health security are based on the best available science, evaluation, and quality improvement.

Why Is Preparedness Important?

The United States, like all countries, faces many threats with the potential for large-scale health consequences, including disease outbreaks, natural disasters, and terrorist attacks. The public health, health care, and emergency response systems must be prepared to mitigate the morbidity and mortality associated with these threats. Securing the Nation’s health is a formidable task, and it is a shared responsibility for virtually all parts of society.

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Understanding Preparedness

Many factors determine a community’s level of preparedness and its ability to recover after an emergency. These factors include:

  • The general health of a population
  • Individual behaviors, lifestyles, and social interconnectedness
  • Individual community members planning and preparing for an emergency
  • Economic and social conditions
  • Having broad and prepared health services
  • Access to health services12, 3, 4

Emerging Issues in Preparedness

Over the decade, more communities will focus on improving their ability to withstand, recover, and learn from an emergency. To become resilient communities, they will need to:

  • Account for and address their vulnerabilities.
  • Develop capabilities that aid the community in preventing, withstanding, and mitigating the stress of a health incident.
  • Recover in a way that moves the community to a state of self-sufficiency and at least the same level of health and social functioning following adversity as before it, if not better.
  • Use knowledge gained from 1 incident to strengthen the community’s ability to withstand the next.

Additional research and experiences will likely reinforce the importance of the following factors that contribute to a community’s preparedness and resilience:

  • Informed and empowered communities
  • Preincident planning that engages citizens and at-risk individuals
  • Social interconnectedness
  • Robust and prepared infrastructures for health services
  • Availability of nongovernmental sources of assistance during and after an incident


1Eisenman DP, Wold C, Fielding J, et al. Differences in individual-level terrorism preparedness in Los Angeles County. Am J Prev Med. 2006

2Nozawa M, Watanabe T, Katada N, et al. Residents’ awareness and behaviour regarding typhoon evacuation advice in Hyogo prefecture, Japan. Int Nurs Rev. 2008 Mar;55(1):20-6.

3Chandra A, Acosta J, Meredith LS, et al. Understanding community resilience in the context of national health security: A literature review. Santa Monica, CA: RAND; 2010 Jan. p. 22-4.

4Moore S, Daniel M, Linnan L, et al. After Hurricane Floyd passed: Investigating the social determinants of disaster preparedness and recovery. Fam Community Health. 2004 July–Sep;27(3):204-17.

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