Wednesday, July 15, 2009

U.S. agencies get mixed reviews on swine flu

NEW YORK (Reuters Health) – Many local health departments across the U.S. were slow to get information on the swine flu outbreak onto their Web sites, according to a new study.

The study, by the non-profit research organization RAND, found that most state health departments were quick to respond when the federal government declared swine flu a public health emergency on April 26. Within 24 hours, 46 of 50 state departments had posted swine flu information on their Web sites.

On the other hand, local health departments showed greater variation, the RAND researchers report in the journal Health Affairs. Only one-third of county departments surveyed posted information on the outbreak within 24 hours -- with only one-quarter of smaller counties doing so.

In California, 73 percent of county health departments got some information online within 24 hours. In Kansas, that figure was 8 percent.

"We found that the capability to conduct basic crisis and emergency risk communication is quite good at the state level, but there remains significant variation at the local level," lead researcher Jeanne Ringel said in a RAND news release.

Even at the state level, she and her colleagues say, there is room for improvement -- especially in providing information in languages other than English.

The need for information in Spanish was especially acute, the researchers note, because the swine flu outbreak arose in Mexico, and much of the initial U.S. media focus was on "border and immigration issues."

When it came to the quality of health departments' online information, most states performed fairly well, according to the study. In all, 43 state health departments provided information on how to reduce the risk of contracting swine flu -- though fewer (36 states) gave advice on when to seek treatment and which individuals should take anti-viral drugs.

The reasons for the wide variation among local health departments' responses are not clear, Ringel and her colleagues say. But one possibility is that smaller departments are confused about what their role is in responding to disease outbreaks; some may automatically defer to state and federal health officials, the researchers note.

"In the long run," the researchers write, "more clarity about both state and local health department responsibilities may reduce some of the variability in health departments' performance and may help clarify the need for stable funding to fulfill those responsibilities."

SOURCE: Health Affairs, online July 7, 2009.

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