NHSPI requires additional validation going forward

U.S. preparedness data should include data from past disasters and response and recovery efforts to compare to outcomes before, during and after disasters, according to a study recently published in Biosecurity and Bioterrorism.

Researchers from the University of Pittsburgh Medical Center's Center for Health Security recently evaluated the National Health Security Preparedness Index (NHSPI). The NHSPI was part of a collaborative agreement between the Centers for Disease Control and Prevention Office of Public Health Preparedness and Response and the Association of State and Territorial Health Officials to create an annual measure of national health security preparedness.

"Given the health threats our nation faces from natural disasters, unintended and international human acts, infectious diseases, and other emerging diseases, there is a pressing need to be able to formally characterize national health security and evaluate associated preparedness efforts over time," the researchers said. "To address that need, a coalition of national experts and stakeholders created and launched a state-by-state and national-level composite indicator of health security preparedness, the (NHSPI)."

The first NHSPI was released in December and determined the national index result was a 7.2 out of 10. The result was a combined average of the overall index results from the 50 individual states.

The researchers found that U.S. health security is influenced by many different factors and that well-organized groupings of information provide a better picture than a sum of the parts.

According to the study, an important step for the NHSPI going forward will be validation.

"The ultimate goal of the NHSPI is external validity, to determine how the index predicts state and/or national outcomes during a future actual emergency," the researchers said.

The researchers suggested two approaches for validation. One was the use of case study reviews of past disasters and comparing the historical data with actual disaster outcomes. The other was to use data collection during the response and recovery phases of future events and match them against pre-event index results.

"By developing the NHSPI described herein, a new model and methodology for evaluating the nation's health security preparedness have been introduced to the stakeholder community," the researchers said. "The insight of (future) studies will provide additional direction on future model design and implementation efforts."