“disease du jour” and does not always build on the core functions that public health is supposed to deliver during disaster response, such as surveillance. When an event like the Gulf oil spill occurs, the expectation is that public health agencies will be able to ensure the safety of public health and track the consequences, said Rosenstock. However, in order to fully deliver on that perceived promise, many participants suggested that those agencies need more continuous investments so they can build the necessary capacities. While not disagreeing with the need for more federal-level resources, Lichtveld emphasized the importance of also building on existing consortia, partnerships, and mechanisms. Goldman also addressed concerns about funding. She said that making funds available for disaster-related health research should be a high priority and explained that funding could supplement existing research grants, or it could be used to launch completely new research initiatives.

Over the course of the workshop, a number of panelists and participants, such as John Hosey, stated that surveillance and research activities should drive action rather than merely generate new knowledge. Thomas Matte defined surveillance as “actionable information to make things better now,” and Bailar defined it as “service to the individual” (see Chapter 5). Accordingly, at several different times throughout the discussion, panelists commented on the importance of not only identifying individuals that need care but also providing a means for those individuals to receive care. For example, Osofsky explained how post-Katrina mental health surveillance has tracked symptoms and guided interventions, services, and resource availability (see Chapters 2 and 5). Rosenstock also expressed a desire to identify areas where additional mental health services are needed. For example, a hotline not only could collect information about potential exposures and adverse outcomes, but also could guide individuals toward available health care services.

Surveillance, Research, and Legal Liability

Although the Department of Health and Human Services (HHS) did not ask the Institute of Medicine (IOM) to consider how the threat of litigation may complicate surveillance and research design and implementation, panel members echoed concerns from workshop participants that litigation may compromise the reliability and the longevity of short-and long-term surveillance and research activities. Certain states have been reluctant to protect research data, explained Goldman. For example, she continued, by allowing research subjects to be recontacted, attorneys



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