health.” The way that funds are redirected from one topic to another, year by year, means that “we can’t be strategic in our approach. We are truly not building the infrastructure that we need to carry out the surveillance that is being described here.” Rather than focusing on individual events or outbreaks, efforts need to be directed toward putting systems in place that can address all public health threats.
Although mental health and chronic health surveillance were both identified as major areas for improvement, Clements’ remark about the challenge posed by the reactionary nature of the political agenda prompted some heated discussion. Some panelists agreed that directing federal funds toward specific public health threats weakens the overall public health preparedness infrastructure, which affects all disaster response efforts. The surveillance systems needed for the Gulf oil spill are no different than the surveillance systems needed for other public health emergencies. As Currier said, “Surveillance for oil spill illness is surveillance for everything.” Viamonte Ros echoed Clements’ call for more sustained federal funding so that state-level efforts can be directed toward developing long-term surveillance systems. Williamson agreed that state-level capacity to build the necessary surveillance systems will be uncertain without sustained support. Additionally, Williamson pointed to the lack of surge capacity for “unusual” laboratory testing (e.g., polyaromatic hydrocarbon testing) as another example of activities needing sustained federal commitment.
There was some discussion about the importance of research collaboration among states, federal agencies, private industry, and the affected communities. Guidry pointed out that, even though a great deal of money was put into health research following the Exxon Valdez spill, “We still don’t have the answers.” He emphasized the importance of collective