Plan needed to fight terrorism: Public health officials are urging state lawmakers to strengthen a public health system that has been in serious need of financial and political support for years.

• Author: Guiden, Mary

Texas Representative Dianne White Delisi doesn't have psychic powers, but four years ago she did call for a study to see how prepared the Lone Star State was for a bioterrorism attack.

How did her colleagues react? "I was met with chuckles when I floated that idea around," she says. Delisi knew, from talks with her constituents (her district includes Fort Hood, which houses one-fifth of the Army's total population) and taking part in national public health meetings, that the issue was no laughing matter.

"Because of my relationship with the military, I became aware of the threat of bioterrorism and the lack of our coordination in the state. I saw we were very vulnerable to an attack in Texas," she explains. Undaunted by the lack of support at the state Capitol, Delisi continued work on bioterrorism, approaching it from the broader angle of public health.

Her dedication paid off, as Texas lawmakers and former Governor George W. Bush OK'd in 1999 a Delisi-crafted measure to beef up what's known as the "public health infrastructure" in her state. Among the provisions, the law defines public health services to include monitoring communities' health, diagnosing community health problems and developing policies and plans that support community efforts to improve health. In addition, the measure details the importance of a competent workforce and calls for a report on the public health system to be filed with the governor and legislative leaders every other year.

DEFINING THE TERMS

Words like "workforce" and "infrastructure" sound a little technical, complicated and detached, but what Delisi's measure aims to target--and what's being talked about more and more these days following the events of Sept. 11--is the general public health system. It includes clinics and other facilities where people go for treatment or check-ups. Infrastructure also encompasses personnel--public health workers from nurses to lab techs to doctors. Improving that system means employees will know what to do in case of an emergency, epidemic or terrorist attack with biological, chemical or radiological weapons. It also means making sure those workers can sometimes spot disease outbreaks before they become widespread.

In Delisi's words, it means creating a system "that will not only protect Texans from some madman with anthrax, but will also assure them protection from lyme disease, dengue fever and even obesity."

Since the events of Sept. 11, many people equate public health only with bioterrorism or anthrax scares, but it covers infectious diseases like HIV/AIDS and chicken pox, environmental health, chronic conditions like asthma, immunizations, injury prevention and occupational health and safety as well.

WHAT HAPPENS WHEN THOUSANDS ARE INFECTED?

Colorado public officials acquired a better grasp on the public health infrastructure after the state participated in a congressionally mandated test of emergency preparedness called Operation Topoff in May 2000. In the mock drill, thousands of people were infected and many...