• Emergency preparedness;
  • public health system research;
  • survey

Objective. To study the relationship between elements of public health infrastructure and local public health emergency preparedness (PHEP).

Data Sources/Study Setting. National Association of County and City Health Officials 2005 National Profile of Local Health Departments (LHDs).

Study Design. Cross-sectional.

Principal Findings. LHDs serving larger populations are more likely to have staff, capacities, and activities in place for an emergency. Adjusting for population size, the presence of a local board of health and the LHDs' experience in organizing PHEP coalitions were associated with better outcomes.

Conclusions. The results of this study suggest that more research should be conducted to investigate the benefit of merging small health departments into coalitions to overcome the inverse relationship between preparedness and population size of the jurisdiction served by the LHD.