Public Health Requirements and Authorities in State Statutory Disaster Recovery Law: A Cross-Sectional Legal Assessment

Abstract

State statutory laws serve as a vital tool for public health entities to assist communities with recovery from disasters. However, no systematic assessment has examined the content of state law addressing disaster recovery or explored if and how the public health role is discussed in state law addressing disaster recovery. This study examined public health-related requirements, authorities, and activities in state disaster recovery laws. Nexis Uni, a legal database, was used to identify codified state statutory laws that authorize or require specific state or local public health entity actions, or set conditions where public health entity actions could be authorized/required, related to disaster recovery planning, implementation, or evaluation (ie, health disaster recovery laws). Disaster recovery laws were reviewed and coded to identify health-related requirements, authorities, and activities planned for recovery. Most states (n = 47) have disaster recovery laws, and 17 states were found to have 30 codified statutory health disaster recovery laws. Half (n = 15) of identified laws require a public health liaison to or representation on a recovery committee or other organization/body working on recovery planning or implementation activities. State disaster recovery laws have limited public health requirements, authorities, and activities. Further research is needed to assess the potential public health benefits of components of state law supporting public health involvement in disaster recovery. The development and dissemination of best practices or model laws and tools to provide opportunities for public health actors to inform recovery decision making may enhance the potential for health promotion during disaster recovery.

Introduction

Disasters pose a substantial risk to public health, requiring robust support from all levels of government for disaster preparedness, response, and recovery activities.¹ Disasters resulting from natural and technological hazards create disruptions to the natural,^2-5 built,^6-10 and social environment^6,11-13 that have been shown to result in sustained and substantial health consequences. Natural hazards—such as hurricanes, earthquakes, tornadoes, droughts, wildfires, winter storms, and floods—can negatively impact physical and behavioral health directly due to infrastructure damage, degraded water and air quality, and social disruption during disaster response and recovery.^1,3,6,11 Resultant disasters may also negatively impact public health by reducing healthcare systems' capacity to provide sufficient quality and quantity of care for disaster-impacted populations.^14,15 While there is growing research and policy attention to the public health impacts of disasters, more explicit involvement of public health is needed in disaster preparedness, response, and recovery policy decision making.^16,17

Increased exposure, vulnerability, frequency, and severity of climate-related hazards is increasing disaster risk, with cascading consequences to human health and wellbeing.^16,18 In fact, the United States experienced more than twice as many “billion-dollar disasters” in the 2010s compared with the 2000s.¹⁸ In 2019 alone, 61 major disaster declarations were made under the federal authority of the Robert T. Stafford Disaster Relief and Emergency Assistance Act (the Stafford Act).^19-21 Major disaster declarations provide federal assistance for a wide range of public infrastructure and individual needs, and can finance both emergency and permanent work.^19,21 The influx of resources available following major disasters may enable communities to address longstanding public health issues and make structural improvements to promote health and increase equity through the disaster recovery process.¹⁷

Disaster recovery strategies with explicit goals to address health and impacts to health systems, such as community health counseling and exercise programs, have been shown to have positive health impacts.^22,23 Additionally, recovery decisions and actions made in nonhealth sectors also have the potential to positively impact health and wellbeing.^12,17,24,25 Disaster recovery guidance from the Institute of Medicine (2015)¹⁷ and the Federal Emergency Management Agency (FEMA) (2016)²⁶ emphasize the need to integrate health considerations into recovery decision making. The 2015 Institute of Medicine report Healthy, Resilient, and Sustainable Communities After Disasters²⁷ calls for a focus on activities that enable health in disaster recovery, such as provision and restoration of public health and healthcare. The report also encourages the use of a Health in All Policies approach, defined as “a collaborative approach that integrates and articulates health considerations into policymaking across sectors to improve the health of all communities and people,”²⁷ in recovery decision making, as well as the development of evaluation tools to assess health impacts in disaster recovery. Through the 2016 update to the FEMA National Disaster Recovery Framework,²⁶ FEMA also emphasizes the need for integration of health considerations into disaster recovery policy decisions.

Laws, including statutes, ordinances, regulations, and implementing measures, are a core element of public health legal preparedness.²⁸ Law has promoted public health preparedness by prioritizing planning, allocating responsibility in preparedness and response, encouraging collaboration and coordination, helping to deploy responsive funding, and placing emphasis on vulnerable populations in preparedness and response activities.²⁹ As such, law may help prepare public health entities with the tools and resources needed for disaster recovery. There has not been a study to compile or evaluate all state laws to determine which states have implemented laws specifically related to disaster recovery planning, or how state laws promote public health engagement in disaster recovery.

There is clear precedent for the use of state statutory law to provide states with the power to respond to a specific subset of disaster situations, such as bioterrorist events or emerging infectious disease outbreaks. As of 2012, an assessment of the 50 US states and the District of Columbia found 40 states had adopted some portion of the Model State Emergency Health Powers Act, developed by the Center for Law and the Public's Health at Georgetown University Law Center and the Johns Hopkins School of Public Health in 2001.^30,31 Currently, no such legal assessment has been conducted on states' adoption of public health powers specific to disaster recovery.

This study examines how state statutory law requires or authorizes public health entities' role in disaster recovery. Public health entities include state, county, or local health departments or boards of health. Understanding public health authorities and requirements during recovery may facilitate academics and practitioners' evaluation of the implementation, effectiveness, and sufficiency of public health policy approaches to disaster recovery.

Methods

Standard public health legal research methods were used to assess state statutory laws in the 50 US states.³² Similar approaches to legal assessments have been conducted on a variety of public health legal preparedness topics, including on state laws that provide gubernatorial authority to remove emergency response legal barriers, issues in emergency preparedness, response and recovery litigation since September 2011, and state-level legislative responses to the 2014-2015 Ebola outbreak.^33-35

Nexis Uni was used to identify codified state statutory laws across the 50 US states that addressed disaster recovery. A search performed in July 2018 using the search string (“disaster!” and “recover!”) yielded 1709 unique state laws (Table 1). This search string was selected in order to identify state laws with content related to natural and technological hazard events and that specifically addressed the disaster recovery period. Given the breadth of content classified as an “emergency,” this search term was excluded in an effort to feasibly scope the study and ensure the study's results aligned with public health engagement in recovery activities for disasters that would be eligible for access to federal resources for recovery through a major disaster declaration made under the authority of the Robert T. Stafford Disaster Relief and Emergency Assistance Act, PL 100-707.¹⁹

Table 1.

Number of Disaster Recovery Laws Identified and Included in Analysis by State

	Laws Identified from NexisUni Search^a	Laws Meeting Inclusion Criteria	Laws Addressing the Public Health Role in Recovery
Laws identified	1709	380	30
States represented	50	47	17
State
Alabama	28	8	0
Alaska	23	12	0
Arizona	26	4	0
Arkansas	41	21	1
California	211	23	4
Colorado	40	20	1
Connecticut	15	2	0
Delaware	14	8	0
Florida	76	15	1
Georgia	20	3	1
Hawaii	21	3	0
Idaho	17	6	0
Illinois	42	10	0
Indiana	38	7	0
Iowa	28	7	2
Kansas	33	10	0
Kentucky	26	6	0
Louisiana	135	12	4
Maine	30	7	0
Maryland	14	0	0
Massachusetts	24	1	0
Michigan	22	11	0
Minnesota	33	11	1
Mississippi	30	6	1
Missouri	17	3	0
Montana	36	10	0
Nebraska	11	6	0
Nevada	15	5	0
New Hampshire	17	2	0
New Jersey	28	5	3
New Mexico	5	2	0
New York	105	12	3
North Carolina	34	6	1
North Dakota	19	12	0
Ohio	27	3	0
Oklahoma	18	9	1
Oregon	45	7	1
Pennsylvania	34	6	0
Rhode Island	13	4	0
South Carolina	15	2	0
South Dakota	2	0	0
Tennessee	29	11	2
Texas	58	20	2
Utah	59	9	0
Vermont	9	1	0
Virginia	34	9	1
Washington	21	10	0
West Virginia	29	12	0
Wisconsin	34	1	0
Wyoming	8	0	0

Based on a search performed in July 2018 using the search string (“disaster!” and “recover!”).

Laws were included if they authorized or required state or local governments to (1) plan for, fund, or create programs to support disaster recovery; or (2) develop committees to oversee, advise, implement, or evaluate disaster recovery. Laws that appropriated funds without setting disaster recovery requirements or authorities, or laws that authorized or required disaster recovery actions for only a specific disaster were excluded.

To ensure clarity of inclusion criteria for laws in the final sample, 2 investigators independently reviewed identified laws from 5 randomly selected states to determine if they met inclusion criteria. Decisions were compared, and discrepancies were discussed and adjudicated through consensus-building discussion, and inclusion criteria language was clarified if any ambiguity was identified during the adjudication process.³⁶ A single member of the study team reviewed the remainder of the laws and determined a total of 380 laws from 47 US states met inclusion criteria.

Two investigators read the text of all 380 laws in their entirety to identify key elements and variation across the laws. A single coding question was developed to determine if the law specifically discussed public health activity or responsibility during disaster recovery. The specific language of the coding question was:

Does the law authorize or require specific state or local public health agency or authority action/activity (excluding general cooperation, coordination, or participation), or set conditions where specific state or local public health agency or authority action/activity could be required/authorized (eg, at the request of the governor), related to disaster recovery planning, implementation, or evaluation?

Two investigators independently reviewed the text of each law to determine if it positively answered the coding question. Decisions were compared, and discrepancies were discussed and adjudicated to improve coding integrity. One member of the study team then coded the section of the law that addressed the coding question using NVivo qualitative data analysis software version 12 (QSR International Inc., Burlington, MA) and abstracted the coded text into a spreadsheet. Two team members reviewed the coded text and 5 discrete categories of recovery-related requirements/authorities were identified inductively based on the content of the laws. The 5 categories included: 1.

Health Department is required to serve on a standing committee or appoint a liaison to coordinate with other agencies about recovery pre-disaster.

Health Department is required to develop a recovery plan or include a recovery element in an emergency or health emergency plan.

Health Department is assigned or can be delegated a responsibility in recovery implementation, including ability to delegate authority or responsibility.

Board of Health is assigned recovery oversight authority.

Health Department is required to develop recovery educational campaign.

Two investigators independently assigned the coded text from each law to 1 or more categories. Decisions were compared, and discrepancies were discussed and adjudicated between the 2 investigators until agreement was reached on the appropriate category for each law in the sample.

Results

The majority (n = 47) of states have statutory laws that authorized or required state or local governments to (1) plan for, fund, or create programs to support disaster recovery; or (2) develop committees to oversee, advise, implement, or evaluate disaster recovery. Only about one-third (n = 17) of states, however, have laws that authorized or required specific disaster recovery-related actions for state or local public health entities (ie, excluding general discussion of cooperation, coordination, or participation in disaster recovery), or set conditions where specific state or local public health entity action could be required (eg, at the request of the governor), related to disaster recovery planning, implementation, or evaluation (Table 1). Of the 17 states with disaster recovery laws specifically addressing the public health role, 7 had more than 1 such law.

Our analysis identified 2 laws that authorized, required, or set conditions for requirements/authority for local/county health departments or boards of health. Twenty-eight laws authorized, required, or set conditions for requirements/authority state health departments or boards of health (Table 2). Laws included requirements for state or local health departments to serve on a standing committee, appoint a liaison, or coordinate with other agencies or organizations about recovery pre-disaster (n = 15) and requirements for state or local health departments to develop a recovery plan or include a recovery element in an emergency or health emergency plan (n = 13). Laws also assigned responsibility(ies), or set conditions for assignment of responsibility(ies) (ie, authority for an entity to delegate a responsibility to the health department) to a state or local health department during recovery implementation, including the ability for the health department to delegate authority of responsibility to another entity (n = 10). Two laws assigned recovery oversight authority to a board of health (n = 2). One law required the state health department to develop a recovery educational campaign (n = 1).

Table 2.

Public Health Authorities and Requirements in Recovery Laws by State

State	Law	HD Is Required to Serve On a Standing Committee or Appoint a Liaison to Coordinate with Other Agencies About Recovery Pre-Disaster	HD Is Required to Develop a Recovery Plan or Include a Recovery Element in an Emergency or Health Emergency Plan	HD Is Assigned or Can Be Delegated a Responsibility in Recovery Implementation, Including Ability to Delegate Authority or Responsibility	Board of Health Is Assigned Recovery Oversight Authority	HD Is Required to Develop Recovery Educational Campaign	State Role or Responsibility	Local Role or Responsibility
Arkansas	Ark Code Ann §12-75-116^a	✓					✓
California	Cal Health & Safety Code §1797.153^b		✓					✓
	Cal Health & Safety Code §18307^b			✓			✓	✓
	Cal Health & Safety Code §18865.8^b			✓			✓	✓
	Cal Health & Safety Code §114662^b		✓	✓			✓
Colorado	Colo Rev Stat 24-33.5-1614^a	✓					✓
Florida	Fla Stat §252.35^a		✓				✓
Georgia	Ga Code Ann §38-3-51^a		✓	✓			✓
Iowa	Iowa Code §135.141^a		✓	✓			✓
	Iowa Code §136.3^a				✓		✓
Louisiana	La Rev Stat §29:725.6^a	✓					✓
	La Rev Stat §29:726^a		✓				✓
	La Rev Stat §29:726.4^a	✓					✓
	La Rev Stat §29:766^a	✓	✓	✓			✓
Minnesota	Minn Stat §145A.04^a				✓			✓
Mississippi	Miss Code Ann §33-15-53^a	✓	✓				✓
New Jersey	NJ Rev Stat §26:13-3^a	✓	✓	✓			✓
	NJ Rev Stat §App.A:9-67^a	✓					✓
	NJ Stat §App.A:9-68^a	✓					✓
New York	NY Exec Law §21^a	✓					✓
	NY Exec Law §22^a	✓					✓
	NY Exec Law §28-a^a	✓					✓
North Carolina	NC Gen Stat §143B-1331^a		✓				✓
Oklahoma	Okla Stat §63-6403^a		✓	✓			✓
Oregon	Or Rev Stat §431.133^a		✓	✓			✓
Tennessee	Tenn Code Ann §58-2-107^a			✓			✓
	Tenn Code Ann §58-2-108^a	✓	✓				✓
Texas	Tex Code §418.013^c	✓					✓
	Tex Code §418.186^c					✓	✓
Virginia	Va Code Ann §2.2-222.3^a	✓					✓
TOTAL		15	13	10	2	1	28	4

LEXIS through 2018 session; ^bDeering, LEXIS through 2018 session; ^cLEXIS through 2017 session.

Abbreviations: Ann, annotated; App, appendix; Exec, executive; Gen, general; HD, health department; Rev, revised; Stat, statute.

Discussion

Our legal assessment found few states have formally authorized or required state and local public health entities to engage in disaster recovery planning or implementation through statutory law. About half of the state disaster recovery laws that explicitly discussed public health require public health agencies to serve on a standing committee, appoint a liaison, or coordinate with other agencies or organizations about recovery pre-disaster (n = 15). These organizational structures provide opportunity for public health actors to inform recovery decision making, and inform nonhealth actors about the potential health impacts of recovery decisions and actions, thereby promoting a Health in All Policies approach to recovery.²⁹ Additional research is necessary to understand the extent to which these committees and organizational structures are being leveraged for this purpose, as well as associated challenges, opportunities, and resource needs.

Model laws and legal guidance may also help states identify opportunities to incorporate recovery health promotion activities into state laws and set requirements that enable the development of the health recovery evidence base (eg, by requiring health-specific evaluation activities). For example, diverse portions of the 2001 Model State Emergency Health Powers Act³⁰ have been widely adopted, increasing states' readiness for bioterrorist events or emerging infectious disease outbreaks.³¹ A Model State Public Health in Disaster Recovery Act could facilitate the incorporation of relevant state authorities that facilitate health promotion through disaster recovery. The model legislation could feature requirements or authorities for public health agencies to engage in recovery activities pre- and post-event, as outlined in the Institute of Medicine's Healthy Resilient and Sustainable Communities After Disasters checklist,¹⁷ such as requirements to engage in community rebuilding and redevelopment planning. An all-hazards approach to public health-informed disaster recovery as well as specific language for natural hazards of concern for particular states could be included in the model legislation, allowing legislators to ensure the act aligns with the specific priority hazards of their state.

Statutory laws, however, may be neither necessary nor sufficient to achieve public health legal preparedness for disaster recovery. Public health entities may leverage authority granted through “infrastructural” public health law that creates their agencies and grants them with broad legal authorities to conduct public health-relevant activities to participate in disaster recovery planning and implementation.²⁸ Public health agencies are endowed with broad legal authorities by infrastructural public health laws to, for example, gather data, inspect, license, educate, and design interventions. These existing authorities may in many cases be sufficient to authorize and/or equip public health entities to support public health during the disaster recovery period.³⁷ In addition, statutory law is only 1 type of categorical public health law (eg, ordinances, judicial rulings, organizational policies) that can be used to grant disaster-specific authority.²⁸ Additional research is necessary to determine if states with laws that grant specific authorities to public health entities for disaster recovery planning and implementation are better prepared to conduct disaster recovery activities.

Law is also only 1 component of public health legal preparedness. Core components of public health legal preparedness also include building a competent public health workforce to make, implement, and interpret the law; obtaining the requisite information necessary for those practitioners; and implementing cross-sector and cross-jurisdictional coordination.²⁸ Future research should assess the competencies of those responsible for developing, applying, and interpreting public health recovery law; the adequacy of information available to them; and mechanisms for and impact of cross-sector and cross-jurisdictional public health recovery efforts.

While the law is a core component of public health legal preparedness,²⁸ specific legal mandates may be detrimental to their intended policy goals. For example, state-level environmental planning mandates have been shown to negatively impact local jurisdiction's commitment to such planning, as shown by Burby and May's 1998 study of local governments in Florida and New South Wales.³⁸ They found that many local elected officials had minimal interest in hazard mitigation planning in spite of higher-level government mandates to participate. However, they noted that information programs and participatory planning may increase local commitment to higher-level policy objectives. In addition, a survey of 32 European states found that some states proposed public health powers in a pandemic that could override human rights protections.³⁹ Follow-on studies should assess the appropriateness, implementation, and effectiveness of different policy strategies for recovery, as well as the sufficiency of infrastructural public health law to achieve public health goals in recovery, and to guide state statutory disaster recovery public health law development.

While this study's research question and methodology examined natural hazards and general disaster events rather than infectious disease events such as COVID-19, our findings offer some insight on the legal context of disaster recovery during the COVID-19 pandemic. States whose current disaster recovery laws require public health involvement may have developed collaborations and recovery protocols that better equip government leadership to mobilize a comprehensive recovery effort that centers public health as well as the pandemic's substantial social and economic impacts. Given the unique challenges of response and recovery to natural hazards such as Hurricane Laura and the West Coast wildfires in the midst of the COVID-19 pandemic,⁴⁰ our findings suggest that states with legal requirements for public health involvement in disaster recovery may have more robust capacity and expertise for navigating this complex environment of disaster recovery.

This study has limitations. First, the search terms used to identify disaster recovery laws may have omitted laws addressing public health threats that are not consistently referred to as disasters, such as infectious disease events. Future studies with broader research questions or a specific interest in the public health role in recovery from the opioid crisis or biological threats should build on this work by adapting our methodology to include additional or alternative search terms. Our study also did not assess local disaster recovery laws or policies. Future studies should examine local-level legal preparedness, given the National Disaster Recovery Framework's emphasis on local primacy in disaster recovery implementation.²⁶

The policy surveillance data on disaster recovery laws presented here is a necessary first step in legal epidemiology, enabling future research efforts to evaluate implications and effectiveness of policy strategies to improve public health during the recovery period. However, laws are being constantly updated and refined. States may be updating, or planning to update, relevant policies in response to the Institute of Medicine's Healthy, Resilient and Sustainable Communities After Disasters report (2015) and the FEMA National Disaster Recovery Framework guidance (2016).^17,26 There is a need for ongoing policy surveillance to systematically track and map updates to disaster recovery laws moving forward.⁴¹ Future research should examine how our findings compare with the body of state disaster recovery laws after COVID-19 to identify if and how the public health role in disaster recovery law changes in response to the pandemic.

Conclusions

This study examines how states authorized or required health departments to engage in disaster recovery planning or implementation through statutory law. While 47 states have statutory laws to require government activities related to disaster recovery, only 17 have laws that authorize or require public health entity activities as part of disaster recovery. Findings can be used to inform future policy opportunities to enhance public health entities' engagement in postdisaster recovery planning and implementation, as well as for future epidemiological research to evaluate the effect of these laws on health impacts during the disaster recovery period. Additional research is also necessary to assess the appropriateness and implementation of different public health policy approaches for disaster recovery.

Footnotes

Acknowledgments

Support for this research was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.

References

Shoaf

, Rotiman

. Public health impact of disasters. Austrailian J Emerg Manag. 2000; 15(3):58-63.

Albrecht

, Sartore

, Connor

, et al. Solastalgia: the distress caused by environmental change. Australas Psychiatry. 2007; 15(suppl 1):S95-S98.

Warsini

, Mills

, Usher

. Solastalgia: living with the environmental damage caused by natural disasters. Prehosp Disaster Med. 2014; 29(1):87-90.

Eisenman

, McCaffrey

, Donatello

, Marshal

. An ecosystems and vulnerable populations perspective on solastalgia and psychological distress after a wildfire. Ecohealth. 2015; 12(4):602-610.

Lichtveld

, Sherchan

, Gam

, et al. The Deepwater Horizon oil spill through the lens of human health and the ecosystem. Curr Environ Heal Rep. 2016; 3(4):370-378.

Morgan

, Begg

, Beaven

, et al. Monitoring wellbeing during recovery from the 2010-2011 Canterbury earthquakes: the CERA wellbeing survey. Int J Disaster Risk Reduct. 2015; 14:96-103.

Scannell

, Cox

, Fletcher

, Heykoop

. “That was the last time I saw my house”: the importance of place attachment among children and youth in disaster contexts. Am J Community Psychol. 2016; 58(1-2):158-173.

Tsuboya

, Aida

, Hikichi

, et al. Predictors of decline in IADL functioning among older survivors following the Great East Japan earthquake: a prospective study. Soc Sci Med. 2017; 176:34-41.

Hikichi

, Aida

, Kondo

, et al. Increased risk of dementia in the aftermath of the 2011 Great East Japan Earthquake and Tsunami. Proc Natl Acad Sci U S A. 2016; 113(45):E6911-E6918.

10.

Hick

, Chipman

, Loppnow

, et al. Hospital response to a major freeway bridge collapse. Disaster Med Public Health Prep. 2008; 2(suppl 1):S11-S16.

11.

Yagi

, Fujiwara

, Yambe

, Okuyama

, Kawachi

, Sakai

. Does social capital reduce child behavior problems? Results from the Great East Japan Earthquake Follow-up for Children Study. Soc Psychiatry Psychiatr Epidemiol. 2016; 51(8):1117-1123.

12.

Koyama

, Aida

, Kawachi

, et al. Social support improves mental health among the victims relocated to temporary housing following the Great East Japan Earthquake and Tsunami. Tohoku J Exp Med. 2014; 234(3):241-247.

13.

Galea

, Ahern

, Resnick

, et al. Psychological sequelae of the September 11 terrorist attacks in New York City. N Engl J Med. 2002; 346(13):982-987.

14.

Myrtle

, Masri

, Eeri

, Nigbor

, Caffrey

. Classification and prioritization of essential systems in hospitals under extreme events. Earthquake Spectra. 2005; 21(3):779-802.

15.

Kirsch

, Mitrani-Reiser

, Bissell

, et al. Impact of hospital functions following the 2010 Chilean earthquake. Disaster Med Public Health Prep. 2010; 4(2):122-128.

16.

Keim

ME.

Building human resilience: the role of public health preparedness and response as an adaptation to climate change. Am J Prev Med. 2008; 35(5):508-516.

17.

Institute of Medicine. Healthy, Resilient, and Sustainable Communities after Disasters: Strategies, Opportunities, and Planning for Recovery. Washington, DC: The National Academies Press; 2015. Accessed March 11, 2021. https://doi.org/10.17226/18996

18.

Smith

AB.

2010-2019: a landmark decade of U.S. billion-dollar weather and climate disasters. NOAA Climate.gov website. Accessed October 26, 2020. https://www.climate.gov/news-features/blogs/beyond-data/2010-2019-landmark-decade-us-billion-dollar-weather-and-climate

19.

Robert

Stafford Disaster Relief and Emergency Assistance Act (42 USC §§5131 et seq.), Pub L 93-288 (Approved May 22, 1974), Amended Through Pub L 116-284 (enacted January 1, 2021). https://www.congress.gov/bill/116th-congress/senate-bill/3418/text/pl?overview=closed

20.

Federal Emergency Management Agency. Declared disasters. Accessed October 26, 2020. https://www.fema.gov/disasters/disaster-declarations

21.

Federal Emergency Management Agency. How a disaster gets declared. Accessed October 26, 2020. https://www.fema.gov/disasters/how-declared

22.

Russell

, Oberlink

, Shah

, Evans

, Bassuk

. Addressing the health and wellness needs of vulnerable Rockaway residents in the wake of Hurricane Sandy: findings from a health coaching and community health worker program. J Public Health Manag Pract. 2018; 24(2):137-145.

23.

Tsuji

, Sasaki

, Matsuyama

, et al. Reducing depressive symptoms after the Great East Japan Earthquake in older survivors through group exercise participation and regular walking: a prospective observational study. BMJ Open. 2017; 7(3):e013706.

24.

Tuckson

RV.

, Dzau

, Lurie

Creating healthy communities after disasters. N Engl J Med. 2017; 377(19):1806-1808.

25.

Dzau

, Lurie

, Tuckson

. After Harvey, Irma, and Maria, an opportunity for better health-rebuilding our communities as we want them. Am J Public Health. 2018; 108(1):32-33.

26.

Federal Emergency Management Agency (FEMA). National Disaster Recovery Framework. 2nd ed. Washington, DC: FEMA; 2016. Accessed March 11, 2021. https://www.fema.gov/sites/default/files/2020-06/national_disaster_recovery_framework_2nd.pdf

27.

Centers for Disease Control and Prevention. Health in All Policies. Accessed October 20, 2020. https://www.cdc.gov/policy/hiap/index.html

28.

Moulton

, Gottfried

, Goodman

, Murphy

, Rawson

. What is public health legal preparedness?. J Law Med Ethics. 2003; 31(4):672-683.

29.

Gakh

, Rutkow

. Lessons from public health legal preparedness to operationalize health in all policies. J Law Med Ethics. 2017; 45(3):392-401.

30.

Gostin

, Sapsin

, Teret

, et al. The Model State Emergency Health Powers Act: planning for and response to bioterrorism and naturally occurring infectious diseases. JAMA. 2002; 288(5):622-628.

31.

The Network for Public Health Law. The Model State Emergency Health Powers Act summary matrix. Last updated June 2012. Accessed May 6, 2021. https://perma.cc/NN6T-GJYJ

32.

Wagenaar

, Burris

, eds. Public Health Law Research: Theory and Methods. Hoboken, NJ: John Wiley & Sons; 2013.

33.

McCourt

, Sunshine

, Rutkow

. Judicial opinions arising from emergency preparedness, response, and recovery activities. Health Secur. 2019; 17(3):240-247.

34.

Sunshine

, Thompson

, Menon

, Anderson

, Penn

, Koonin

. An assessment of state laws providing gubernatorial authority to remove legal barriers to emergency response. Health Secur. 2019; 17(2):156-161.

35.

Rutkow

, Jabs

. US state-level legislative responses to the Ebola outbreak, 2014-2015. Disaster Med Public Health Prep. 2016; 10(4):649-653.

36.

Hill

, Thompson

, Williams

. A guide to conducting consensual qualitative research. Couns Psychol. 1997; 25(4):517-572.

37.

Institute of Medicine. For the Public's Health: Revitalizing Law and Policy to Meet New Challenges. Washington, DC: The National Academies Press; 2011. Accessed April 20, 2021. https://doi.org/10.17226/13093

38.

Burby

, May

. Intergovernmental environmental planning: addressing the commitment conundrum. J Environ Plan Manag. 1998; 41(1):95-110.

39.

Martin

, Conseil

, Longstaff

, et al. Pandemic influenza control in Europe and the constraints resulting from incoherent public health laws. BMC Public Health. 2010; 10:532.

40.

Federal Emergency Management Agency. COVID-19 best practice information: natural hazards preparedness. Published June 25, 2020. Accessed October 22, 2020. https://www.fema.gov/sites/default/files/2020-07/fema_covid_bp_natural-hazards-preparedness.pdf

41.

Burris

, Hitchcock

, Ibrahim

, Penn

, Ramanathan

. Policy surveillance: a vital public health practice comes of age. J Health Polit Policy Law. 2016; 41(6):1151-1173.