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The emergence of biological threats and public health preparedness: Experimental interventions into the field of biosecurity.

机译：生物威胁和公共卫生准备的出现：生物安全领域的实验性干预。

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摘要

This dissertation examines the emergence of biological threats and public health preparedness in the United States. The principal aims of this research revolved around tracking the ways in which pathogens and diseases have come to be understood as dangerous both to populations and to the state, as well as how responses to these dangers have been rendered thinkable and "actionable.".;There were three research sites, including: (1) the US Congress, where biological threats were articulated largely within the Congressional committee hearing setting; (2) the Centers for Disease Control and Prevention and the Advisory Committee on Immunization Practices, which collectively contributed to thinking about a specific biological threat, smallpox, around the turn of the century, feeding into the ill-fated Smallpox Vaccination Program; and (3) public health departments in five counties in California, where preparedness strategies and efforts have been put into practice.;Data sources for this study included 30 interviews with experts at federal, state and local levels; direct- and participant-observation of several preparedness exercises, meetings, clinics, etc.; and a wide array of documents from the various research sites and elsewhere. Several modes of analysis were employed, including policy narrative analysis, genealogical tracings of specific practices and logics, and grounded theory techniques.;Three sets of findings are presented. First, legislators and experts testifying at committee hearings employed a number of narrative techniques which successfully rendered ambiguous information, past and present events, and other uncertainties into dangers requiring imminent intervention. Second, techniques such as the risk- or cost-benefit analysis seem highly ineffective as a method to organize and structure difficult-to-grasp objects such as extremely unlikely (low probability) events. Moreover, the Smallpox Vaccination Program appears not to have been an instance of an emergent preparedness rationality, but rather a traditional public health program ill-suited to the demands of a national or homeland security program. Third, local public health preparedness efforts appear to lack structures and mechanisms to help sustain them in the long run, which in some sense also violates the logic of a preparedness rationality.
机译：本文考察了美国生物威胁和公共卫生准备的出现。这项研究的主要目标围绕着追踪病原体和疾病被理解为既对人口又对国家构成危险的方式，以及如何使对这些危险的反应变得可想和可采取的行动。研究地点共有三个，其中包括：（1）美国国会，主要在国会委员会的听证会上阐明了生物威胁； （2）疾病控制和预防中心以及免疫实践咨询委员会共同致力于思考特定的生物威胁天花，并在世纪之交之前将其纳入命运不佳的天花疫苗接种计划； （3）在加利福尼亚州的五个县的公共卫生部门，这些国家的防疫策略和努力已经付诸实践。直接和参加者观察一些备灾演习，会议，诊所等；以及来自各个研究站点和其他地方的大量文档。采用了多种分析模式，包括政策叙事分析，特定实践和逻辑的家谱追踪以及扎实的理论技巧。首先，在委员会听证会上作证的立法者和专家采用了许多叙事技巧，成功地将模棱两可的信息，过去和现在的事件以及其他不确定因素转化为需要立即干预的危险。其次，诸如风险或成本效益分析之类的技术作为一种组织和构造难以把握的对象（例如极不可能（低概率）的事件）的方法似乎非常无效。此外，天花疫苗接种计划似乎不是突发事件防范合理性的一个实例，而是传统的公共卫生计划，不适合国家或国土安全计划的要求。第三，地方公共卫生防备工作似乎缺乏长期帮助维持这些公共卫生的结构和机制，从某种意义上说，这也违反了防备合理性的逻辑。

著录项

  • 作者

    Rose, Dale Aubrey.;

  • 作者单位

    University of California, San Francisco.;

  • 授予单位 University of California, San Francisco.;
  • 学科 Public policy.;Public health.;Public administration.
  • 学位 Ph.D.
  • 年度 2007
  • 页码 427 p.
  • 总页数 427
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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