Outbreak or Attack: The Effects of Federalism on the U.S. Public Health System as Shown by the Emergence of the West Nile Virus

Abstract

In today’s ever shrinking world, the complexities of the U.S. public health model, and the federalism system in which it operates, jeopardize the government’s ability to effectively and efficiently deal with an outbreak or biological attack. This is clearly demonstrated by the events surrounding the 1999 West Nile outbreak. Problems persist in the public health arena—problems that can be addressed to make public health preparedness more effective and efficient than it is today. The West Nile virus seems to advance farther summer, spreading into new areas and infecting more and more people. Changes need to be made to ensure a system is in place that adequately meets the demands of a natural outbreak or biological terrorism event. The current federal system divides the powers of government between roles allocated to the federal government and roles allocated to the state governments. The principles of federalism seem to be somewhat fluid in meeting the current demands of the country. In the past, levels of federal involvement have increased and decreased over the years. However, public health, which has