In December 2006, President George W. Bush signed the Pandemic and All Hazards Preparedness Act (PAHPA) into law. This act established the US Department of Health and Human Services' Office of the Assistant Secretary for Preparedness and Response (ASPR) and mandated the development of a strategy for the nation's health security. Over the past several years, the National Association of County & City Health Officials (NACCHO) has worked with ASPR to support local health departments' (LHDs') initiatives related to national health security and community resilience. National health security is defined as "a state in which the nation and its people are prepared for, protected from, and resilient in the face of incidents with health consequences."1 Communities face intentional and naturally occurring threats and risks, both persistent and emerging, such as severe weather, infectious diseases, and terrorist attacks. Like so many things, improving the health security of our nation begins at the community level.1

The goal of the National Health Security Strategy (NHSS) is supported by the 5 strategic objectives and corresponding priority areas. The 5 strategic objectives are as follows:

1. Build and sustain healthy, resilient communities;

2. Enhance the national capability to produce and effectively use both medical countermeasures and nonpharmaceutical interventions;

3. Ensure comprehensive health situational awareness to support decision making before incidents and during response and recovery operations;

4. Enhance the integration and effectiveness of the public health, health care, and emergency management systems; and

5. Strengthen global health security.

By focusing on these strategic objectives, LHDs are demonstrating the important role they play in contributing to health security in their communities. Over the past 2 years, NACCHO and ASPR have made a concerted effort to highlight the activities of those LHDs that are setting the example of national health security in action and to provide resources and support to LHDs that are looking to improve health security in their communities. To accomplish these goals, NACCHO, with support from ASPR, developed the National Health Security Awards Program and the NHSS Strategic Messaging Guide.

National Health Security Awards

At NACCHO's Annual Conference in 2015, ASPR and NACCHO announced a new award program recognizing the accomplishments of LHDs related to national health security. The National Health Security Awards highlight departments that have demonstrated significant achievements and successes in improving health security within their jurisdictions. As evidenced by the strategic objectives, LHDs can impact health security in a number of ways. This impact is not limited to public health preparedness-an LHD's day-to-day operations also have a significant impact on national health security. For example, every vaccination clinic or disease prevention campaign improves health security. When public health officials track a disease outbreak or connect people with preventive or health promotion services, health security gets a boost. Coordinating the delivery of drugs, supplies, and provisions to disaster survivors or supporting skills-building and continuing education within LHDs advances the nation's health security. In fact, everything LHDs do is meant to improve the health of people in their community; healthier people are more likely to survive a disaster and bounce back faster.

For the initial offering of the National Health Security Awards Program, LHDs were invited to submit applications in the following categories: (1) health care coalition building; (2) youth engagement; and (3) volunteer recruitment and training. These categories reflected some of the important health security concepts and provided applicants with a familiar frame of reference for making the connection between their existing programs or initiatives and the NHSS.

NACCHO received a number of high-quality applications and selected 3 organizations to receive the award for their valuable contributions and commitment to national health security.

Healthcare Coalition Development: Salt Lake County Health Department (Utah)

The Salt Lake, Summit, Tooele Healthcare Coalition partnered with the Granite School District to conduct an exercise at a school designated for students with access and functional needs. Not only did this exercise strengthen the abilities of the health care coalition but it also engaged external partners in public health preparedness planning.

Youth Engagement: Macomb County Health Department (Michigan)

The Macomb County Health Department created a program to teach fifth-grade students about the importance of emergency preparedness. During these trainings, students learned about different types of emergencies, how to build a preparedness kit for their homes, and how to create a communications plan with their families.

Volunteer Recruitment and Training: Seattle King County Health Department (Washington)

The Seattle King County Health Department Medical Reserve Corps provided health screenings at a local food bank on a regular basis. Nurse volunteers worked with clients to address physical and mental health needs and provided referrals for follow-up care. This activity provided critical health screening services to people who otherwise may not have access to them.

In addition to recognizing these LHDs for their achievements, NACCHO developed a resource for departments that aimed to strengthen the connection between their day-to-day activities and national health security.

NHSS Strategic Messaging Guide

In the fall of 2016, NACCHO announced the release of the NHSS Strategic Messaging Guide. This tool is designed for LHDs to easily create and communicate messages about national health security to media outlets, policy makers, and the general public. To develop this guide, NACCHO began with federal guidance and used feedback from local public health officials to modify the messages to meet the needs of LHDs. The messages are intended to be edited and expanded to reflect agency-specific activities and effectively demonstrate the importance of national health security at the local level.

NACCHO created this messaging guide to help tie national health security to the day-to-day operations of LHDs in the United States. By incorporating the content of this guide with a messaging strategy (eg, speeches, printed materials, communication plans), local public health officials can effectively raise awareness about national health security to a variety of audiences.

The messaging guide comprises 5 chapters, each focused on a different strategic objective of the NHSS. Each chapter begins with a messaging goal that conveys what can be achieved by talking about the chosen strategic objective, followed by several lead messages, which are short, concrete statements meant to introduce the topic to the intended audience. Each lead message has several supporting messages that can be used to elaborate upon and strengthen the topic being addressed. Lead and supporting messages should be edited and expanded to reflect specific details as appropriate, enabling public health officials to deliver appropriate messages to different target audiences.

In addition to messaging strategies, each chapter also includes short stories that provide real-world examples of how LHDs are contributing to national health security in their jurisdictions. These short stories are used to inspire and encourage the reader to make similar connections between health security and their own activities.

Finally, discussion questions at the end of each chapter encourage the readers to make the connection between national health security and their agency's daily work. These questions are meant to be thought-provoking and reflective and should be used to brainstorm specific examples of how various activities relate to each strategic objective.

Everything that LHDs do impacts the nation's health security. Through activities such as the National Health Security Awards Program and the NHSS Strategic Messaging Guide, NACCHO is supporting LHDs in their efforts to build stronger, healthier, and more resilient communities.

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