An Overview of US One Health Initiatives: Conflicting Roles and Authorities between Public Health and Emergency Management during Animal Health Infectious Disease Outbreaks

Introduction: One Health plays an important role in public health emergencies and pandemic preparedness. Successful public health interventions of infectious disease spread require cooperation of human health, environmental health, and animal health partners. However, One Health is still a new policy initiative in the United States. Few studies have looked at One Health initiatives across U.S. states, and which agencies are involved or excluded from such policy priorities. Methods: To assess scope, primary data was collected from federal and state agencies, ASTHO, and the NCSL. This data was supplemented with elite interviews of state bureaucrat leaders in emergency management and public health to determine whether One Health was an explicitly mentioned policy priority in public health emergency preparedness across states. Results: Less than a third of US states have/had a One Health Committee or Task Force, many of which have little authority or power to ensure intragovernmental collaboration and cooperation. One-fourth have a division within an agency dedicated to One Health, or they have One Health listed as an official policy priority. Very few states have passed laws or policies that establish official state One Health programs. One Health is most commonly located within a state department of health or public health. Moreover, relationships between emergency management and public health agencies are variable, with little coordination at the subnational level. Formal One Health initiatives are located in environmental health departments or siloed departments within public health. Informal initiatives are coalitions across academic research institutions, nonprofit actors, community organizations, and individual state bureaucratic “policy entrepreneurs”. Conclusion: While One Health pushes for a collaborative, multisectoral, and transdisciplinary approach, there is little evidence that such initiatives are occurring in practice across US states and localities. Stronger collaborations between emergency management and public health agencies are needed at both the state and local levels.