By James Devitt
January 3, 2013
The “siloed” structure of U.S. health agencies hinders efforts to spot and combat animal-to-human afflictions such as West Nile virus, NYU sociologist Colin Jerolmack concludes after conducting an organizational analysis of their operations.
Even though many newly emerging infectious diseases spread from one species to another, Jerolmack found that “agency members interpret certain diseases as ‘livestock diseases’ or ‘wildlife diseases,’ and they view categories of animals outside their purview as irrelevant to their institutional prerogatives. Consequently, there is little sense of mutual understanding and common goals, and thus little coordination across these various organizations.”
Jerolmack’s study, which appeared in the journal Sociology of Health and Illness, examined a state Department of Health; the U.S. Department of Agriculture (USDA); a state Department of Wildlife; a state Department of Agriculture; and the Centers for Disease Control and Prevention (CDC). Through interviews with agency or departmental personnel, he looked at how the distinct organizational cultures of these agencies produced incompatible or even competing agendas that hampered efforts to respond to “zoonoses”—infectious diseases that can be passed between species.
Jerolmack’s interviews revealed several instances in which agencies and departments adopted a siloed, rather than cooperative, approach when faced with zoonoses. In one case, a state Department of Agriculture official bristled at efforts to remove livestock that may have posed a health risk to residents because, “We’re here to support anyone doing farming,” said the official. In another, a city public health official, responding to an outbreak of salmonella, did not turn to the state’s Department of Agriculture, the USDA, or any other agencies involved in animal health. Even instances in which agency cooperation has led to medical breakthroughs—such as the discovery that West Nile virus may be transmitted from birds to humans—have not produced reform.
“Though the discovery of West Nile was greeted with alarm and massive pesticide sprays, it did not usher in a sea change regarding zoonotic surveillance and communications across states and agencies,” Jerolmack observes, adding that a USDA official told him that following the West Nile outbreak in 1999, agency and departmental practices returned to “business as usual.”
Jerolmack notes the CDC has recognized the need to do a better job of building relationships with the veterinary world. In 2006, it created the Geographic Medicine and Health Promotion Branch, which tracks the flows of both humans (as travelers) and animals (as they are imported or exported), and its director, Nina Marano, is a veterinarian. He adds that during an outbreak of rabies in the 1990s, state agencies worked together to stem the tide of the disease—a response he views as an “example of the successful alignment of priorities and action among the myriad agencies responsible for human and animal health.”
However, his study found these instances to be the exception rather than the norm.
“Although each agency’s institutionalized habits of thought and action may have been relatively well-adapted to addressing the diseases that traditionally concerned each organization,” Jerolmack writes, “they constrain members from building the inter-organizational and interdisciplinary bridges required to manage the latest ‘hybrid’ diseases.”