Disasters and public health emergencies—whether local or global, natural or human-caused—result in unique combinations of human exposures, hazards, and stressors. These conditions are often not well understood in terms of their immediate physical and mental health impacts, as well as longer-term consequences.
Too often, basic questions on the safety and health of communities impacted by a disaster or public health emergency, as well as of those who respond to such events, go unanswered. The historical lack of research that considers questions such as these is a critical missed opportunity. Such questions might include:
- Are the risks different for certain people such as pregnant women, older adults, or those with pre-existing health conditions?
- How do we accurately measure environmental exposures over time? How do we intervene to prevent harm from them?
- How do we diagnose and treat harm that has occurred?
- Is my home and yard safe for my family and pets?
- Is it OK to breath the air, drink the water, or eat food grown in our neighborhood?
- What are the best strategies for reducing potential physical and mental health effects, both immediately and over the long term?
- What are the burdens on underserved communities with a history of elevated toxic exposures?
Environmental health sciences (EHS) research that is appropriately integrated into existing and emerging response frameworks for disasters and public health emergencies can help attain answers. This information can inform future response, recovery, and preparedness efforts, which in turn, will help increase resiliency among individuals, communities, and nations.
The NIH Disaster Research Response (DR2) Program spearheads U.S. efforts and works with global partners to improve capacity for timely disaster and public health emergency research through:
- Access to highly relevant research tools through the DR2 Resources Portal.
- Connection to a broadly inclusive DR2 Community of Practice.
- Information on research and engagement Funding & Support.
- Support for Human Studies & Research Ethics in the context of disasters.
- Training & Education materials, workshops, and symposia.
- Disaster Research Response: Learning from Disasters - This 8.5-minute video describes the activities of the NIH Disaster Research Response program and the need for expanded research into the health impacts of disasters and integration of research with response.
- Exposure: Research and Training for Emerging Health Threats - This 10-minute retrospective video describes highlights of disaster research in response to the World Trade Center collapse and the Exxon Valdez oil spill.
Visit the DR2 Videos webpage to view all DR2-related videos.
DR2 Program Strategic Alignment
Just as disasters and public health emergencies cut across myriad aspects of health and society, the DR2 Program is similarly crosscutting in its efforts to address the human consequences of such events. DR2 integrates knowledge from nearly every aspect of environmental health sciences, combines the specialized skills and perspectives of multiple research and implementation disciplines, and collaborates across an ever-broadening network of societal sectors and stakeholders. DR2 Program initiatives occur in purposeful alignment with the goals and objectives of the Strategic Plans of the NIEHS, National Institutes of Health (NIH), and U.S. Department of Health and Human Services (HHS). DR2 also contributes to U.S. efforts under global agreements and guidance including the Sendai Framework for Disaster Risk Reduction, the U.N. 2030 Sustainable Development Goals, the Global Health Security Agenda, and WHO guidance to protect health from climate change through adaptation planning, among others.
NIEHS Strategic Plan Advancing Science, Improving Health: A Plan for Environmental Health Research, 2018-2023
The DR2 Program supports the goals and objectives of the NIEHS Strategic Plan, and is especially relevant to achievement of:
- Theme 2: Promoting Data to Knowledge to Action
- Goal 5: Emerging Environmental Health Issues
“We live in an increasingly complex environment in which new exposures and related health threats continuously arise, both locally and globally. Some, such as industrial accidents and weather-related disasters, pose acute public health emergencies that require the capacity for immediate action to understand and respond to them. Others, such as long-term climate impacts on health and pandemic diseases, create a need for both immediate response and ongoing study, to help prepare for future threats. NIEHS is strongly committed to addressing emerging environmental health issues through our research and translation goals, as well as by continuing to work with our public health partners to improve response, recovery, remediation, and resilience to EHS threats.”
- Goal 5: Emerging Environmental Health Issues
NIEHS Strategic Plan Advancing Science, Improving Health: A Plan for Environmental Health Research, 2012-2017
The DR2 Program supports the goals and objectives of the NIEHS Strategic Plan, and is especially relevant in the achievement of:
- Goal 5: Identify and respond to emerging environmental threats to human health, on both a local and global scale
- Enlist the capacity of the environmental health science (EHS) research enterprise to elucidate information necessary for timely and effective public health action
- Act proactively with other public health partners to provide appropriate responses to emerging environmental threats, both natural and man-made
- Focus on research needs to help inform policy responses in public health situations in which lack of knowledge hampers policymaking
NIH-Wide Strategic Plan 2021-2025
The DR2 Program support the Priorities and Objectives of the NIH-Wide Strategic Plan, and is especially relevant in the achievement of:
- Objective 1: Advancing Biomedical and Behavioral Sciences: Meeting Emerging Public Health Needs
The DR2 Program support the priorities and objectives of the NIH-Wide COVID-19 Strategic Plan, and is especially relevant in the achievement of:
- Priority 1: Improve Fundamental Knowledge of SARS-CoV-2 and COVID-19
- Objective 1.3: Advance the understanding of SARS-CoV-2 transmission and COVID-19 dynamics at the population level
- Objective 1.4: Understand COVID-19 disease progression, recovery, and psychosocial and behavioral health consequences
- Priority 5: Prevent and Redress Poor COVID-19 Outcomes in Health Disparity and Vulnerable Populations
- Crosscutting Strategies:
- Supporting the research workforce and infrastructure
- Investing in data science
The DR2 Program supports the Goals and Objectives of the HHS Strategic Plan, and is especially relevant in the achievement of:
- Strategic Goal 2: Protect the Health of Americans Where They Live, Learn, and Play
- Strategic Objective 2.4: Prepare for and respond to public health emergencies
- Strategic Goal 4: Foster Sound, Sustained Advances in the Sciences
- Strategic Objective 4.1: Improve surveillance, epidemiology, and laboratory services
- Strategic Objective 4.2: Expand the capacity of the scientific workforce and infrastructure to support innovative research
- Strategic Objective 4.3: Advance basic science knowledge and conduct applied prevention and treatment research to improve health and development
History of the DR2 Program
NIEHS has improved understanding of the health impacts of disasters and public health emergencies for more than 30 years, through research in response to events ranging from the 2001 World Trade Center terrorist attacks; the 2010 Deepwater Horizon Gulf Oil Spill; Hurricanes Katrina, Sandy, and Harvey; and the infectious disease outbreaks of Zika, Ebola, and COVID-19. These events and others have created awareness of the need for acquiring timely scientific evidence to better understand and more effectively address the range of health concerns arising from disasters and public health emergencies. This awareness has continued to grow over the past decade as disasters and public health emergencies have increasingly impacted communities, resulting in calls for action and the creation of the DR2 Program.
2011: The National Biodefense Science Board issues a call for scientific investigations as an integral component of disaster planning and response.
2012: The HHS Assistant Secretary for Planning and Response Workshop: Scientific Preparedness and Response for Public Health Emergencies outlined six areas of need for improvement in disaster research response, including: clinical standards protocols and datasets; surveys, rosters, and medical testing; specimen and scientific collections; policies and processes; funding mechanisms; and identifying responders.
2013: NIH Director Francis Collins and other federal public health leaders co-author a seminal article, Research as Part of Public Health Response, in the New England Journal of Medicine. Subsequently, NIEHS and the National Library of Medicine (NLM) receive funding from NIH to collaboratively initiate the Disaster Research Response Pilot Project. The project quickly launches a public website, including a repository of research tools and resources, to reduce delays in fielding studies in response to disasters and public health emergencies.
2014: NIH, the Centers for Disease Control and Prevention, the U.S. Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response, and the National Academy of Science, Engineering, and Medicine’s Institute of Medicine convene a workshop on Enabling Rapid and Sustainable Public Health Research During Disasters. More than 200 stakeholders from government agencies, academia, professional associations, emergency management, industry, and the private sector identify challenges to improving the nation’s public health research capacity in response to disasters, including:
- The lack of a formal way to activate and coordinate research among agencies, academia, and other stakeholders
- Difficulty in providing time-critical funding for both government and non-governmental research efforts
- Slowness of reviews of research protocols involving human subjects
- Lack of ready-to-go research tools and protocols
- Lack of trained researchers to design protocols and quickly gather perishable data in the field
- Lack of meaningful inclusion of community stakeholders as part of the research efforts
Workshop participants also discussed how best to integrate research into existing response structures, as well as how to share ideas, technologies, and mechanisms necessary to support rapid and longitudinal disaster research. The workshop findings helped to serve as an organizing framework for the DR2 Program going forward.
2015: The Sendai Framework for Disaster Risk Reduction 2015-2030 recognizes that disaster research issues are part of a growing global concern, and asserts that risk management should be based on an understanding of the disaster risks in all of its dimensions, including vulnerability, capacity, exposure of persons and assets, hazard characteristics, and the environment.
2016: NIEHS and National Toxicology Program Director Linda Birnbaum, Ph.D., creates a dedicated funding designation to transform the DR2 Pilot Project to a sustained, permanent program of the Institute. NLM continues to contribute support through hosting of the website, development of the data repository, and expert staff engagement. The DR2 Program continues to grow, increasing access to disaster research tools and resources, providing workshops and trainings around the country and the world, developing a template for the rapid review of research protocols, regularly convening a federal Interagency Disaster Interest Group , and providing leadership and support to build a DR2 Community of Practice among researchers and other stakeholders.
2016–2020: A series of academic reports and federal assessments underscore the growing need for disaster and public health emergency research, and begin to document best practices and lessons learned from response to specific events.
In 2016, the U.S. Global Change Research Program releases a scientific assessment, The Impacts of Climate Change on Human Health in the United States, which describes the increasing frequency and severity of extreme weather events and their effect on people’s health, including specific chapters on effects on mental health and vulnerable populations of concern. Though not intended as a research needs assessment, the process of developing the document brings to light myriad research gaps, including those that might best be filled through disaster research.
In 2017, NASEM publishes Integrating Clinical Research into Epidemic Response: The Ebola Experience, an assessment of the value of the clinical trials held during the 2014–2015 epidemic and recommendations about how the conduct of trials could be improved in future international emerging or re-emerging infectious disease events.
A January 2017 report published by the American Academy of Sciences, Science During Crisis: Best Practices, Research Needs, and Policy Priorities, lays out the case for research as part of response to disasters.
2017-2018: Hurricane Harvey slams Houston in August, providing a test of the DR2 Program. A DR2 training exercise had been held in Houston in 2015 based on a similar hurricane and flood disaster scenario. The academic and community partners that participated in that exercise launched data and sample collection in the community within two weeks after the hurricane to inform exposure and other environmental health studies. Harvey was followed in quick succession by Hurricanes Maria (September 2017), Florence (September 2018), and Michael (October 2018), each of which posed numerous environmental health threats to affected communities.
2020: The onset of the COVID-19 pandemic in 2020 presented a new set of challenges for the DR2 Program, including the urgent need for ready-to-deploy research tools and resources to empower the global scientific community to determine the type and extent of the threat, and how to intervene.
- Disaster Research Response (DR2) Program
Aubrey K. Miller, M.D., M.P.H.
Senior Medical Advisor
31 Center Dr
Claude D Pepper Building
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Richard Kwok, Ph.D.
P.O. Box 12233Mail Drop A3-05Durham, N.C. 27709
Joan P. Packenham, Ph.D.
Director, NIEHS Office of Human Research Compliance (OHRC);
DIR CRP OCR CD
P.O. Box 12233Mail Drop CU-02Durham, N.C. 27709
April L. Bennett
31 Center Dr
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Kimberly Thigpen Tart, J.D., M.P.H.
Health Science Policy Analyst
P.O. Box 12233Mail Drop K3-02Durham, N.C. 27709
Champ-Blackwell, Siobhan, M.S.L.I.S.
Health Science Librarian
National Library of Medicine
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Stacey Arnesen, M.S.
Deputy Chief, Public Services Division, Library Operations
National Library of Medicine
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