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About one year ago, we were preparing to visit Puerto Rico and St. Croix for a STate Activation and Response (STAR) meeting.
Our STAR meetings are one of the most impactful things we do at NACDD – within 24-48 hours, we help Chronic Disease Units to assess their capabilities, identify opportunities for increasing organizational efficiency and effectiveness, and develop a short-term (six-month to one year) plan for achieving increased organizational capacity.
But one year ago, Hurricane Maria hit, and everything changed for Puerto Rico and St. Croix.
This past week, NACDD team members and I were honored to visit these two islands and complete STAR visits with their chronic disease teams.
Remnants of Hurricane Maria’s devastating damage and its impact - not just on chronic disease prevention and control, but also on islands' daily functions - permeated everything we saw and did even 11 months later.

St. Croix health department staff have been working for months in temporary space as their original office remains uninhabitable. In Puerto Rico, the bottom floor of the health department is still flooded. 
On both islands, boarded up businesses are a common sight, and infrastructures are still recovering. Electrical grid functioning is mostly back up, but remains in a fragile state, especially in Puerto Rico.
Mental health and stress are becoming significant concerns, as health department workers must deal with the significant emotional trauma that they experienced from the hurricane while working to help their communities recover.
Both teams shared with us that they have a clearer vision for tangible things jurisdictions and states can do before and after a crisis to help chronic disease programs recover.
Puerto Rico and St. Croix have not given up on their original program goals. Instead, they have learned to be more flexible in achieving what is possible given the many challenges they face following such a significant natural disaster.
And we are here for them.
During the past year, we have been working to increase our crisis capabilities, and even have been selected as one of a core group of organizations that can be called upon to provide as-needed emergency support to U.S. states and territories experiencing public health or healthcare crises. We’re also collecting your crisis plans for chronic disease response (email them to me directly at
We can’t predict the next major health crisis or natural disaster. However, we are preparing to help you and the communities you serve to overcome these challenges, both in the short and long-term.

In Good Health,

John W. Robitscher, MPH
National Association of Chronic Disease Directors

P.S. Check out the news, events, and other opportunities that we have curated for you below in our monthly newsletter. 
Learn about the latest developments in research and policy and chronic disease prevention, control, and health promotion. GET ENGAGED
Find white papers, webinars, and networking events that can enhance your current work.
  • Participate in a Live Webinar with CMS Administrator Seema Verma on Monday, Aug. 27 from 11:30 a.m. - 12:00 p.m. ET. In a conversation led by ACLC co-chair Dr. Mark McClellan, Administrator Verma will share plans for CMS alternative payment models including the recently announced Pathways for Success ACO changes, her vision for CMS’ role in value-based care, and how private sector collaborations play a part in advancing value throughout the country. She will also take a few questions from the audience. This webinar is available to NACDD Members as a Member benefit through NACDD's partnership with the Accountable Care Learning Collaborative.
Look for opportunities for you or your staff's professional development. ATTEND EVENTS 
Visit NACDD's chronic disease calendar to view relevant upcoming events in chronic disease prevention and control and health promotion. 
Copyright © 2018 National Association of Chronic Disease Directors, All rights reserved.

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