Since the terrorist attacks of 2001, much research has examined national- and state-level preparedness against bioterrorism or naturally-occurring epidemics. Few studies, however, have adequately addressed preparedness at the local level, and research indicates the difficulty of accurately assessing preparedness at any level. In this vein, this dissertation examined preparedness across the thirty-five health districts of Virginia in four defined preparedness categories: personnel, services, technology, and emergency. Preparedness indicators were examined with respect to demographic, geographic, and critical infrastructure characteristics at the county and city level. In all four categories of preparedness, statistically significant models were derived relating factors of demography, geography, and critical infrastructure to higher or lower levels of preparedness across the Commonwealth of Virginia. This dissertation serves as a basis for the extended research necessary of all local health districts across the United States.
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