Background: The Emory Preparedness and Emergency Response Research Center (Emory PERRC) that CPHPR led from 2008 - 2015 focused on the comparative analysis of public health systems to produce practical and sustainable outcomes that serve to improve our nation's public health systems in the event of a disaster. The Emory PERRC addressed the third theme within the IOM's 2008 Research priorities in emergency preparedness and response for public health systems: A letter report: "creating and maintaining sustainable preparedness and response systems throughout US public health network." Led by Ruth Berkelman, MD and an interdisciplinary team of project directors and staff from epidemiology, health policy and management, emergency medicine, and medicine, the Emory PERRC examined state and local health departments' systems of preparedness to identify factors that affect a community's ability to successfully respond to a crisis with public health consequences and documented the systems and infrastructure needed to foster constructive responses in a sustainable manner.