About the Pennsylvania Public Health Risk Assessment Tool (PHRAT)

The Pennsylvania Public Health Risk Assessment Tool (PHRAT) was developed for the Pennsylvania Department of Health to help public health and health care planners prioritize their planning efforts for emergencies that impact the health of the public.

The Pennsylvania Department of Health used funding from the CDC’s Risk-based Funding Pilot Project to contract with the Center for Public Health Readiness and Communication at Drexel University's Dornsife School of Public Health to complete the PHRAT.

The PHRAT workbook and guide lead planners through an analysis of the health-related impacts of various hazards that can occur in their jurisdictions.

The PHRAT assesses the planning that is necessary to ensure access to emergency response and preparedness resources, taking into account the services provided by public health agencies and the healthcare system.

New: Updated PHRAT in 2023

The CPHRC team updated the PHRAT in 2023. We made several changes to facilitate use and interpretation of the tool’s findings. We also simplified the Preparedness Score calculation, added an at-risk population to the tool’s Adjusted Risk Score, and integrated several hazards that have emerged as important public health threats.

This 2023 version of the PHRAT contains the following changes:

• The Severity Score, which compiles a hazards impact, is now assessed in only 4 domains (Human Health, Healthcare Services, Community Operations, Public Health Services). The Healthcare Infrastructure domain is no longer included in the severity score.

• Hospitalizations per day is now included in the Human Health impact assessment, replacing primary care visits.
• Hospital personnel (nurses per patient) is now included in the Healthcare Service assessment.

• The Preparedness Score consists only of the Public Health Emergency Preparedness (PHEP) capabilities. The Healthcare Preparedness Program Capabilities (HPP) are no longer used for this calculation.
• The At-Risk Populations score now includes the population of a jurisdiction with “Limited Access to Technology,” in addition to the 9 previous categories.
• The opioid epidemic has been added to the list. Planning assumptions for “Active Shooter,” “Pandemic,” and “Cyber-Terrorism” have been updated to reflect more recent experiences with these threats.

Why did we make these changes?

These changes highlight the public health focus of this approach to risk assessment. In the 13 years since we developed this tool for public health risk assessment, we have learned that health care facilities use different tools for their own healthcare-oriented hazard and vulnerability analyses. The omission of the healthcare infrastructure domain and the HPP capabilities makes the tool easier to use, simplifies data collection, and makes the analysis more straightforward. We believe that the existing domains sufficiently capture a hazard’s impact on human health and health services without unnecessary complexity or detail. We believe that the updates to the metrics within these domains are a more appropriate way to assess a hazard’s impact.

Our public health colleagues in Pennsylvania requested the addition of the “limited access to technology” to the at-risk population calculation, based on their experiences during the COVID-19 pandemic. These users also requested the inclusion of the opioid epidemic in the list of hazards that are priorities for public health risk analysis, based on their recent experiences.

How to Use PHRAT

This tool can be used to generate a composite risk to the overall health of the entire jurisdiction, or it can be used to assess the risk of a hazard from the perspective of either the public health system or healthcare system, respectively.

PHRAT examines the severity of specific hazards based on their impact in four major domains:

• Human Health
• Healthcare Services
• Community Operations
• Public Health Services

This tool takes a quantitative approach to impact assessment, measuring baseline levels of morbidity, services, and activities, and comparing them to the morbidity, service impacts and activities that result from specific hazard incidents.

Download the Pennsylvania PHRAT User Guide and Assessment Tool here:

PHRAT User Guide (PDF)

Assessment Tool (Excel workbook)