A jurisdictional risk assessment for the whole community: A new, systematic approach to participatory decision-making in public health emergency preparedness using the analytic hierarchy process

In 2018, the New York City (NYC) Department of Health and Mental Hygiene piloted a novel jurisdictional risk assessment (JRA) for public health disasters using the analytic hierarchy process (2018 JRA-AHP). This new approach offers a replicable and equitable model for consensus decision-making that incorporates the complexities of disaster preparedness. Its main contribution to the field is to offer a practical manifestation of emergency management's Whole Community Approach. The 2018 JRAAHP applied this principle by expanding traditional definitions of expertise' to include lived experience of disaster and facilitating direct participation in the risk decision by a variety of individuals with diverse backgrounds, expertise and knowledge of public health disasters. This paper describes the theory, methods and results behind the JRA-AHP. The paper also presents a critical analysis of public health disaster risk assessments; contextualizes the Whole Community Approach using models of the relationship between democratic governments and communities; and addresses the practical applications of the 2018 JRA-AHP in NYC while exploring the potential challenges that other jurisdictions may face in attempted adaptation.