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TFAH (Trust For America's Health) and the Robert Wood Johnson Foundation (RJWF) have released their 6th annual report card - Ready or Not? Protecting the Public's Health from Diseases, Disasters, and Bioterrorism - on the level of preparedness of each state to deal with disease, disasters, and bioterrorism.
The complete report is available as a PDF file (2mb), and there is a press release, as well.
While it finds that progress has been made in many areas to prepare for biological disasters, much remains to be done. Budget cuts over the past three years have had a significant impact on the ability of states to meet these challenges, and the level of preparedness varies considerably from state to state.
The ranking is based on 10 criteria with one point awarded to states that have:
- Has adequate plans to distribute emergency vaccines, antidotes, and medical supplies from the Strategic National Stockpile
- Purchased 50 percent or more of its share of federally-subsidized antiviral medications to prepare for a potential pandemic flu outbreak
- Public health lab has an intra-state courier system that operates 24 hours a day for specimen pick up and delivery
- State public health lab can meet the expectations of the state's pandemic flu plan
- Uses a disease surveillance system that is compatible with CDC's National Electronic Disease Surveillance System (NEDSS)
- Has laws that reduce or limit the liability exposure for health care volunteers who serve in a public health emergency
- Has laws that reduce or limit the liability for businesses and non-profit organizations that serve in a public health emergency
- State has a Medical Reserve Corps Coordinator
- State identified the pathogen responsible for reported foodborne disease outbreaks at a rate that met or exceeded the national average of 44 percent
- Increased or maintained level of funding for public health services from FY 2006-07 to FY 2007-08
Based on these criteria, states received between 5 and 10 points, with only Louisiana, New Hampshire, North Carolina, Virginia, and Wisconsin getting a perfect score.
Arizona, Connecticut, Florida, Maryland, Nebraska, and Montana are at the bottom of the list with 5 points.
One could argue that the criteria used here to judge each state's level of preparedness doesn't tell whole story, and perhaps that's true. But these items would certainly seem to be important indicators of how well each state is prepared.
(From the TFAH Web Page)
The report also offers a series of recommendations for improving preparedness, including:
- Restoring Full Funding. At a minimum, federal, state, and local funding for public health emergency preparedness capabilities should be restored to FY 2005 levels.
- Strengthening Leadership and Accountability. The next administration must clarify the public health emergency preparedness roles and responsibilities at the U.S. Department of Health and Human Services and U.S. Department of Homeland Security.
- Enhancing Surge Capacity and the Public Health Workforce. Federal, state, and local governments and health care providers must better address altered standards of care, alternative care sites, legal concerns to protect community assistance, and surge workforce issues.
- Modernizing Technology and Equipment. Communications and surveillance systems and laboratories need increased resources for modernization.
- Improving Community Engagement. Additional measures must be taken to engage communities in emergency planning and to improve protections for at-risk communities.
- Incorporating Preparedness into Health Care Reform and Creating an Emergency Health Benefit. This is needed to contain the spread of disease by providing care to the uninsured and underinsured Americans during major disasters and disease outbreaks.
If you don't want the whole report, you can click on your state at the bottom of this web page, and view just that report.
