Public Health

Public Health Readiness Plagued by Budget Cuts, Report Says

National report says that although significant progress has been made toward improving public health preparedness, persistent gaps remain.

While there has been significant progress toward improving public health preparedness over the past 10 years, persistent gaps remain in the country’s ability to respond to health emergencies. Issued by the Trust for America’s Health and Robert Wood Johnson Foundation, the 10th annual Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism report said 35 states and Washington, D.C., scored a six or lower on 10 key indicators of public health preparedness.

Kansas and Montana scored lowest — three out of 10 — and Maryland, Mississippi, North Carolina, Vermont and Wisconsin scored highest — eight out of 10.

“In the past decade, there have been a series of significant health emergencies, including extreme weather events, a flu pandemic and foodborne outbreaks,” said Jeffrey Levi, executive director of Trust for America’s Health, in a press release. “But for some reason, as a country, we haven’t learned that we need to bolster and maintain a consistent level of health emergency preparedness.”

Key findings from the report include:

  • 29 states cut public health funding from fiscal years 2010-2011 to 2011-2012, with 23 of these states cutting funds for a second year in a row and 14 for three consecutive years.
  • 35 states and Washington, D.C., do not currently have complete climate change adaptation plans, which include planning for health threats posed by extreme weather events.
  • 21 states have not been accredited by the Emergency Management Accreditation Program.
  • 13 state public health laboratories reported they do not have sufficient capacity to work five, 12-hour days for six to eight weeks in response to an infectious disease outbreak.

“Public health preparedness has improved leaps and bounds from where we were 10 years ago,” said Paul Kuehnert, director of the Public Health Team at the Robert Wood Johnson Foundation, in a statement. “But severe budget cuts at the federal, state and local levels threaten to undermine that progress. We must establish a baseline of ‘better safe than sorry’ preparedness that should not be crossed.”

The report outlines recommendations that address gaps in emergency health preparedness, including:

  • Reauthorize the Pandemic and All-Hazards Preparedness Act.
  • Sufficient, dedicated funds are needed for public health preparedness to ensure basic capabilities to respond to threats public health departments face every day and also to have the trained experts and systems in place to act quickly in the face of major, unexpected emergencies.
  • Provide ongoing support to communities so they better cope and recover from emergencies.
  • Modernize biosurveillance to a real-time, interoperable system to better detect and respond to problems.

State Scores

For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. The data for the indicators are from publicly available sources or were provided from public officials. The indicators included that the states increased or maintained the level of funding for public health services; have a climate change adaptation plan; and have been accredited by the Emergency Management Accreditation Program.

8 out of 10: Maryland, Mississippi, North Carolina, Vermont and Wisconsin

7 out of 10: Alabama, Arkansas, California, Delaware, Nebraska, New Hampshire, New Mexico, New York, North Dakota and Virginia

6 out of 10: Connecticut, Idaho, Iowa, Kentucky, Louisiana, Maine, Massachusetts, Missouri, Ohio, Oklahoma, South Carolina, Tennessee, Utah, Washington and Wyoming

5 out of 10: Alaska, Arizona, Washington, D.C., Florida, Illinois, Indiana, Michigan, Minnesota, Oregon, Pennsylvania, Rhode Island, South Dakota, Texas and West Virginia

4 out of 10: Colorado, Georgia, Hawaii, Nevada and New Jersey

3 out of 10: Kansas and Montana

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