On the 20th Anniversary of the September 11th Terror Attacks the Nation is Better Prepared but Still not Fully Prepared for Public Health Emergencies


(Washington, DC – September 6, 2021) – On the 20th anniversary of the September 11th attacks on the World Trade Center and the Pentagon, Trust for America’s Health (TFAH) reflects on the nation’s strong progress in preparedness for public health emergencies, as well as the major challenges that still exist, including those illuminated by the COVID-19 pandemic.

In 2002, following the first anniversary of this tragedy and the subsequent anthrax attacks, TFAH released its first analysis of the response and limitations of the public health system, Public Health Preparedness: Progress and Challenges Since September 11, 2001. From this report, TFAH’s Ready or Not: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism report series was developed.  The 2021 Ready or Not report highlights the urgent need for federal, state, and local policymakers to prioritize the nation’s health security as we work toward ending the COVID-19 pandemic and preparing for extreme weather, the health impacts of climate change, future pandemics, and other emerging threats.

“The COVID-19 pandemic, the devastating wildfires, and the unfolding impacts of Hurricane Ida are only the most recent reminders of the need to strengthen our nation’s health security,” said J. Nadine Gracia, MD, MSCE, TFAH President and CEO. “The 20th anniversary of September 11th is an important milestone to mark the progress we have made in the past two decades: we have built a public health preparedness enterprise from the ground up, including a dedicated public health emergency workforce. But we must make additional and sustained investments in public health infrastructure and workforce, and we must ensure equity is at the center of preparedness, response, and recovery efforts.”

TFAH recommends the following policy actions to strengthen the nation’s emergency response capacity:

  • Federal, state, and local governments should bolster public health infrastructure investments. Congress should enact the Public Health Infrastructure Saves Lives Act and make annual investments in public health infrastructure to build the workforce and systems that have been chronically neglected for decades.
  • Congress should invest in modernizing public health data systems. Modern and sustainable public health data systems and the collection of complete and disaggregated demographic data will facilitate a more effective and equitable public health response during future emergencies.
  • Public health and government leaders must be equipped to deliver effective public communications and counter misinformation. Misinformation, such as inaccurate social media messaging, has been a significant barrier to developing a proactive public health response during the COVID-19 pandemic and has increased vaccine hesitancy. Congress must fund research and implementation of public health communications and messaging, grounded in the best available science, to counter misinformation.
  • Equity should be an explicit and foundational component of preparedness and response at all levels of public health. The COVID-19 pandemic has highlighted that health inequities are exacerbated during emergencies. Health departments and policymakers should build the health equity workforce, partner with, and provide resources to trusted community organizations, and incorporate equity leadership into all emergency planning and response.
  • Federal and state lawmakers should invest in policies and capacity to improve social and economic conditions in communities and advance equity and resilience. People at highest risk during disasters and those who have the hardest time recovering are often those with unstable or unhealthy housing, limited access to transportation, and people who live in low-income communities – circumstances often rooted in longstanding systemic inequities. Congress should invest in the Center for Disease Control and Prevention (CDC) efforts to address the social determinants of health. Lawmakers and employers should advance policies and promote multisector efforts to ensure access to healthy, affordable housing; promote economic mobility through living wage and paid sick and family leave policies; eliminate poverty; address food security; and improve transportation.

This month, the nation commemorates the thousands of lives lost during the 9/11 attacks, continues to mourn the hundreds of thousands of lives lost to COVID-19, and honors the heroic efforts of first responders, the public health workforce, and healthcare workers. As we reflect and move forward, we must commit to preventing and preparing for public health emergencies in ways that ensure that everyone’s health and well-being are protected during times of crisis.


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Trust for America’s Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.


Rhea Farberman [email protected]