Outbreaks: Protecting Americans from Infectious Diseases

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Nation Scored N/A out of 10 on Key Indicators of Policies and Capabilities to Protect against Infectious Disease Threats

Majority of States Reach Half or Fewer of Key Indicators

Washington, D.C., December 17, 2013 – A new report released today by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) finds Nation scored N/A out of 10 on key indicators of policies and capabilities to protect against infectious disease threats.

The Outbreaks: Protecting Americans from Infectious Diseases report finds that the nation’s ability to prevent and control infectious disease outbreaks is hampered by outdated systems and limited resources.

A majority of states (33) score 5 or lower out of 10 key indicators in the report. Three states tied for the lowest score, achieving two out of 10 possible indicators – Georgia, Nebraska and New Jersey. New Hampshire had the highest score, with 8 out of 10.

“From antibiotic-resistant Superbugs to Salmonella to the seasonal flu, infectious diseases disrupt lives and communities,” said Jeffrey Levi, PhD, executive director of TFAH. “Fighting these diseases requires constant vigilance. The bad news is that we found major gaps in the country’s ability to prevent, control and treat outbreaks, leaving Americans at an unacceptable level of unnecessary risk.”

Some key Nation findings include:

No. Indicator Nation Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Increased or maintained level of funding for public health services from FY 2011-12 to FY 2012-13. N/A 17
2 Met the HHS goal of vaccinating 90 percent of 19- to 35-month-olds against whooping cough. N/A 2 + D.C.
3 Requires the HPV vaccine for teens — or funds HPV vaccination efforts or educates the public about the HPV vaccine. N/A 25 + D.C.
4 State vaccinated at least half of their population (ages 6 months and older) for the seasonal flu during the 2012-2013 flu season. N/A 12
5 State has a complete climate change adaptation plan that include focusing on the impact of human health. N/A 15
6 State mandates that healthcare facilities in their state report healthcare-associated infections. N/A 35 + D.C.
7 Does your public health lab have a plan and capability to handle a significant surge in testing over a six to eight week period in response to an outbreak that increases testing over 300%. N/A 37 + D.C.
8 Does your public health lab currently have the capacity in place to assure the timely transportation (pick-up and delivery) of samples 24/7/365 days to the appropriate public health Laboratory. N/A 46 + D.C.
9 From July 1, 2012 to June 30, 2013 did your public health lab evaluate the functionality of your continuity of operations plan (COOP) via a real event or an exercise. N/A 27
10 State covers routine HIV screening under their Medicaid programs. N/A 31 + D.C.
Total N/A

The report’s indicators are developed in consultation with leading public health experts based on data from publicly available sources or information provided by public officials.

“Many infectious disease threats keep me up at night – from the emergence of a new deadly disease, such as the Middle East Respiratory Syndrome (MERS), to the prospect of bioterrorism, to antibiotic resistant infections, to the worsening of mosquito-borne illnesses being driven by changes in the climate,” said Tom Inglesby, MD, chief executive officer and director of the UPMC Center for Health Security.

Outbreaksprovides a series of recommendations that address many of the major gaps in infectious disease control and prevention, including:

  • Strengthening fundamental capabilities – maintaining an expert workforce and giving them state-of-the-art tools required to conduct investigations to quickly detect, control and treat disease outbreaks;
  • Countering antibiotic resistance and prioritizing research and development of medical countermeasures should be top health and national security priorities;
  • Increasing the number of Americans receiving recommended vaccinations and routine screenings for particular diseases, since these are the safest and most effective ways to reduce infectious diseases in the United States;
  • Modernizing disease surveillance and ensuring public health laboratories have the equipment and capacity to not only test for routine problems like foodborne illnesses but also for new and large-scale threats like bioterrorism or a pandemic;
  • Supporting policies and incentives to reduce the number of healthcare-associated infections, ensuring Americans can receive safe care;
  • Improving global coordination to prevent and contain emerging new illnesses like MERS while maintaining defenses against “old-school” threats like malaria and tuberculosis;
  • Shoring up the nation’s public health preparedness capabilities to respond to major disease outbreaks or acts of bioterrorism to ensure new threats can be rapidly identified and contained; and
  • Countering complacency around HIV/AIDS, hepatitis B and C (HBV and HCV) and tuberculosis- including countering an alarming rise in new HIV infections among young gay men, and screening millions of Baby Boomers who may be infected with HCV and do not know they are at risk for developing serious liver disease as they age.

The report and state-by-state materials are available on TFAH’s website at www.healthyamericans.org. The report was supported by a grant from RWJF.

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’s website. 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.

8 out of 10: New Hampshire

7 out of 10: Connecticut, Delaware, Minnesota, New York, North Carolina, Oregon, Rhode Island and Washington

6 out of 10: California, Colorado, D.C., Hawaii, Maryland, Missouri, Pennsylvania, Tennessee and Virginia

5 out of 10: Alaska, Florida, Illinois, Iowa, Louisiana, Maine, Massachusetts, Michigan, New Mexico, Oklahoma, South Carolina, South Dakota, Vermont and Wisconsin

4 out of 10: Alabama, Idaho, Indiana, Kansas, Kentucky, Mississippi, North Dakota, Ohio, Texas, Utah and West Virginia

3 out of 10: Arizona, Arkansas, Montana, Nevada and Wyoming

2 out of 10: Georgia, Nebraska and New Jersey

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. www.healthyamericans.org

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measureable, and timely change. For more than 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org. Follow the Foundation on Twitter www.rwjf.org/twitter or Facebook www.rwjf.org/facebook.