Ready or Not?

Delaware Scored Seven out of 10 on Key Indicators Related to Preventing, Detecting, Diagnosing and Responding to Outbreaks

Report Finds the Nation Often Caught Off Guard when a New Threat Emerges

Washington, D.C., December 20, 2016 – A report released today by Trust for America’s Health (TFAH) finds Delaware scored seven out of 10 on key indicators of public health preparedness.

In Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism, 26 states and Washington, D.C. scored a six or lower on 10. Alaska and Idaho scored lowest at 3 out of 10, and Massachusetts scored the highest at 10 out of 10, with North Carolina and Washington State scoring 9’s.

The report found that the nation is often caught off guard when a new threat arises, such a Zika or the Ebola outbreak or bioterrorist threat, which then requires diverting attention and resources away from other priorities.

“Health emergencies can quickly disrupt, derail and divert resources from other ongoing priorities and efforts from across the government,” said Rich Hamburg, interim president and CEO, TFAH.  “Many areas of progress that were made after 9/11 and the anthrax attacks to improve health security have been undercut.  We aren’t adequately maintaining a strong and steady defense, leaving us unnecessarily vulnerable when new threats arise.”

Ready or Not? examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies.  Some key Delaware findings include:

No. Indicator Delaware Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Public Health Funding Commitment: State increased or maintained funding for public health from FY 2014 to FY 2015 and
FY 2015 to FY 2016.
N/A 26
2 National Health Security Preparedness Index: State met or exceeded the overall national average score (6.7) of the National Health Security Preparedness IndexTM, as of 2016. Y 30 + D.C.
3 Public Health Accreditation: State had at least one accredited public health department. Y 43 + D.C.
4 Flu Vaccination Rate: State vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2015 to Spring 2016. Y 10
5 Climate Change Readiness: State received a grade of C or above in States at Risk: America’s Preparedness Report Card. Y 32 + D.C.
6 Food Safety: State increased the speed of DNA fingerprinting using pulsed-field gel electrophoresis (PFGE) testing for all reported cases of E. coli. Y 45 + D.C.
7 Reducing Healthcare-Associated Infections (HAIs): State implemented all four recommended activities to build capacity for HAI prevention. N/A 35 + D.C.
8 Public Health Laboratories: State public health laboratory provided biosafety training and/or provided information about biosafety training courses for sentinel clinical labs (from July 1, 2015 to June 30, 2016). Y 44
9 Public Health Laboratories: State public health laboratories reported having a biosafety professional on staff (from July 1, 2015 to June 30, 2016). Y 47 + D.C.
10 Emergency Healthcare Access: State has a formal access program or a program in progress for getting private sector healthcare staff and supplies into restricted areas during a disaster. N/A 10
Total 7

In addition, the report examined trends in public health preparedness over the last 15 years, finding successes and ongoing concerns.

  • One-third of funds for health security and half of funds for healthcare system preparedness have been cut: Health emergency preparedness funding for states has been cut from $940 million in fiscal year (FY) 2002 to $660 million in FY 2016; and healthcare system preparedness funding for states has been cut by more than half since FY 2005 – down to $255 million.
  • Some major areas of accomplishment: Improved emergency operations, communication and coordination; support for the Strategic National Stockpile and the ability to distribute medicines and vaccines during crises; major upgrades in public health labs and foodborne illness detection capabilities; and improvements in legal and liability protections during emergencies.
  • Some major ongoing gaps: Lack of a coordinated, interoperable, near real-time biosurveillance system; insufficient support for research and development of new medicines, vaccines and medical equipment to keep pace with modern threats; gaps in the ability of the healthcare system to care for a mass influx of patients during a major outbreak or attack; and cuts to the public health workforce across states.

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Requiring strong, consistent baseline public health Foundational Capabilities in regions, states and communities-so that everyone is protected.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of foundational capabilities alongside a complementary Public Health Emergency Fund which would provide immediate surge funding during an emergency.
  • Improving federal leadership before, during and after disasters – including at the White House level.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as the Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks by developing stronger coalitions and partnerships among providers, hospitals, insurance providers, pharmaceutical and health equipment businesses, emergency management, and public health agencies.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop Superbugs and antibiotic resistance.
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.

Ready or Not? was released annually from 2003-2012, and more recently, TFAH has released Outbreaks: Protecting Americans from Infectious Diseases, from 2013-2015The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF) and is available on TFAH’s website at www.healthyamericans.org.

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.

  • 10 out of 10: Massachusetts
  • 9 out of 10: North Carolina and Washington
  • 8 out of 10: California, Connecticut, Iowa, New Jersey, Tennessee and Virginia
  • 7 out of 10: Colorado, Delaware, Florida, Indiana, Maryland, Michigan, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Carolina, Utah and Wisconsin
  • 6 out of 10: Arizona, Arkansas, District of Columbia, Georgia, Hawaii, Illinois, Kansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Montana, Nebraska, Ohio, Pennsylvania, Texas and Vermont
  • 5 out of 10: Alabama, Missouri, Oklahoma, South Dakota and West Virginia
  • 4 out of 10: Nevada and Wyoming
  • 3 out of 10: Alaska and Idaho

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