Ready or Not? 2006

Trust for America’s Health (TFAH) today released the fourth annual “Ready or Not? Protecting the Public’s Health from Disease, Disasters, and Bioterrorism,” which found that five years after the September 11th and anthrax tragedies, emergency health preparedness is still inadequate in America.

The “Ready or Not?” report contains state-by-state health preparedness scores based on 10 key indicators to assess health emergency preparedness capabilities. All 50 U.S. states and the District of Columbia were evaluated. Half of states scored six or less on the scale of 10 indicators. Oklahoma scored the highest with 10 out of 10; California, Iowa, Maryland, and New Jersey scored the lowest with four out of 10. States with stronger surge capacity capabilities and immunization programs scored higher in this year’s report, since four of the measures focus on these areas.

Among the key findings:

• Only 15 states are rated at the highest preparedness level to provide emergency vaccines, antidotes, and medical supplies from the Strategic National Stockpile.
• Twenty-five states would run out of hospital beds within two weeks of a moderate pandemic flu outbreak.
• Forty states face a shortage of nurses.
• Rates for vaccinating seniors for the seasonal flu decreased in 13 states.
• Eleven states and D.C. lack sufficient capabilities to test for biological threats.
• Four states do not test year-round for the flu, which is necessary to monitor for a pandemic outbreak.
• Six states cut their public health budgets from fiscal year (FY) 2005 to 2006; the median rate for state public health spending is $31 per person per year.

The report also offers a series of recommendations to help improve preparedness. Some key recommendations include:

• The federal government should establish improved “optimally achievable” standards that every state should be accountable for reaching to better protect the public, and the results should be made publicly available. Appropriate levels of funding should be provided to the states to achieve these standards.
• Establishment of temporary health benefits for the uninsured or underinsured during states of emergency. This benefit is necessary to ensure that sick people will stay home, and the uninsured and underinsured will seek treatment in times of emergency, helping to prevent the unnecessary spread of infectious diseases, including resulting from acts of bioterrorism or a pandemic flu outbreak.
• A single senior official within the U.S. Department of Health and Human Services should be designated to be in charge of and accountable for all public health programs. The senior official would streamline government efforts and be the clear leader during times of crisis.
• Emergency surge capacity capabilities should be improved by integrating all health resources and partnering with businesses and community groups in planning, and increasing stockpiles of needed equipment and medications.
• The volunteer medical workforce should be expanded and an investment must be made in the recruitment of the next generation of the public health workforce.
• Technology and equipment must be modernized and research and development must be strengthened.
• The public should be better included in emergency planning, and risk communication must be modernized.