Trust for America's
Health (TFAH) released the fifth annual "Ready or Not? Protecting the
Public's Health from Disease, Disasters, and Bioterrorism" report, which
found that while important progress has been made, critical areas of the
nation's emergency health preparedness effort still require attention. In
addition, the continuing trend of annual cuts in federal funding for state
and local preparedness activities threatens the nation's safety.
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 (D.C.) were
evaluated. Thirty-five states and D.C. scored eight or higher on the scale
of 10 indicators. Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania,
Tennessee, and Virginia scored the highest with 10 out of 10. Arkansas,
Iowa, Mississippi, Nevada, Wisconsin, and Wyoming scored the lowest with
six out of 10.
"The improvements in state preparedness are encouraging, but the job of
preparing the United States for major health emergencies is not nearly
done," said Jeff Levi, Ph.D., Executive Director of TFAH. "And, just when
we are beginning to see a return on the federal investment in preparedness
programs, the President and Congress have continued to cut these funds.
These efforts may seem penny wise now, but could prove pound foolish
later."
For the state-by-state scoring, states received one point for each
indicator they achieved and zero points for each indicator they did not
achieve, therefore zero is the lowest possible overall score and 10 the
highest. Data for the public health indicators were collected from publicly
available sources or public officials in 2007.
Among the key findings:
-- Thirteen states do not have adequate plans to distribute emergency
vaccines, antidotes, and medical supplies from the Strategic National
Stockpile.
-- Twenty-one states do not have statutes that allow for adequate
liability protection for healthcare volunteers during emergencies.
-- Twelve states do not have a disease surveillance system compatible
with the Centers for Disease Control and Prevention's (CDC) National
Electronic Disease Surveillance System.
-- Seven states have not purchased any portion of their
federally-subsidized or unsubsidized antivirals to use during a pandemic
flu.
-- Seven states and D.C. lack sufficient capabilities to test for
biological threats.
"There is little doubt that emergency health preparedness is on the
national radar," Levi added. "But until all states are equally well
prepared, our country is not as safe as it can and should be."
The report highlights two areas of particular concern with regard to
state-level preparedness:
-- Twenty-one states do not provide sufficient legal protection from
liability for healthcare volunteers who respond to a call for assistance in
an emergency. Lack of such protections has been identified as a key
impediment to recruiting sufficient volunteers to respond to a major health
emergency. TFAH recommends that states adopt the Uniform Emergency
Volunteer Health Practitioners Act (UEVHPA), which has been approved by the
National Conference of Commissioners on Uniform State Laws.
-- Seven states have made no purchases toward their share of the
stockpile of antivirals for pandemic influenza. States have been asked to
purchase 31 million treatment courses of the 81 million course stockpile
target set by the federal government. Containment of a pandemic must be a
national priority. Any differences in capacity on a state-by-state basis
place the entire nation at risk.
The report also evaluates federal progress in preparing the country for
bioterrorism, disasters and disease. TFAH finds that the passage of the
Pandemic and All-Hazards Preparedness Act (PAHPA) of 2006, issuance of
presidential directives, and start-up of the new Office of the Assistant
Secretary for Preparedness and Response (ASPR) are significant steps
forward. Major challenges that remain include assuring adequate funding for
the ASPR's key programs, such as the Biomedical Advanced Research and
Development Authority (BARDA), and delivering on the requirements of PAHPA
to increase transparency and accountability in all federally-funded
preparedness programs.
"Ready or Not? 2007" also includes new information from a U.S. public
opinion poll commissioned by TFAH. The poll finds that:
-- Six years after the tragedies of September 11th, 54 percent of
Americans believe that the United States is not as safe now as it was prior
to September 11th, 2001.
-- Two years after Hurricane Katrina, nearly 60 percent of Americans do
not think their community would be prepared to respond to a natural
disaster.
-- Nearly 9 out of 10 Americans say they would abide by a voluntary
quarantine and stay home in the case of an outbreak of a pandemic flu.
Willingness to accept this type of quarantine exists across the public at
high levels. Among the 10 percent who say they would not adhere to the
government's request of a voluntary quarantine, most indicate that they
could not stay at home due to fears of losing needed income (64 percent) or
losing their jobs altogether (39 percent).
The survey was designed and conducted by Greenberg Quinlan Rosner
Research, Inc. Interviewing was conducted by professional interviewers, and
the survey reached 1,020 adults ages 18 and older.
TFAH's report was supported by a grant from the Robert Wood Johnson
Foundation. TFAH's report and state-by-state materials are available at:
healthyamericans.
Preparedness Indicators
1. Mass Distribution - Strategic National Stockpile - Does the state
have an adequate plan to distribute emergency vaccines, antidotes, and
medical supplies from the Strategic National Stockpile (SNS)?
2. Mass Distribution - Antiviral Stockpiling - Did the state purchase a
portion of its share of federally subsidized or unsubsidized antiviral
drugs to stockpile for use during an influenza pandemic?
3. Public Health Laboratories - Bio-Threat Testing - Does the state lab
director report having sufficient laboratory capabilities to test for
biological threats?
4. Public Health Laboratories - Workforce Surge Preparedness - If
needed in an emergency, does the state public health laboratory have the
capability to provide 24/7 coverage to analyze samples?
5. Biosurveillance -Does the state use a disease surveillance system
that is compatible with CDC's national system, including integrating data
from multiple sources, using electronic lab reporting, and using an
Internet browser?
6. Healthcare Volunteer Liability Protection - Does the state have laws
that reduce or limit the liability exposure for healthcare volunteers who
serve in a public health emergency?
7. Emergency Preparedness Drills - Does the state health department
engage the state National Guard in public health emergency preparedness
drills or training exercises?
8. Community Resiliency - Does the state meet a minimum threshold of
Medical Reserve Corps volunteers per 100,000 persons?
9. Public Health Progress - Seniors' Seasonal Flu Vaccination - Did the
state increase its rates for immunizing adults aged 65 and older for the
seasonal flu?
10. Funding Commitment - Did the state maintain or increase funding for
public health programs for FY 2005-06 to FY 2006-07?
State Score Summary
10 out of 10: Illinois, Kentucky, Nebraska, New Jersey, Pennsylvania,
Tennessee, Virginia
9 out of 10: Alabama, Colorado, Georgia, Hawaii, Indiana, Michigan,
Missouri, New Hampshire, New York, North Carolina, Ohio, Oregon, Utah,
Vermont
8 out of 10: Alaska, Arizona, California, Connecticut, Delaware,
District of Columbia, Louisiana, Maine, Maryland, Minnesota, New Mexico,
Oklahoma, South Carolina, Texas, West Virginia
7 out of 10:, Florida, Idaho, Kansas, Massachusetts, Montana, North
Dakota, Rhode Island, South Dakota, Washington
6 out of 10: Arkansas, Iowa, Mississippi, Nevada, Wisconsin, Wyoming
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.
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 quality of 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, meaningful, and timely change. For more than 35 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.
Trust for America's Health
healthyamericans
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