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Study: Many states fall short on emergency preparedness :

December 20, 2017

Many states are not well-prepared to respond to public health emergencies, according to a new report.

Nonprofit group Trust for America’s Health found inconsistent approaches and significant reductions in federal funding for preparedness.

“We need to pay attention to strengthening our public health preparedness efforts,” said Trust for America’s Health President and CEO John Auerbach, M.B.A. “Last year the focus was on Zika; this year the focus is on weather-related emergencies. There’s no predicting what the next emergency will be that public health departments have to respond to.”

The group scored states’ health emergency preparedness using 10 indicators, including funding, antibiotic stewardship, flu vaccination rates and biosafety training. It noted scores are not an indicator of how specific health departments are performing. The findings are detailed in the report Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism, which is available at

Twenty-five states met five or fewer of the 10 indicators. Massachusetts and Rhode Island topped the list with nine, while Alaska was at the bottom with two.

One of the major stumbling blocks is federal funding for preparedness, which has been cut by more than half since 2002, according to the report. Nineteen states and Washington, D.C., maintained or increased their public health budgets in the 2016-’17 fiscal year compared to the previous year.

“Cuts and inconsistent funding can often threaten the ability to consistently maintain some very core types of protections,” Auerbach said.

Another key metric was flu vaccination rates. At least half of the eligible population was vaccinated during the 2016-’17 flu season, and no state was above 56%, according to the report.

AAP CEO/Executive Vice President Karen Remley, M.D., M.B.A., M.P.H., FAAP, a member of the Trust for America’s Health Board of Directors, emphasized that vaccines save lives.

“Engaging in ongoing education about the value and safety of vaccines now will … help better support our communities when rapid vaccination campaigns may be necessary in the event of a new major outbreak or a bioterrorism threat,” she said.

The study also found

  • 30 states and Washington, D.C., have accredited health departments,
  • 20 states and Washington, D.C., have 70% or more hospitals meeting core elements of antibiotic stewardship programs,
  • 47 states and Washington, D.C., have laboratories with biosafety professionals, and
  • 14 states are members of the United States Climate Alliance to reduce greenhouse gas.

The group made several recommendations to improve preparedness, including supporting a supplementary public health emergency fund, improving vaccination rates, mitigating climate threats, expanding efforts to stop antibiotic resistance and modernizing infrastructure to support science and technology.

“We must support a culture of resilience, so all communities are better prepared to cope with and recover from emergencies, particularly focusing on those who are most vulnerable,” Auerbach said.

Those who are vulnerable include children, according to Dr. Remley, who called for preparedness efforts tailored to children’s unique needs. Those efforts include making sure enough child-appropriate medical equipment, immunizations and medications are available in an emergency. In addition, she said every family and school district should have a preparedness plan that is regularly practiced and updated.

“If a community is prepared to meet the needs of a child during a disaster, that community will be more resilient,” she said. “If they are not prepared to meet the needs of children during that disaster, then we as a nation cannot say we are prepared because they are our future.”

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