For the past eight years, Trust for America's Health and the Robert Wood Johnson Foundation has released the Ready or Not? report to ascertain how well the nation's public health system is prepared to respond to disease outbreaks, natural disasters, or acts of bioterrorism.
We feel it is incredibly important to conduct this report because the public deserves to know how prepared their states and communities are to respond to public health emergencies.
To date, federal and state governments have only released limited current specific data about the status of emergency preparedness. We want to shine a light on preparedness because all Americans have the right to expect fundamental health protections during public health emergencies no matter where they live. This report helps identify the areas of strength and weakness that should be addressed in our nation's capabilities.
We have good news!
The states had the highest scores ever for health emergency preparedness. These scores reflect nearly ten years of progress to improve how the nation prevents, identifies, and contains new disease outbreaks and bioterrorism threats and responds to the aftermath of natural disasters in the wake of the September 11, 2001 and anthrax tragedies. In addition, the real-world experience responding to the H1N1 flu pandemic - supported by emergency supplemental funding - also helped bring preparedness to the next level.
We found that more than three-quarters of the states scored a seven or higher on key indicators of public health preparedness, with 14 states of those states scoring a nine or higher. Three states - Arkansas, North Dakota, and Washington State - scored 10 out of 10. Meanwhile, no state scored lower than a five.
But, as we find in the report - this year, the Great Recession is taking its toll on emergency health preparedness.
And the bad news: nearly a decade of gains are in real jeopardy due to severe budget cuts at the federal, state, and local level.
In the report, we found that 33 states and Washington, D.C. cut funding for public health last year. For 18 states, this was the second year in a row of cuts. The Center on Budget and Policy Priorities has found that states have experienced overall budgetary shortfalls of $425 billion since FY 2009.
So far, some of the cuts have not yet affected public health as dramatically as in some other sectors due to various one-time funding streams including the supplemental funding provided by the American Recovery and Reinvestment Act and emergency funding for the H1N1 response- but now, the cuts are really hitting home.
Quite simply, the combined federal, state, and local cuts constitute an emergency for emergency health preparedness in the United States.
This is not a funding wolf cry. While most reports and sectors call for additional funding to spur advancements, we know that increased funding leads to increased preparedness. We are far more ready for a bioterrorist attack or natural disaster than we were a decade ago. However, we're beginning the slide back to the pre-September 11 world.
If we continue, our country will have persistent and prevalent gaps in our ability to respond to a major health emergency. Most notably, there are currently gaps in basic infrastructure and funding, biosurveillance, maintaining an adequate and expertly trained workforce, developing and manufacturing vaccines and medicines, surge capacity for providing care in major emergencies, and helping communities cope with and recover from emergencies.
I'll address some recommendations for these concerns in future posts. For now, I want the report to serve as a clarion call to continue the progress to date. We don't want to look back in three, five, or ten years and say we were better prepared in 2010 than we are in 2013, 2015 and 2020.
The full report and recommendations are available at http://healthyamericans.org/reports/bioterror10/.