Most states get a failing grade on their current systems in place to safeguard public health, according to a new report from the nonprofit groups Trust for America’s Health and the Robert Woods Johnson Foundation. The report’s authors warn that officials must do more to strengthen their emergency preparedness plans, particularly because some looming threats — like contagious outbreaks, weather disasters, and potential bio-terrorism attacks — threaten to put Americans at risk.
The groups assessed states on 10 indicators of public health capacity — including vaccination rates, climate change adaption plans, effective reporting procedures to track infectious outbreaks, lab capacity, and funding and staffing levels. Just 16 states and the District of Columbia scored at least 60 percent. Another 15 states scored 50 percent, and the rest did worse.
“There are many components of public health response that we need to strengthen,” Tom Inglesby, the head of the Center for Health Security at the University of Pittsburgh Medical Center, notes in the report’s conclusion. “For example, for some time, our vaccination programs were among the strongest in the world. but, in recent years, we are struggling with falling vaccination rates.”
The consequences of low vaccination rates are becoming particularly evident. Many of the other public health indicators scored in the report, like whether states have come up with a plan to tackle the diseases that will become more prevalent as climate change progresses, are intended to protect Americans from future emergencies. Those crises haven’t happened yet. But this past year, several outbreaks of potentially deadly diseases were directly tied to vaccine denial.
Many states are falling behind in these areas because they’ve been repeatedly slashing their budgets for public health services. According to the Trust for America’s Health, two thirds of states cut funding for this area between 2011 and 2012, leaving their health departments stretched too thin. Public health investment isn’t faring much better on a federal level, either. The Centers for Disease Control’s (CDC) overall budget was hit with a $577 million cut between fiscal years 2012 and 2013.
Congress has only made this situation worse. “2013 was a year marked by limited congressional action, a government shutdown, the implementation of sequestration and a series of short term continuing resolutions to keep the government running for weeks at a time. Each of these conditions had a profound impact on the ability of the public health and health systems to protect Americans,” the authors write. Indeed, October’s government shutdown disrupted the CDC’s efforts to prepare for flu season and analyze a new outbreak of salmonella, and could have long-term consequences for scientific research.