New Report Places 25 States and DC in High Performance Tier on 10 Public Health Emergency Preparedness Measures

WASHINGTON, Feb. 5, 2020 /PRNewswire/ -- Twenty-five states and the District of Columbia were high-performers on a three-tier measure of states' preparedness to protect the public's health during an emergency, according to a new report released today by Trust for America's Health (TFAH). The annual report, Ready or Not 2020: Protecting the Public's Health from Diseases, Disasters, and Bioterrorism, found year-over-year improvement among 10 emergency readiness measures, but also notes areas in need of improvement. Last year, 17 states ranked in the report's top tier.

For 2020, 12 states placed in the middle performance tier, down from 20 states and the District of Columbia in the middle tier last year, and 13 placed in the low performance tier, the same number as last year.

The report found that states' level of preparedness has improved in key areas, including public health funding, participation in healthcare coalitions and compacts, hospital safety, and seasonal flu vaccination. However, other key health security measures, including ensuring a safe water supply and access to paid time off, stalled or lost ground.


                Performance Tier              States  
       
           Number of States

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     High Tier              AL, CO, CT, DC, DE,
                                  IA, ID, IL, KS, MA,
                                  MD, ME, MO, MS, NC,
                                  NE, NJ, NM, OK, PA,
                                  TN, UT, VA, VT, WA,
                                  WI                    
       25 states and DC

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     Middle Tier            AZ, CA, FL, GA, KY,
                                  LA, MI, MN, ND, OR,
                                  RI, TX                  
         12 states

    ---


       
     Low Tier               AK, AR, HI, IN, MT,
                                  NH, NV, NY, OH, SC,
                                  SD, WV, WY              
         13 states

    ---

The report measures states' performance on an annual basis using 10 indicators that, taken together, provide a checklist of a jurisdiction's level of preparedness to prevent and respond to threats to its residents' health during an emergency. The indicators are:


            
     
       Preparedness Indicators

                ---


       
     1     Incident Management: Adoption of the Nurse Licensure    6 Water Security: Percentage of the population who used a
                 Compact.                                                 community water system that failed to meet all
                                                                          applicable health-based standards.

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     2     Cross-Sector Community Collaboration: Percentage of     7 Workforce Resiliency and Infection Control: Percentage
                 hospitals participating in healthcare coalitions.        of employed population with paid time off.

    ---


       
     3     Institutional Quality: Accreditation by the Public      8 Countermeasure Utilization: Percentage of people ages 6
                 Health Accreditation Board.                              months or older who received a seasonal flu
                                                                          vaccination.

    ---


       
     4     Institutional Quality: Accreditation by the Emergency   9 Patient Safety: Percentage of hospitals with a top-
                 Management Accreditation Program.                        quality ranking ("A" grade) on the Leapfrog Hospital
                                                                          Safety Grade.

    ---


       
     5     Institutional Quality: Size of the state public health 10 Health Security Surveillance: The public health
                 budget, compared with the past year.                     laboratory has a plan for a six- to eight-week surge
                                                                          in testing capacity.

    ---

Four states (Delaware, Pennsylvania, Tennessee, and Utah) moved from the low performance tier in last year's report to the high tier in this year's report. Six states (Illinois, Iowa, Maine, New Mexico, Oklahoma, Vermont) and the District of Columbia moved up from the middle tier to the high tier. No state fell from the high to the low tier but six moved from the middle to the low tier: Hawaii, Montana, Nevada, New Hampshire, South Carolina, and West Virginia.

"The increasing number of threats to Americans' health in 2019, from floods to wildfires to vaping, demonstrate the critical importance of a robust public health system. Being prepared is often the difference between harm or no harm during health emergencies and requires four things: planning, dedicated funding, interagency and jurisdictional cooperation, and a skilled public health workforce," said John Auerbach, President and CEO of Trust for America's Health.

"While this year's report shows that, as a nation, we are more prepared to deal with public health emergencies, we're still not as prepared as we should be. More planning and investment are necessary to saves lives," Auerbach said.

TFAH's analysis found that:

    --  A majority of states have plans in place to expand healthcare capacity
        in an emergency through programs such as the Nurse Licensure Compact or
        other healthcare coalitions. Thirty-two states participated in the Nurse
        Licensure Compact, which allows licensed nurses to practice in multiple
        jurisdictions during an emergency. Furthermore, 89 percent of hospitals
        nationally participated in a healthcare coalition, and 17 states and the
        District of Columbia have universal participation, meaning every
        hospital in the state (+ DC) participated in a coalition. In addition,
        48 states and DC had a plan to surge public health laboratory capacity
        during an emergency.
    --  Most states are accredited in the areas of public health, emergency
        management, or both. Such accreditation helps ensure that necessary
        emergency prevention and response systems are in place and staffed by
        qualified personnel.
    --  Most people who got their household water through a community water
        system had access to safe water. Based on 2018 data, on average, just 7
        percent of state residents got their household water from a community
        water system that did not meet applicable health standards, up slightly
        from 6 percent in 2017.
    --  Seasonal flu vaccination rates improved but are still too low. The
        seasonal flu vaccination rate among Americans ages 6 months and older
        rose from 42 percent during the 2017-2018 flu season to 49 percent
        during the 2018-2019 season, but vaccination rates are still well below
        the 70 percent target established by Healthy People 2020.
    --  In 2019, only 55 percent of employed people had access to paid time off,
        the same percentage as in 2018. The absence of paid time off has been
        shown to exacerbate some infectious disease outbreaks. It can also
        prevent people from getting preventive care.
    --  Only 30 percent of hospitals, on average, earned top patient safety
        grades, up slightly from 28 percent in 2018. Hospital safety scores
        measure performance on such issues as healthcare associated infection
        rates, intensive-care capacity and an overall culture of error
        prevention. Such measures are critical to patient safety during
        infectious disease outbreaks and are also a measure of a hospital's
        ability to perform well during an emergency.

Other sections of the report describe how the public health system was critical to the vaping crisis response, how health inequities put some communities at greater risk during an emergency, and the needs of people with disabilities during an emergency.

The full text of the report can be accessed at www.tfah.org/report-details/readyornot2020

Trust for America's Health is a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority. www.tfah.org. Twitter: @healthyamerica1

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SOURCE Trust for America's Health