The yearlong study outlines 10 criteria, including state funding levels and infrastructure readiness, to gauge states' readiness to respond to a health crisis. Seventy-five percent of states failed to meet at least half of those criteria, with five states -- Arkansas, Kentucky, Mississippi, New Mexico and Wisconsin -- meeting only two of the 10 indicators. Even the four states at the top of the list -- California, Florida, Maryland and Tennessee -- still satisfy only seven of the study's indicators.
Trust for America's Health Executive Director Shelley Hearne said state budget cuts for public health programs mean that much of the federal money is being used to replace state funding, not to supplement it. Additionally, she said, bureaucratic obstacles such as state hiring freezes often leave the federal funds in limbo. Also, despite the national focus on emergency preparedness in the past two years, health emergency response programs at the state level face a history of inadequate attention and funding, Hearne said.
"The federal bioterrorism funds were an important first step," she said. "However, two years of increased funding cannot make up for two decades of underinvestment."
The report calls on Congress and the president to convene a national summit to develop a cohesive idea for the national public health system.