Much of the country is ill-equipped and ill-prepared to deal with a public health emergency, such as a bioterror attack, a large foodborne illness outbreak or a natural disaster, according to a new report from Trust for America’s Health (TFAH), a nonprofit, nonpartisan public-health advocacy organization.
Specifically, the report, “Ready or Not: Protecting the Public’s Health from Diseases, Disasters and Bioterrorism,” found that 26 states and the District of Columbia scored six or lower on 10 high-priority indicators of health emergency preparedness.
Minnesota was one of those 26 states.
That’s not to say that the country has failed to make progress on the emergency preparedness front in recent years. The report notes, for example, that 45 states (including Minnesota) and the District of Columbia are now able to more speedily test for cases of Shiga toxin-producing E. coli — a measure of a state’s ability to detect foodborne outbreaks. And 32 states (including Minnesota) and the District of Columbia have received a grade of C or higher for state-level preparedness for climate change-related threats.
“Public health preparedness has improved leaps and bounds from where we were 10 years ago,” said Paul Kuehnert, director of the public health team at the Robert Wood Johnson Foundation, which funded the report, in a released statement. “But severe budget cuts at the federal, state and local levels threaten to undermine that progress. We must establish a baseline of ‘better safe than sorry’ preparedness that should not be crossed.”
As the report makes clear, the country frequently finds itself being caught off guard when a new public health emergency arises, whether it’s a disease outbreak (like Zika or Ebola), a natural disaster, or a bioterrorist threat.
“The current system is not built for “readiness” — to be able to consistently respond in an effective and efficient way when new crises occur,” the report explains. “Health security is chronically underfunded. So when emergencies happen, they divert time, attention and resources away from other ongoing needs and priorities.”
The report notes that health emergency funding has fallen from $940 million in 2002 (soon after 9/11) to $660 in 2016.
Minnesota’s middling score
The state with the highest ranking for health-related emergency preparedness is Massachusetts, which had a perfect score of 10. Next comes North Carolina and Washington, each with a score of 9. The states with the lowest scores (3 of 10) are Alaska and Idaho.
Minnesota’s score was 6 — above that of South Dakota (5), but below that of its other immediate neighbors, Iowa (8), Wisconsin (7) and North Dakota (7).
The four emergency preparedness indicators that Minnesota did not receive a point for were:
- Increasing or maintaining funding for public health over the past fiscal year. (Twenty-six other states did meet this goal.)
- Vaccinating at least half of the state’s residents (ages six months and older) for the seasonal flu during the 2015-2016 influenza season. (Ten states met this goal.)
- Implementing four recommended activities to build capacity for the prevention of healthcare-associated infections, which are infections “caught” by people while they are receiving treatment in a hospital or other health-care facility. The four activities include creating an infrastructure that can quickly identify and respond to such outbreaks and training health-care personnel to prevent them. (Thirty-five states and the District of Columbia met this goal.)
- Having a formal program in progress for getting private sector health-care staff and medical supplies into restricted areas during a disaster. (Ten states met this goal.)
Room for improvement
MinnPost reached out to the Minnesota Department of Health (MDH) for comment on the state’s somewhat disappointing performance in the report.
“Like Trust for America’s Health (TFAH), we strongly believe that being prepared for public health emergencies and crises should be a high priority for health departments and state governments across the nation,” responded MDH spokesperson Michael Schommer via e-mail. “While Minnesota has ranked highly on many other rankings of states with regard to public health, and by another recent report focusing on emergency preparedness (the National Health Security Preparedness Index), we appeared to fall just short on some of the indicators chosen by TFAH. Nevertheless, we are proud of the work we’ve done in the area of preparedness even as we continue to work hard to improve that readiness.”
Schommer pointed out that Minnesota’s flu vaccination rate is currently 49.7 percent — which is just under the 50 percent rate that TFAH uses for its flu vaccination metric. In addition, at the time TFAH collected its information for the current report, Minnesota had implemented three of the four activities designated to increase capacity for preventing health-care-associated infections, and has since added the fourth one — a structured way of validating state-level data collected about such infections.
The MDH does not play a major role in getting medical supplies and health-care personnel into restricted areas during an emergency (that’s the purview of the Minnesota Department of Public Safety), Schommer noted. As for the fourth indicator Minnesota fell short on — public health funding — Schommer explained that “states vary widely in the details of their budgets and this makes direct comparisons across states difficult.”
“In the case of Minnesota, our approach to public health has always been a collaboration across federal, state and local levels of government,” he stated. “Minnesota has historically been successful at seeking federal grant dollars, for example, to fund activities like emergency response and readiness. However, in recent years this federal funding has been reduced.”
FMI: You’ll find the full “Ready or Not” report — and a page providing details about Minnesota’s scores — on the TFAH website.