By Michael Doyle Bee
Fresno Bee (California)
Copyright 2006 McClatchy Newspapers, Inc.
All Rights Reserved
WASHINGTON — California remains more vulnerable than most states to public health disasters, a new nationwide assessment concluded Tuesday.
Citing the state’s nursing shortage, relative lack of hospital beds and vaccination gaps, among other problems, the nonpartisan Trust for America’s Health gave California the lowest possible preparedness grade. Forty-six other states did better.
Even so, the report found problems coast to coast.
“The nation is nowhere near as prepared as we should be for bioterrorism, bird flu or other natural disasters,” said Jeff Levi, executive director of Trust for America’s Health.
California flunked six out of 10 public health categories assessed by the Washington-based nonprofit organization. Only New Jersey, Iowa and Maryland did as poorly.
Funded by foundations including the Pew Charitable Trusts and the Robert Wood Johnson Foundation, the Trust for America’s Health has produced three previous state-by-state report cards. Those reports, though, did not cover all the same health measures.
Still, on some measures the state has shown improvement. In 2004, California was criticized for lacking sufficient labs and lab scientists. Now, the report gives the state passing grades in those categories.
Some alleged shortcomings, like an imperfect disease surveillance system, are in the state’s control. Others, like the nursing shortage, present both public and private challenges. And some already have been dealt with, in ways not reflected in the 84-page report.
Recently, for instance, California kicked in $214 million to boost the state’s ability to handle a surge in hospital patients. The money will fund three mobile disaster hospitals. No decision has been made on where they will be based.
“California, in the last few months, has been making an investment,” acknowledged Trust for America’s Health spokeswoman Laura Segal. “They’re taking some creative measures.”
The director of California’s Emergency Medical Services Authority, Dr. Cesar Aristeiguieta, said Tuesday that the 200-bed mobile facilities will be fully equipped with operating rooms, pharmacies and supplies by June.
“This is the largest civilian purchase of field hospitals ever,” Aristeiguieta said. “It will be a very robust capacity.”
Gov. Schwarzenegger’s latest budget included funding for 50 million masks for use in a flu epidemic, 2,400 battery-powered ventilators to help emergency patients breathe and 3.7 million courses of anti-viral medicine.
California’s nursing shortage cited in the new report likewise strikes a familiar chord. The state currently graduates nearly 6,000 nurses annually but needs an additional 9,000 each year.
San Joaquin Valley colleges train nurses, “but then they like to go off to more exciting places,” said Gloria Fitzgerald, program manager for a nurses training program at the Fresno-based Community Medical Centers.
Community, along with Madera Community Hospital and others, now tries to reinforce its nursing staff through its own training program. Support employees work part time while the hospitals pay for nursing school, after which the new nurses face a two-year work commitment.
The Trust report found other public health system shortcomings.
California and most other states, for instance, stumble for allegedly not being fully prepared to distribute medicines held in a Strategic National Stockpile.
The report, completed before California’s new budgeting for mobile hospitals, also cited a hospital bed shortage. Within two weeks of a “moderate” flu pandemic, analysts predicted, California’s hospitals would be overwhelmed by more patients than there are beds.
Other parts of the report appear to be a close call.
In California, for instance, 69.3% of senior citizens received flu vaccinations between 2003 and 2005. This was higher than states like Texas or Virginia. But because California’s vaccination rate fell from 72% in 2002, the state was downgraded on the new report card. Texas and Virginia, meanwhile, all received credit for minuscule increases — less than 1% — during the same period.
The nation experienced significant shortages of flu vaccines in 2004, with scattered shortages reported again last year.