Nation’s ability to manage health emergencies rises

The Index analyzes 129 different measures for each state and the nation —including the number of paramedics and medical volunteers

Associated Press

PRINCETON, N.J. — America’s day-to-day readiness to manage health emergencies has improved significantly over the past six years according to a nationwide index of health security, though the last year saw relatively slow rates of progress as deep regional differences remain.

Funded by the Robert Wood Johnson Foundation (RWJF), the 2019 National Health Security Preparedness Index shows that the United States scores a 6.7 on a 10-point scale for preparedness. That’s a 3.1 percent improvement over the last year, and a 11.7 percent improvement since the Index began in 2013.

Howard University Hospital in Washington is seen Friday, Oct. 3, 2014, as a District of Columbia ambulance passes. (AP Photo/J. Scott Applewhite)
Howard University Hospital in Washington is seen Friday, Oct. 3, 2014, as a District of Columbia ambulance passes. (AP Photo/J. Scott Applewhite)

The Index analyzes 129 different measures for each state and the nation—including the percentage of bridges that are in good condition, the prevalence of hazard planning in nursing homes, the number of paramedics and medical volunteers, and other factors—to calculate a composite score providing the most comprehensive picture of health security available. The scores indicate the ability to protect the health security of Americans from incidents like newly emerging infectious diseases, terrorism, and extreme weather conditions at the state and national levels.

“We are seeing some promising national numbers when it comes to our nation’s ability to cope with health emergencies,” said Alonzo Plough, PhD, MPH, chief science officer at RWJF. “Disasters like recent major hurricanes show that to take the next step in increasing our preparedness levels, we must focus on improving equity within our efforts.”

According to the 2019 Index, at the current rate of improvement, the nation will require 10 additional years to reach a strong health security level of at least 9.0. Conversely, if the country improved at the rate achieved by the five fastest-improving states, this threshold could be reached in fewer than six years.

“We’ve seen steady gains nationwide, but some states and regions are falling behind while others are moving ahead,” said Glen Mays, PhD, MPH, who leads a team of researchers at the University of Kentucky in developing the Index. “The overall progress is commendable, but we need to accelerate the pace of improvement and help all regions get stronger. The frequency and intensity of disasters is increasing, and we are all at risk.”

A total of 11 states and the District of Columbia had health security levels that were significantly above the national average in 2018, down from 22 jurisdictions a year earlier. Conversely, 17 states had health security levels that fell significantly below the national average, down from 20 states.

Additionally, a total of 32 states and the District of Columbia experienced one-year gains in health security levels in 2018. Four states saw reductions in 2018, and 14 states saw no change. Clusters of below-average states remain in the South-Central, Upper Mountain West, Pacific Coast, and Midwest regions. Above-average states cluster in the Northeast, Mid-Atlantic, Upper Midwest, and Central Rocky Mountain regions.

“States and communities have a responsibility to be prepared to respond to health emergencies, and to recover quickly from them,” said Nancy Messonnier, MD, acting director of CDC’s Center for Preparedness and Response. “Having a comprehensive index helps states see where cross-sector investments and cooperation are paying off and where more effort is needed.”

Based on a sophisticated model informed by experts in public health, emergency management, academia, health care, and other sectors, researchers collect, aggregate, and measure health security using data from more than 60 sources. The final measures fall into six categories, each of which is assessed independently, and cover topics such as:


  Average Since 2013
Overall score 6.7 11.7%
Health security surveillance: The ability to monitor and detect health threats, and to identify where hazards start and spread so that they can be contained rapidly. 8.3   10.7%
Community planning and engagement: The ability to develop and maintain supportive relationships among government agencies, community organizations, and individual households.   5.2  15.6%
Incident and information management: The ability to deploy people, supplies, money and information to the locations where they are most effective in protecting health. 
 8.7   10.1%
Healthcare delivery: The ability to ensure access to high-quality medical services across the continuum of care during and after disasters and emergencies.  4.9   8.9%
Countermeasure management: The ability to store and deploy health-related products and supplies that protect people from diseases and injuries.    6.5   16.1%
Environmental and occupational health: The ability to maintain the security and safety of water and food supplies, to test for hazards and contaminants in the environment, and to protect workers and emergency responders.    5.9   7.3%

 Originally developed by the CDC as a tool to drive dialogue to improve health security and preparedness, the Index is a collaborative effort funded by RWJF involving more than 30 organizations. State and local health officials, emergency management experts, business leaders, nonprofits, researchers, and others help shape the Index.

Associated Press
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