Reports | March 13, 2021

TFAH Report Finds Gaps in States’ Preparedness for Public Health Emergencies

The Trust for America’s Health (TFAH) this week released its report Ready or Not 2021: Protecting the Public’s Health Against Diseases, Disasters, and Bioterrorism providing an annual assessment of states’ level of readiness to respond to public health emergencies. The report measures states’ performance on 10 key emergency preparedness indicators and found room for improvement in every jurisdiction. California falls in the middle tier of preparedness with 14 other states.

While the report’s findings do not measure any state’s COVID-19 response, the report demonstrates that while states’ readiness is important, national health emergencies on the scale of a pandemic require strong federal leadership and coordination and long-term investment in public health infrastructure and workforce. States alone, even those that rank highly in the report, are not sufficiently equipped to respond to a pandemic without federal assistance.

TFAH’s key findings from its 2021 report include:

  • A majority of states have made preparations to expand health care and public health capabilities in an emergency, often through collaboration and resource sharing.
  • Most states are accredited in the areas of public health, emergency management, or both. As of December 2020, the Public Health Accreditation Board or the Emergency Management Accreditation Program (EMAP) accredited 42 states and the District of Columbia.
  • Approximately 95 percent of people who get their household water through a community water system had access to safe water.
  • Seasonal flu vaccination rates, while still low, have risen significantly. The seasonal flu vaccination rate among Americans age six months and older rose from 42 percent during the 2017-18 flu season to 52 percent during the 2019-20 season, but vaccination rates are still well below the 70 percent target established by Healthy People 2030.
  • In 2019, only 55 percent of employed people used paid time off, the same percentage as in 2018. Those without paid leave are more likely to work when they are sick and risk spreading infection.

TFAH outlines a number policy recommendations to better prepare for public health emergencies. These recommendations include:

  • Provide stable, sufficient funding for domestic and global public health security.
  • Strengthen policies and systems to prevent and respond to outbreaks and pandemics.
  • Build resilient communities and promote health equity generally and in preparedness.
  • Ensure effective public health leadership, coordination, and workforce.
  • Accelerate development and distribution, including last mile distribution, of medical countermeasures.
  • Strengthen the health system’s ability to respond and recover during and from health emergencies.
  • Prepare for environmental threats and extreme weather.

The full TFAH Ready or Not report is available here.