States make strides in emergency health preparedness

States are more prepared than ever to respond to a bioterrorism attack, disease outbreak or natural disaster, but such progress is being threatened by widespread budget cuts brought on by a dour economy, according to a new report.

Thirty-three states and Washington, D.C., have cut their funding by $425 billion in the last two fiscal years. Local public health agencies have lost an estimated 23,000 jobs, or 15% of their work force, since January 2008, the report said.

"The Great Recession is taking its toll," said Jeffrey Levi, PhD, executive director of the Trust for America's Health, an advocacy organization focused on disease prevention. "The potential impact of these cuts cannot be overstated. The combined federal, state and local cuts constitute an emergency for emergency health preparedness in the United States."

Fourteen states scored a nine or higher, including Arkansas, North Dakota and Washington, which each scored a perfect 10. Twenty-five states and Washington, D.C., scored a seven or eight, while Iowa and Montana had the lowest marks at five.

But the survey gives only glimpses of a complex issue, said James S. Blumenstock, chief program officer of public health practice at the Assn. of State and Territorial Health Officials.

"This is just 10 of what could be hundreds of indicators given the breadth and depth of preparedness," he said.

Budget cuts mean that many local health departments are being forced to cut services, said Robert M. Pestronk, MPH, executive director of the National Assn. of County and City Health Officials. Fifty-three percent of local health departments said their core funding had been cut in 2010, and 47% of those expect additional reductions in 2011.

This means health departments have fewer resources to respond to an emergency, leaving them dependent on emergency funding after an event has occurred, he said.

"It leaves us all vulnerable to the next public health crises," Pestronk said. "It is equivalent to funding fire departments after the fire has already occurred."

Meanwhile, the federal government has decreased public health preparedness funding by 27% since 2005. Past budget reductions have been softened with supplemental funding, such as emergency funding for pandemic flu response efforts, but states will begin feeling the hit more now, Levi said.

"We've come a long way, and it could have tragic circumstances if we start to backslide now," he said.