Ready or Not? 2004

TFAH’s second annual study of preparedness against public health emergencies finds that, despite incremental progress, three years after September 11, 2001, there is still a long way to go to protect the American people from a bioterror attack. The report examined 10 key indicators to gauge state preparedness and determine America’s overall readiness to respond to bioterrorist attacks and other health emergencies. This is the second year in a row that TFAH conducted a review of bioterrorism and public health preparedness, while the federal government’s efforts to release performance measures have stalled.

Over two-thirds of states and D.C. achieved a score of six or less. Florida and North Carolina scored the highest, achieving nine out of the possible 10 indicators, and Alaska and Massachusetts scored the lowest, at three out of 10. Although direct comparisons are difficult because the indicators were modified to reflect the changed expectations of additional time and funding, in this year’s report, 34 states and D.C. obtained higher scores, nine scores remained the same, and seven scores declined.

The scores demonstrate continued incremental progress; however, preparedness is still lagging behind goals and expectations. With most states still in the middle range of the scale and no states meeting all of the indicators, there are still major areas of vulnerability that leave Americans at risk. Overall, the report found that many basic bioterrorism detection, diagnosis, and response capabilities are still not in place.