Issue Category: Infectious Disease

TFAH Statement on the Draft House Republican Obamacare Replacement Bill: Our Nation’s Health Will Suffer

Washington, D.C., February 24, 2017 – The below is a statement from John Auerbach, president and CEO, of Trust for America’s Health (TFAH).

“The draft House Republican Obamacare replacement bill—which would eliminate the Prevention and Public Health Fund—would threaten the health of American children, families and communities.

Thanks to the Prevention Fund, hundreds of thousands of Americans benefit from increased access to vaccines and other preventive health services. Quite simply, more people are getting and remaining healthy because of the Prevention Fund.

Yet, the proposed replacement bill would eliminate this important Fund and 12 percent of the U.S. Centers for Disease Control and Prevention’s (CDC) budget along with it.

And, without the Prevention Fund, states will lose substantial sums of money—totaling as much as $3 billion over the next 5 years—which fight growing epidemics and emerging diseases.

Every year, we spend $3 trillion on healthcare, yet millions suffer from chronic diseases and death rates among Blacks and other people of color remain too high. At the same time, death rates among white middle-aged Americans increased for the first time in decades, mainly due to preventable conditions.

Time and again research shows that the vast majority of these conditions—heart disease, diabetes and others—can be prevented by investing in addressing the root causes. Yet, the country has repeatedly failed to do so.

The nation cannot afford to trade away our single best investment in preventing disease, preparing for and responding to infectious disease outbreaks, reducing rates of chronic illness, and saving lives and money.

If this draft becomes law, our nation’s health will suffer—and it will be exponentially harder to fight growing epidemics, like the rise in prescription drug and heroin overdoses.”

 

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Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

CDC to Lose More than $5 Billion, States to Lose More than $3 Billion to Fight Health Epidemics over Five Years, if the ACA and Prevention and Public Health Fund are Repealed

Washington, D.C., January 17, 2017 – The U.S. Centers for Disease Control and Prevention (CDC) would lose 12 percent of its annual budget if the Prevention and Public Health Fund, part of the Affordable Care Act (ACA), were repealed, according to an analysis by the Trust for America’s Health (TFAH).

States would end up losing more than $3 billion over the next five years – from grants and programs supported by the Prevention Fund.

“CDC is the world’s leading public health authority and the front line against major threats to the health and well-being of the American people—such as disease outbreaks, prescription drug  misuse and diabetes,” said John Auerbach, President and CEO of TFAH. “Losing the Prevention Fund would result in diminished support for public health in every state, undermining their ability to fight epidemics and keep people safe. The costs of these vital public health efforts will either be passed along to states or the efforts will be eliminated—resulting in more people becoming sick and higher healthcare costs.”

The $890 million gap in CDC’s annual funding created by eliminating the Prevention Fund could not be filled under current laws without drawing funds away from other Department of Labor, Education and Health and Human Services programs. Among activities supported directly by the Prevention Fund are grants to states for infectious disease control, resources through the Preventive Health and Health Services Block Grant and other core public health programs which, if cut, would increase illness, injuries and preventable deaths.

If the Prevention Fund is eliminated, the impact will be felt at the local, state and federal levels as public health organizations respond to several major health crises that are on the rise, such as:

  • Health Security Funds for Disease Outbreaks, Disasters and Bioterrorism:  With the exception of the one-time-only funding for Ebola and Zika, the core funding for preparedness and response to health emergencies has been cut by more than one-third in the past decade. CDC has responded to more than 750 health emergencies in the past two years. Infectious diseases cost the country more than $120 billion per year, and that cost grows exponentially when major new diseases strike.
  • Prescription Painkiller and Heroin Use: Deaths from opioids have more than quadrupled in the past 15 years. Nationally, more than 2 million Americans misuse prescription drugs, and nearly a half million are addicted to heroin, costing the country more than $55 billion a year in healthcare, workplace and criminal justice spending. CDC plays a critical role by providing support to states and healthcare providers to monitor and control the inappropriate prescribing of opioids.
  • Obesity and Diabetes: Nearly 38 percent of adults are obese and more than one-third of children are overweight or obese, contributing to more than $200 billion in direct health costs. One in three children could develop diabetes in their lifetime, and one in four are not healthy enough to serve in the military by the ages of 17 to 24.
  • Declining Life Expectancy:  Life expectancy in the United States has declined for the first time in two decades. While death rates are higher among Blacks and other people of color, death rates have increased the fastest (by 10 percent since 1999) among middle-aged White men and women (ages 45 to 54). Increasing death rates among middle-aged Whites are the highest in West Virginia, Mississippi, Oklahoma, Tennessee, Kentucky, Alabama and Arkansas. Amounts each state stands to lose over the next 5 years if the Prevention Fund was repealed (based on fiscal year 2016 grants to state)

State

Potential Five Year PPHF Loss, Based on FY 2016 Funding

Alabama

$44,867,115

Alaska

$22,312,985

Arizona

$46,840,075

Arkansas

$29,599,945

California

$307,768,530

Colorado

$44,671,845

Connecticut

$36,728,860

Delaware

$12,462,820

District of Columbia

$51,533,080

Florida

$101,864,250

Georgia

$100,421,755

Hawaii

$40,025,880

Idaho

$22,428,585

Illinois

$93,084,850

Indiana

$41,381,450

Iowa

$35,630,210

Kansas

$45,329,065

Kentucky

$40,687,570

Louisiana

$45,111,030

Maine

$27,588,000

Maryland

$84,876,045

Massachusetts

$88,112,505

Michigan

$110,739,075

Minnesota

$80,759,870

Mississippi

$31,276,855

Missouri

$53,853,865

Montana

$24,831,145

Nebraska

$47,957,625

Nevada

$19,174,580

New Hampshire

$24,967,020

New Jersey

$60,558,365

New Mexico

$43,257,135

New York

$207,587,230

North Carolina

$85,917,320

North Dakota

$14,975,550

Ohio

$114,951,125

Oklahoma

$46,585,755

Oregon

$46,462,400

Pennsylvania

$111,991,355

Rhode Island

$40,238,960

South Carolina

$56,576,525

South Dakota

$18,732,825

Tennessee

$67,537,910

Texas

$147,214,850

Utah

$49,396,510

Vermont

$14,637,565

Virginia

$77,104,520

Washington

$70,060,890

West Virginia

$22,669,320

Wisconsin

$64,120,145

Wyoming

$11,024,970

 Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. 

Majority of States Score 6 or Lower Out of 10 Indicators in Report on Health Emergency Preparedness

Washington, D.C., December 20, 2016 – In Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism, 26 states and Washington, D.C. scored a six or lower on 10 key indicators of public health preparedness.

The report, issued by the Trust for America’s Health (TFAH), found that the nation is often caught off guard when a new threat arises, such a Zika or the Ebola outbreak or bioterrorist threat, which then requires diverting attention and resources away from other priorities.

In the report, Alaska and Idaho scored lowest at 3 out of 10, and Massachusetts scored the highest at 10 out of 10, with North Carolina and Washington State scoring 9’s.

“Health emergencies can quickly disrupt, derail and divert resources from other ongoing priorities and efforts from across the government,” said Rich Hamburg, interim president and CEO, TFAH.  “Many areas of progress that were made after 9/11 and the anthrax attacks to improve health security have been undercut.  We aren’t adequately maintaining a strong and steady defense, leaving us unnecessarily vulnerable when new threats arise.”

Ready or Not? examines the nation’s ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies.  Some key findings include:

  • 26 states increased or maintained funding for public health from Fiscal Year (FY) 2014-2015 to FY 2015-2016.
  • Just 10 states vaccinated at least half of their population (ages 6 months and older) against the seasonal flu during the 2015-2016 flu season (from July 2015 to May 2016).
  • 45 states and Washington, D.C. increased the speed of DNA fingerprinting using pulsed-field gel electrophoresis (PFGE) testing for all reported cases of Shiga toxin-producing E. coli O157, a measure of a state’s ability to detect foodborne outbreaks.
  • 10 states have a formal access program or a program in progress for getting private sector healthcare staff and supplies into restricted areas during a disaster.
  • 30 states and Washington, D.C. met or exceeded the overall national average score (6.7) of the National Health Security Preparedness Index™ (as of 2016).
  • 32 states and Washington, D.C. received a grade of C or above in States at Risk: America’s Preparedness Report Card, a national assessment of state-level preparedness for climate change-related threats – which have an impact on human health.

In addition, the report examined trends in public health preparedness over the last 15 years, finding successes and ongoing concerns.

  • One-third of funds for health security and half of funds for healthcare system preparedness have been cut:  Health emergency preparedness funding for states has been cut from $940 million in fiscal year (FY) 2002 to $660 million in FY 2016; and healthcare system preparedness funding for states has been cut by more than half since FY 2005 – down to $255 million.
  • Some major areas of accomplishment:  Improved emergency operations, communication and coordination; support for the Strategic National Stockpile and the ability to distribute medicines and vaccines during crises; major upgrades in public health labs and foodborne illness detection capabilities; and improvements in legal and liability protections during emergencies.
  • Some major ongoing gaps: Lack of a coordinated, interoperable, near real-time biosurveillance system; insufficient support for research and development of new medicines, vaccines and medical equipment to keep pace with modern threats; gaps in the ability of the healthcare system to care for a mass influx of patients during a major outbreak or attack; and cuts to the public health workforce across states.

The Ready or Not? report provides a series of recommendations that address many of the major gaps in emergency health preparedness, including:

  • Requiring strong, consistent baseline public health Foundational Capabilities in regions, states and communities—so that everyone is protected.
  • Ensuring stable, sufficient health emergency preparedness funding to maintain a standing set of foundational capabilities alongside a complementary Public Health Emergency Fund which would provide immediate surge funding during an emergency.
  • Improving federal leadership before, during and after disasters – including at the White House level.
  • Recruiting and training a next generation public health workforce with expert scientific abilities to harness and use technological advances along with critical thinking and management skills to serve as the Chief Health Strategist for a community.
  • Reconsidering health system preparedness for new threats and mass outbreaks by developing stronger coalitions and partnerships among providers, hospitals, insurance providers, pharmaceutical and health equipment businesses, emergency management, and public health agencies.
  • Prioritizing efforts to address one of the most serious threats to human health by expanding efforts to stop Superbugs and antibiotic resistance.
  • Improving rates of vaccinations for children and adults – which are one of the most effective public health tools against many infectious diseases.

Ready or Not? was released annually from 2003-2012, and more recently, TFAH has released Outbreaks: Protecting Americans from Infectious Diseases, from 2013-2015. The report was supported by a grant from the Robert Wood Johnson Foundation (RWJF).

Score Summary: 

A full list of all of the indicators and scores and the full report are available on TFAH’s website.  For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator.  Zero is the lowest possible overall score, 10 is the highest.  The data for the indicators are from publicly available sources or were provided from public officials.

10 out of 10: Massachusetts

9 out of 10: North Carolina and Washington

8 out of 10: California, Connecticut, Iowa, New Jersey, Tennessee and Virginia

7 out of 10: Colorado, Delaware, Florida, Indiana, Maryland, Michigan, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Carolina, Utah and Wisconsin

6 out of 10: Arizona, Arkansas, District of Columbia, Georgia, Hawaii, Illinois, Kansas, Kentucky, Louisiana, Maine, Minnesota, Mississippi, Montana, Nebraska, Ohio, Pennsylvania, Texas and Vermont

5 out of 10: Alabama, Missouri, Oklahoma, South Dakota and West Virginia

4 out of 10: Nevada and Wyoming

3 out of 10: Alaska and Idaho

 

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 Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.

Outbreaks

«state» Scored «score_upper» Out of 10 on Key Indicators Related to Preventing, Detecting, Diagnosing and Responding to Outbreaks

Report Finds Major Gaps in Country’s Ability to Prevent and Control Infectious Disease Outbreaks

Washington, D.C., December 17, 2015 – A new report released today by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) finds «state» scored «score_lower» out of 10 on key indicators related to preventing, detecting, diagnosing and responding to outbreaks.

Twenty-eight states and Washington, D.C. scored 5 or lower out of 10 key indicators. Five states—Delaware, Kentucky, Maine, New York and Virginia—tied for the top score, achieving eight out of 10 indicators. Seven states — Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon and Utah — tied for the lowest score at three out of 10.

The report, Outbreaks: Protecting Americans from Infectious Diseases, concluded that the United States must redouble efforts to better protect Americans from new infectious disease threats such as MERS-CoV and antibiotic-resistant Superbugs and resurging illnesses like whooping cough, tuberculosis and gonorrhea.

“The overuse of antibiotics and underuse of vaccinations along with unstable and insufficient funding have left major gaps in our country’s ability to prepare for infectious disease threats,” said Jeffrey Levi, PhD, executive director of TFAH. “We cannot afford to continue to be complacent. Infectious diseases – which are largely preventable – disrupt the lives of millions of Americans and contribute to billions of dollars in unnecessary healthcare costs each year.”

Some key «state» findings include:

No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Public Health Funding: State increased or maintained funding for public health between FY 2013 to 2014 and FY 2014 to 2015. «metric1» 34 and Washington, D.C.
2 Flu Vaccination Rates: State vaccinated at least half of their population (ages 6 months and older) for the seasonal flu from Fall 2014 to Spring 2015. The rate was «flu_vaccine_rate» in «state», the national average is 47.1 percent. «metric2» 18
3 Childhood Immunization School Requirement Policies: State law either excludes philosophical exemptions entirely or requires a parental notarization or affidavit to achieve a religious or philosophical exemption for school attendance. In 2014, there were more than 600 cases of measles and nearly 33,000 cases of whooping cough reported. While more than 90 percent of U.S. kindergarteners receive all recommended vaccinations, rates are lower in a number of communities and states. More than 28 percent of preschoolers do not receive all recommended vaccinations. «metric3» 20
4 HIV/AIDS Surveillance: State requires reporting of all (detectable and undetectable) CD4 cell count (a type of white blood cell) and HIV viral load data to their state HIV surveillance program. Of the more than 1.2 million Americans are living with HIV, almost one in eight do not know they are infected. (As of July 2013.) «metric4» 43 and Washington, D.C.
5 Syringe Exchange Programs: State explicitly authorizes syringe exchange programs (SEP). Hepatitis C infections—related to a rise in heroin and injection drug use from people transitioning from prescription painkillers—increased by more than 150 percent nationally from 2010 to 2013. «metric5» 16 and Washington, D.C.
6 Climate Change and Infectious Disease: State currently has climate change adaptation plans completed. «metric6» 15
7 Central Line-Associated Bloodstream Infections (CLABSI): State reduced the standard infection rate (SIR) for CLABSI between 2012 and 2013. «state» has a CLABSI SIR of «clabsi_2013_sir». The national CLABSI SIR is 0.5. Around one out of every 25 people who are hospitalized each year contracts some form of healthcare-associated infection leading to around 75,000 deaths a year. «metric7» 9
8 Public Health Laboratories: State laboratories reported having a biosafety professional from July 1, 2014 to June 30, 2015. «metric8» 36
9 Public Health Laboratories: State laboratories provided biosafety training and/or information about courses for sentinel clinical labs in their jurisdiction from July 1, 2014 to June 30, 2015. «metric9» 35
10 Food Safety: State met the national performance target of testing 90 percent of reported E.coli O157 cases within four days (in 2013). Around 48 million Americans get sick from a foodborne illness each year. «metric10» 39 and Washington, D.C.
Total «score_upper»

“America’s investments in infectious disease prevention ebb and flow leaving our nation challenged to sufficiently address persistent problems,” said Paul Kuehnert, a Robert Wood Johnson Foundation director. “We need to reboot our approach so we support the health of every community by being ready when new infectious threats emerge.”

The Outbreaks report features priority recommendations, including:

  • Increase resources to ensure every state can maintain and modernize basic capabilities – such as epidemiology and laboratory abilities – that are needed to respond to new and ongoing outbreaks;
  • Update disease surveillance to be real-time and interoperable across communities and health systems to better detect, track and contain disease threats;
  • Incentivize the development of new medicines and vaccines, and ensure systems are in place to effectively distribute them when needed;
  • Decrease antibiotic overuse and increase vaccination rates;
  • Improve and maintain the ability of the health system to be prepared for a range of potential threats – such as an influx of patients during a widespread outbreak or the containment of a novel, highly infectious organism that requires specialty care;
  • Strengthen efforts and policies to reduce healthcare-associated infections;
  • Take strong measures to contain the rising hepatitis C epidemic and other sexually transmitted infections, particularly among young adults; and
  • Adopt modern strategies to end AIDS in every state and city.

The indicators represent examples of important capabilities, policies and trends, and were selected in consultation with leading public health and healthcare officials. The report and state-by-state materials are available on TFAH’s website at www.healthyamericans.org.

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’s website. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator, with zero the lowest possible overall score and 10 the highest. The data for the indicators are from publicly available sources or were provided from public officials.

  • 8 out of 10: Delaware, Kentucky, Maine, New York and Virginia
  • 7 out of 10: Alaska, California, Maryland, Massachusetts, Minnesota and Nebraska
  • 6 out of 10: Arkansas, Illinois, Iowa, New Hampshire, New Jersey, New Mexico, North Carolina, North Dakota, Vermont, West Virginia and Wisconsin
  • 5 out of 10: Arizona, Colorado, Connecticut, Georgia, Hawaii, Mississippi, Missouri, Montana, Pennsylvania, Rhode Island, Texas and Washington
  • 4 out of 10: Alabama, District of Columbia, Florida, Indiana, Louisiana, Nevada, South Carolina, South Dakota, Tennessee and Wyoming
  • 3 out of 10: Idaho, Kansas, Michigan, Ohio, Oklahoma, Oregon and Utah

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. www.healthyamericans.org

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.

District of Columbia Healthy Communities Collaborative

DC Healthy Communities Collaborative—a collaborative of community health leaders and organizations—formed in 2012 to assess and address the community health needs in the Washington, D.C. area. The Collaborative works in four key areas identified as community health needs in the D.C. area: asthma, obesity, sexual health, and substance abuse/mental health. To date, the Collaborative has conducted a community health assessment identifying health needs within the D.C. area and produced a community health improvement plan with strategies to address the aforementioned health needs. D.C. Healthy Communities Collaborative is funded by member contributions. To read more about this innovative program, see this brief summary [link].

Dignity Health’s Community Health Investments

For more than 20 years, Dignity Health, a health care provider in multiple states, has been investing in the health of the communities it serves through community benefit programs and community economic initiatives, including grants and low-interest loans to nonprofits addressing community needs. Investments are targeted to populations with disproportionate unmet health needs as identified through the community health needs assessment and a Community Need Index developed by Dignity Health. Since 1990, Dignity Health has awarded more than $51 million in areas such as prevention, HIV/AIDS services, behavioral health services, and improving access to care. The Dignity Health Community Investment Program has had a total loan volume of $143 million, benefiting the community-based health programs of California, Nevada, and Arizona including: providing affordable housing for seniors; access to shelters for the homeless discharged from community hospitals; and healthy food projects. To read more about this innovative program, see this brief summary [link].

Cultivating Health for Success

Cultivating Health for Success (CHS) established in 2010, focuses on the inclusion of safe, affordable, and supportive housing to reduce unplanned care, improve adherence to recommended treatment, and improve health care cost and outcomes as well as quality of life for participants in greater Pittsburgh. CHS serves adults with one or more chronic illnesses and those with a history of at least one year of above average use of unplanned care, such as crisis services, Emergency Department visits, and the homeless. To deliver services, CHS partners with the Allegheny County Department of Human Services, Metro Family Practice, Community Human Services, UPMC for You, and the Community Care Behavioral Health Organization. Since CHS’s inception, per-member per-month (PMPM) medical costs have decreased 11.5 percent, the average PMPM for unplanned care has decreased by 19.2 percent, and the average prescription PMPM increased by 5.2 percent for participants with a meaningful tenure in the program. CHS is funded by UMPC for You contributions. To read more about this innovative program, see this brief summary [link].

Outbreaks: Protecting Americans from Infectious Diseases

«state» Scored «number_upper» out of 10 on Key Indicators Related to Preventing, Detecting, Diagnosing and Responding to Outbreaks — Like Ebola, Enterovirus and Superbugs

25 States Reach Half or Fewer of Key Indicators

Washington, D.C., December 18, 2014 – A new report released today by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) finds «state» scored «number_lower» out of 10 on key indicators related to preventing, detecting, diagnosing and responding to outbreaks, like Ebola, Enterovirus and antibiotic-resistant Superbugs.

The report, Outbreaks: Protecting Americans from Infectious Diseases, finds that the Ebola outbreak exposes serious underlying gaps in the nation’s ability to manage severe infectious disease threats.

Half of states and Washington, D.C. scored five or lower out of 10 key indicators related to preventing, detecting, diagnosing and responding to outbreaks. Maryland, Massachusetts, Tennessee, Vermont and Virginia tied for the top score — achieving eight out of 10 indicators. Arkansas has the lowest score at two out of 10. The indicators are developed in consultation with leading public health experts based on data from publicly available sources or information provided by public officials.

“Over the last decade, we have seen dramatic improvements in state and local capacity to respond to outbreaks and emergencies. But we also saw during the recent Ebola outbreak that some of the most basic infectious disease control policies failed when tested,” said Jeffrey Levi, PhD, executive director of TFAH. “The Ebola outbreak is a reminder that we cannot afford to let our guard down. We must remain vigilant in preventing and controlling emerging threats – like MERS-CoV, pandemic flu and Enterovirus – but not at the expense of ongoing, highly disruptive and dangerous diseases – seasonal flu, HIV/AIDS, antibiotic resistance and healthcare-associated infections.”

Some key «state» findings include:

No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Public Health Funding: Increased or maintained level of funding for public health services from FY 2012-13 to FY 2013-14. «q1» 28
2 Preparing for Emerging Threats: State scored equal to or higher than the national average on the Incident & Information Management domain of the National Health Security Preparedness Index. «q2» 27 + D.C.
3 Vaccinations: Met the Healthy People 2020 target of 90 percent of children ages 19-35 months receiving recommended ≥3 doses of HBV vaccine. «q3» 35 + D.C.
4 Vaccinations: Vaccinated at least half of their population (ages 6 months and older) for the seasonal flu for fall 2013 to spring 2014. «q4» 14
5 Climate Change: State currently has completed climate change adaption plans – including the impact on human health. «q5» 15
6 Healthcare-acquired Infections: State performed better than the national standardized infection ratio (SIR) for central line-associated bloodstream infections. «q6» 16
7 Healthcare-acquired Infections: Between 2011 and 2012, state reduced the number of central line-associated blood stream infections. «q7» 10
8 Preparing for Emerging Threats: From July 1, 2013 to June 30, 2014, public health lab reports conducting an exercise or utilizing a real event to evaluate the time for sentinel clinical laboratories to acknowledge receipt of an urgent message from laboratory. «q8» 47 + D.C.
9 HIV/AIDS: State requires reporting of all CD4 and HIV viral load data to their state HIV surveillance program. «q9» 37 + D.C.
10 Food Safety: State met the national performance target of testing 90 percent of reported Escherichia coli (E. coli) O157 cases within four days. «q10» 38 + D.C.
Total «total»

Some additional findings from the report include progress and gaps in the areas of:

  • Preparing for Emerging Threats: Significant advances have been made in preparing for public health emergencies since the September 11, 2001 and the anthrax attacks, but gaps remain and have been exacerbated as resources were cut over time.
  • Vaccinations: More than 2 million preschoolers, 35 percent of seniors and a majority of adults do not receive all recommended vaccinations.
  • Healthcare-Associated Infections: While healthcare-associated infections have declined in recent years due to stronger prevention policies, around one out of every 25 people who are hospitalized each year still contracts a healthcare-associated infection.
  • Sexually Transmitted Infections and Related Disease Treatment and Prevention: The number of new HIV infections grew by 22 percent among young gay men, and 48 percent among young Black men (between 2008 and 2010); more than one-third of gonorrhea cases are now antibiotic-resistant; and nearly three million Baby Boomers are infected with hepatitis C, the majority of whom do not know they have it.
  • Food Safety: Around 48 million Americans suffer from a foodborne illness each year.

“The best offense to fighting infectious diseases is a strong and steady defense,” said Paul Kuehnert, a Robert Wood Johnson Foundation director. “Infectious disease control requires having systems in place, continuous training and practice and sustained, sufficient funding. As we work with communities across the nation to build a Culture of Health, we recognize that promoting and protecting health, and readiness to respond to wide-scale health threats are essential.”

The Outbreaks report recommends that it is time to rethink and modernize the health system to better match existing and emerging global disease threats. Priority improvements should include:

  • Core Abilities: Every state should be able to meet a set of core capabilities and there must be sufficient, sustained funding to support these capabilities. Some basic capabilities include: investigative capabilities; containment strategies, including vaccines and medicines; continued training and testing for hospitals and health departments for infection control and emergency preparedness; risk communications capabilities that inform the public without creating unnecessary fear; strong surveillance to identify and track threats and communicate across the healthcare system; and maintaining a strong research capacity to develop new vaccines and medical treatments.
  • Healthcare and Public Health Integration: Systems must be improved so the healthcare system, hospitals and public health agencies work better together toward the common goals of protecting patients, healthcare workers and the public; and
  • Leadership and Accountability: Stronger leadership is needed for a government-wide approach to health threats at the federal, state and local levels, and there must be increased support for integration and flexibility of programs in exchange for demonstration of capabilities and accountability

The report and state-by-state materials are available on TFAH’s website at www.healthyamericans.org. The report was supported by a grant from RWJF

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’s website. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. The data for the indicators are from publicly available sources or were provided from public officials.

  • 8 out of 10: Maryland, Massachusetts, Tennessee Vermont and Virginia
  • 7 out of 10: California, Delaware, Nebraska, New Hampshire, North Dakota, Pennsylvania and Wisconsin
  • 6 out of 10: Colorado, Connecticut, Florida, Hawaii, Illinois, Iowa, Minnesota, New York, North Carolina, Rhode Island, South Carolina, South Dakota and Texas
  • 5 out of 10: Alabama, D.C., Georgia, Indiana, Michigan, New Mexico, Oklahoma, Oregon, Utah and West Virginia
  • 4 out of 10: Alaska, Arizona, Maine, Mississippi, Missouri, Montana, Nevada and Washington
  • 3 out of 10: Idaho, Kansas, Kentucky, Louisiana, New Jersey, Ohio and Wyoming
  • 2 out of 10: Arkansas

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority.
www.healthyamericans.org

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit
www.rwjf.org. Follow the Foundation on Twitter
www.rwjf.org/twitter or Facebook
www.rwjf.org/facebook.

Outbreaks: Protecting Americans from Infectious Diseases

Back to the report

«state» Scored «number_upper» out of 10 on Key Indicators of Policies and Capabilities to Protect against Infectious Disease Threats

Majority of States Reach Half or Fewer of Key Indicators

Washington, D.C., December 17, 2013 – A new report released today by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) finds «state» scored «number_lower» out of 10 on key indicators of policies and capabilities to protect against infectious disease threats.

The Outbreaks: Protecting Americans from Infectious Diseases report finds that the nation’s ability to prevent and control infectious disease outbreaks is hampered by outdated systems and limited resources.

A majority of states (33) score 5 or lower out of 10 key indicators in the report. Three states tied for the lowest score, achieving two out of 10 possible indicators – Georgia, Nebraska and New Jersey. New Hampshire had the highest score, with 8 out of 10.

“From antibiotic-resistant Superbugs to Salmonella to the seasonal flu, infectious diseases disrupt lives and communities,” said Jeffrey Levi, PhD, executive director of TFAH. “Fighting these diseases requires constant vigilance. The bad news is that we found major gaps in the country’s ability to prevent, control and treat outbreaks, leaving Americans at an unacceptable level of unnecessary risk.”

Some key «state» findings include:

No. Indicator «state» Number of States Receiving Points
A “Y” means the state received a point for that indicator
1 Increased or maintained level of funding for public health services from FY 2011-12 to FY 2012-13. «q1» 17
2 Met the HHS goal of vaccinating 90 percent of 19- to 35-month-olds against whooping cough. «q2» 2 + D.C.
3 Requires the HPV vaccine for teens — or funds HPV vaccination efforts or educates the public about the HPV vaccine. «q3» 25 + D.C.
4 State vaccinated at least half of their population (ages 6 months and older) for the seasonal flu during the 2012-2013 flu season. «q4» 12
5 State has a complete climate change adaptation plan that include focusing on the impact of human health. «q5» 15
6 State mandates that healthcare facilities in their state report healthcare-associated infections. «q6» 35 + D.C.
7 Does your public health lab have a plan and capability to handle a significant surge in testing over a six to eight week period in response to an outbreak that increases testing over 300%. «q7» 37 + D.C.
8 Does your public health lab currently have the capacity in place to assure the timely transportation (pick-up and delivery) of samples 24/7/365 days to the appropriate public health Laboratory. «q8» 46 + D.C.
9 From July 1, 2012 to June 30, 2013 did your public health lab evaluate the functionality of your continuity of operations plan (COOP) via a real event or an exercise. «q9» 27
10 State covers routine HIV screening under their Medicaid programs. «q10» 31 + D.C.
Total «total»

The report’s indicators are developed in consultation with leading public health experts based on data from publicly available sources or information provided by public officials.

“Many infectious disease threats keep me up at night – from the emergence of a new deadly disease, such as the Middle East Respiratory Syndrome (MERS), to the prospect of bioterrorism, to antibiotic resistant infections, to the worsening of mosquito-borne illnesses being driven by changes in the climate,” said Tom Inglesby, MD, chief executive officer and director of the UPMC Center for Health Security.

Outbreaksprovides a series of recommendations that address many of the major gaps in infectious disease control and prevention, including:

  • Strengthening fundamental capabilities – maintaining an expert workforce and giving them state-of-the-art tools required to conduct investigations to quickly detect, control and treat disease outbreaks;
  • Countering antibiotic resistance and prioritizing research and development of medical countermeasures should be top health and national security priorities;
  • Increasing the number of Americans receiving recommended vaccinations and routine screenings for particular diseases, since these are the safest and most effective ways to reduce infectious diseases in the United States;
  • Modernizing disease surveillance and ensuring public health laboratories have the equipment and capacity to not only test for routine problems like foodborne illnesses but also for new and large-scale threats like bioterrorism or a pandemic;
  • Supporting policies and incentives to reduce the number of healthcare-associated infections, ensuring Americans can receive safe care;
  • Improving global coordination to prevent and contain emerging new illnesses like MERS while maintaining defenses against “old-school” threats like malaria and tuberculosis;
  • Shoring up the nation’s public health preparedness capabilities to respond to major disease outbreaks or acts of bioterrorism to ensure new threats can be rapidly identified and contained; and
  • Countering complacency around HIV/AIDS, hepatitis B and C (HBV and HCV) and tuberculosis- including countering an alarming rise in new HIV infections among young gay men, and screening millions of Baby Boomers who may be infected with HCV and do not know they are at risk for developing serious liver disease as they age.

The report and state-by-state materials are available on TFAH’s website at www.healthyamericans.org. The report was supported by a grant from RWJF.

Score Summary:

A full list of all of the indicators and scores and the full report are available on TFAH’s website. For the state-by-state scoring, states received one point for achieving an indicator or zero points if they did not achieve the indicator. Zero is the lowest possible overall score, 10 is the highest. The data for the indicators are from publicly available sources or were provided from public officials.

8 out of 10: New Hampshire

7 out of 10: Connecticut, Delaware, Minnesota, New York, North Carolina, Oregon, Rhode Island and Washington

6 out of 10: California, Colorado, D.C., Hawaii, Maryland, Missouri, Pennsylvania, Tennessee and Virginia

5 out of 10: Alaska, Florida, Illinois, Iowa, Louisiana, Maine, Massachusetts, Michigan, New Mexico, Oklahoma, South Carolina, South Dakota, Vermont and Wisconsin

4 out of 10: Alabama, Idaho, Indiana, Kansas, Kentucky, Mississippi, North Dakota, Ohio, Texas, Utah and West Virginia

3 out of 10: Arizona, Arkansas, Montana, Nevada and Wyoming

2 out of 10: Georgia, Nebraska and New Jersey

Trust for America’s Health is a non-profit, non-partisan organization dedicated to saving lives by protecting the health of every community and working to make disease prevention a national priority. www.healthyamericans.org

The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation’s largest philanthropy devoted exclusively to improving the health and health care of all Americans, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measureable, and timely change. For more than 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org. Follow the Foundation on Twitter www.rwjf.org/twitter or Facebook www.rwjf.org/facebook.