Originally developed by the Centers for Disease Control and Prevention (CDC), and overseen by our partners at the University of Kentucky, the Preparedness Index analyzes more than 130 measures in each of the states and across the nation. Measures include things like hazard planning in public schools, food and water safety monitoring, wireless 9-1-1 capabilities, flu vaccination rates, and access to paramedics and hospitals.
This year, on a scale from one to 10, the United States as a whole scored 6.8. That’s an improvement of 6.3 percent since the Preparedness Index launched and 1.5 percent over last year. Yet our nation’s health security remains less than optimal.
Gaps persist in how well people are protected in different parts of the country.
In many parts of the nation, we’re just not doing well enough on some basic measures that are important not only in emergencies but for long-term health and well-being overall. Of the six broad categories the measures fall into (community planning and engagement, incident and information management, health care delivery, countermeasure management, and environmental and occupational health), the nation’s lowest score is in health care delivery (5.3 out of 10). This means that hospitals in many regions would be hard-pressed to manage the level of trauma a widespread health emergency might entail.
In their overall scores, the least-prepared states lag 31 percent behind the best-prepared states, which include Vermont, Maryland, Virginia, Maine, Nebraska, New York and Wisconsin. In particular, people who live in states in the Deep South and Mountain West regions have much lower health security than those in other parts of the country. They are also more likely to have low or moderate incomes or live in rural areas, and therefore have fewer personal and community resources to draw upon in the event of an emergency.
Health security is possible when communities come together and plan in advance.
Historically, it’s been a struggle for communities to foster supportive relationships among government agencies, community organizations and individual residents in the interest of responding to emergencies in a coordinated way. But in this regard, things are changing for the better: The national score for community planning and engagement has improved 16.3 percent over the last four years.
That’s a great sign. It tells us that improving health security really is possible when communities come together.
A 2016 RWJF Culture of Health Prize winner, Miami-Dade County, is a strong example of proactive collaboration for health security. Last year, as panic over the Zika virus gripped the Western Hemisphere, all eyes turned to Miami. Given its proximity to Central and South American countries with active Zika transmission, it was one of the places where the disease was expected to surface in the United States.
Miami-Dade public health officials had strong existing relationships and coalitions to engage in preparing for this potential onset and response to emerging cases of Zika. Rather than waiting for an emergency, officials had been proactively meeting and maintaining contact with mayors, police and fire departments, hospital administrators, educators, social service providers, business leaders, and others.
"This ongoing effort made coordinating among 34 municipalities, 35 hospitals, and the nation’s fourth-largest school system much easier than it might have been," says Lillian Rivera, administrator of the Florida Department of Health in Miami-Dade County.
