Outbreaks: Protecting Americans From Infectious Disease 2013

Infectious diseases, from antibiotic-resistant superbugs to Salmonella to the seasonal flu, threaten the health and well-being of families and individuals and cost the country billions.

The Outbreaks: Protecting Americans from Infectious Diseases report by Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) found major gaps in the country’s ability to prevent, control, and treat infectious disease outbreaks because of outdated systems and limited resources.

The report reveals that a majority of states (32) score five or lower out of 10 key indicators of policies and capabilities to protect against infectious disease threats. Three states tied for lowest score, achieving two out of 10 possible indicators–Georgia, Nebraska, and New Jersey. New Hampshire had the highest score, at eight out of 10. Seven states had the second highest score, at seven out of 10–Connecticut, Delaware, New York, North Carolina, Oregon, Rhode Island, and Washington.

Key Findings:

  • One-third of states do not require health care facilities to report health care-associated infections (HAI). Approximately one out of every 20 hospitalized patients will contract a HAI.
  • Only one-quarter of states vaccinated at least half of their population against the seasonal flu. The U.S. Centers for Disease Control and Prevention (CDC) recommends all Americans ages 6 months and older get vaccinated (20% of Americans get the flu each year).
  • Only two states (Connecticut and Delaware) and Washington, D.C. meet the U.S. Department of Health and Human Services (HHS) goal of vaccinating at least 90 percent of preschoolers (ages 19- to 35-months) against the whooping cough.
  • Fewer than half of states require human papillomavirus (HPV) vaccinations, education for parents about the vaccine, or funding for vaccinations. CDC and the American Academy of Pediatrics recommend the vaccination for both males and females at 11 or 12 years of age.
  • One-third of states do not cover routine HIV screening under their Medicaid program. More than 1.1 million Americans are living with HIV/AIDS, and almost one in five do not know they are infected.
  • Just over one-half of public health laboratories did not test their Continuity of Operations (COOP) plans either through a drill or real event last year.
  • Two-thirds of states decreased funding for public health from Fiscal Year (FY) 2011-12 to FY 2012-13.

Media Contacts

Melissa Blair

Robert Wood Johnson Foundation (609) 627-5937


Related reading:

JAMA article, January 22-29, 2014


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US Adults die from vaccine-preventable diseases each year. #OutbreakWeek