CDC Reports On State Preparedness
The CDC recently released a comprehensive report that assesses federal funding distributed to states after the terrorist attacks of September 11, 2001. The report analyzes the use of money and improvements made in each state to determine preparedness to deal with disease outbreaks, natural disasters, and other public health emergencies.
The report, “Public Health Preparedness: Mobilizing State by State,” examines the use of about $5.6 billion given to states since 2001. According to CIDRAP, improvements states have made since 2001 include:
- Every state is now equipped to receive and evaluate health emergency reports at all times, whereas only 12 states had "24/7/365" capability in 2001.
- All states have public health laboratories that can communicate quickly with clinical labs today, compared with only 20 states in 2001.
- Every state now has a plan to receive and distribute drugs and other supplies from the Strategic National Stockpile.
- All states are now conducting year-round influenza surveillance, considered critically important given the threat of pandemic flu.
Every state was evaluated in the report, including major urban areas such as Washington, New York City, Chicago, and Los Angeles County. Recent years have also seen a distribution of money specifically designate to deal with a possible influenza pandemic. With increased funding, states and urban areas have also undergone improvements involving the number of epidemiologists available. According to CIDRAP,
- The number of public health epidemiologists working in emergency response has more than doubled, from 115 in 2001 to 232 in 2006.
- Users of the Epidemic Information Exchange, a CDC-based communication system that helps track disease outbreaks, have increased more than 5-fold, from 890 in 2001 to 4,646 in 2006. Most are in state and local public health.
- State and local public health labs that can detect biological agents now number 110, compared with 83 in 2002.
- In 2005, health departments in all 50 states and Washington DC trained personnel on their roles during an emergency, compared with only 14 states in 1999.
Professionals in the public health world praise the report, seeing it as a stepping stone to evaluate the situation states are in to deal with a variety of issues. Since the increased funding in 2001, the program has been influential in dealing with foodborne illness. The state of Wisconsin was the first to track the outbreak of E. coli 0157:H7 in spinach in the fall of 2006. The CDC report states that the increased funding enabled the state to make the detection.
Although progress has been made, CIDRAP also reports challenges left to face.
- Disease surveillance systems need strengthening. For example, last year 16 states reported no plans to exchange health data electronically with regional networks of healthcare providers.
- For disease surveillance, health departments need to make sure they have a legal framework permitting them to share health information with other jurisdictions.
- The public health lab workforce needs help, with 31 state labs reporting difficulty recruiting qualified scientists.
- Health departments are having trouble finding and keeping qualified epidemiologists, according to a 2006 survey.
- Health departments need to maintain a system of all-hazards planning, training, exercising, and improving, which should equip them to help at-risk groups such as the elderly.
- Though many cities now have systems that allow different response agencies to communicate, more progress is needed in that area.
The full version of the CDC report can be found at http://www.bt.cdc.gov/publications/feb08phprep/
