Funding cuts threaten preparedness gains, study says

State and federal funding cuts have undermined preparedness for public health emergencies amid a troubling array of threats, made clear again in October by superstorm Sandy, according to a study released today by the Trust for America's Health and the Robert Wood Johnson Foundation.

Researchers report that 29 states cut public health funding in fiscal 2011. For 23 states, it was the second consecutive year of cuts, and for 14 states it was the third straight year. According to the report, state and local health departments have slashed more than 45,700 jobs since 2008. In 2011, 23% of emergency-preparedness departments at local health departments also reported job cuts.

The report, “Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism, (PDF)” is in its 10th year. The series is designed to measure how prepared states are for crises in the wake the 9/11 terrorist attacks.

Paul Kuehnert, director of the public health team at the RWJF, said improvements have been made since 9/11, but cuts, including to the Centers for Disease Control and Prevention, threaten that progress. “We must establish a baseline of 'better safe than sorry' preparedness that should not be crossed,” he said in a news release (PDF).

Researchers rated individual states on criteria including preparation for climate change and how well the public was vaccinated against the H1N1 virus. Kansas and Montana ranked lowest among the 50 states, while Maryland, Mississippi, North Carolina, Vermont and Wisconsin scored the highest.

Kuehnert emphasized the importance of electronic health records, noting how such systems eased the transfer of patients after last year's tornado hit St. John's Medical Center in Joplin, Mo. In contrast, healthcare providers helping victims during superstorm Sandy lacked detailed information on patients' medications or illnesses. “A good electronic health record taps into all of that,” Kuehnert said.

Jeffrey Levi, executive director of the Washington-based health policy group Trust for America's Health, said officials need to realize that consistent funding for emergency preparedness will save money. “In the past decade, there have been a series of significant health emergencies, including extreme weather events, a flu pandemic and food-borne outbreaks,” he said. “But, for some reason, as a country, we haven't learned that we need to bolster and maintain a consistent level of health emergency preparedness. Investments made after Sept. 11, the anthrax attacks and Hurricane Katrina led to dramatic improvements, but now budget cuts and complacency are the biggest threats we face.”