Report Highlights Gaps in Nation's Ability to Respond to Disease Outbreaks

The Ebola outbreak exposed some serious gaps in the nation’s ability to manage severe infectious disease threats with half of the country scoring low on key indicators related to preventing, detecting, diagnosing, and responding to outbreaks, according to a report from Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

The Outbreaks: Protecting Americans from Infectious Diseases report found that Arkansas had the lowest score with just 2 out of 10 key indicators. Maryland, Massachusetts, Tennessee, Vermont, and Virginia all received 8 out of 10 indicators for the highest scores in the country. Overall, 25 states reached half or fewer of the key indicators.

“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 controls failed when tested,” Jeffrey Levi, PhD, executive director of TFAH, said in a statement. “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.”

For instance, more than 2 million preschoolers, 35% of seniors and a majority of adults do not receive all recommended vaccinations, according to the report. Just 14 states vaccinated at least half of their population against the seasonal flu.

The priority improvements the report recommends to better match existing and emerging global disease threats 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, which include investigative expertise, continue training and testing for hospitals for infection control, and risk communications capabilities.

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.

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.

“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.”