PUBLIC HEALTH: U.S. Not Prepared for Emergency

Twenty-seven states cut funding for public health from fiscal year 2008 to FY 2009, jeopardizing the country's ability to respond to an emergency, according to a new study released on Tuesday by the not-for-profit Trust for America's Health. The report also found that such funding is allocated haphazardly, making it difficult to tell exactly how much has been spent on emergency preparation.

Since FY 2005, federal funding for public health emergency preparedness has declined by 27% when adjusted for inflation, according to the report. Those reductions undermine improvements made in the wake of the Sept. 11 attacks, according to Richard Hamburg, deputy director of the TFAH. The study also found that 20 states received failing grades in at least four of 10 areas considered to be critical in a public health emergency.

According to the report, 11 states and Washington, D.C, reportedly would not have enough laboratory staff to work five 12-hour days for six to eight weeks -- a level deemed necessary to respond to an infectious disease outbreak such as H1N1. Half of state health departments indicate they expect to lose staff in the future, according to Irwin Redlener, director of Columbia University's National Center for Disaster Preparedness. Redlener added that "because of economic conditions, we can't even come close to saying hospitals are going to be prepared for a pandemic (or) major terrorism. … It's really a big problem."

The report also found that:

• 13 states have purchased fewer than 50% of their share of federally subsidized antiviral drugs to stockpile for use during an influenza pandemic;
  
• 14 states lack the capacity to assure timely pick-up from and delivery of samples to CDC's network of labs at any hour of the day; and
  
• 10 states and Washington, D.C., do not submit weekly hospital bed availability reports for at least half their hospitals, as required by HHS during the H1N1 pandemic, which could hurt the government's ability to know where to send patients during an emergency.
  

The report called for greater accountability and transparency for public health funds. "We've funded on a band-aid approach," Redlener said. "When something bad happens ... Congress is quick to put out money to address the issue. But that's not preventive. That's not in the nature of preparedness. We need a reliable funding source year in and year out so we don't have to necessarily turn to these emergency sources of income."

"The funding issue is most important," Hamburg said. He added that many states would have scored better on the survey if not for inadequate funding. "We've seen some substantial cuts in resources that have truly begun to tie the hands of state and local public health officials." Hamburg added that the H1N1 pandemic "exposed underlying gaps" in the country's public health system, and state and local governments are "trying to do more with less as budgets and staffs were stretched well beyond their limits."

Redlener said the report is a "call to action," adding, "We are not prepared … to deal with the range of potential threats we face."

by Ryan Holeywell, staff writer