RWJF report: U.S. treading a slow path to better emergency preparedness

A lighted emergency room sign outside of a hospital
The nation has made improvements to its emergency preparedness over the past several years, according to a new report. (Getty/MJFelt)

The U.S. has made strides in preparing for health emergencies over the past five years, but challenges still remain, according to a new report. 

Overall, the nation scored a 7.1 out of 10 for preparedness, according to an annual National Health Preparedness Index report by the Robert Wood Johnson Foundation. That's an improvement of about 3% compared to 2016 and an overall improvement of 11% since the index first launched five years ago. 

The index compiles emergency preparedness data from nearly 50 sources and is focused in six areas: health security surveillance, community engagement, healthcare delivery, information management, countermeasure management and environmental health. 

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Anna Goodman Hoover, Ph.D., an assistant professor for preventive medicine and environmental health at the University of Kentucky College of Public Health and RWJF's grantee for the index, told FierceHealthcare in an interview that it is encouraging to see improvement, even if the pace has been fairly slow over time. 

"Health security is not the responsibility of any one group of people," Hoover said. There are elements connected to public health, emergency management, health providers and private industry, she said. 

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Though the country has improved on the whole, disparities in preparedness remain. Maryland scored highest for preparedness with an 8, while Alaska and Nevada scored the lowest with a 6.4, a 25% gap, according to the report.

States in the Deep South and Mountain West generally lag behind states in the Northeast or Pacific Coast on preparedness. Eighteen states earned scores higher than the national average, and 38 states and the District of Columbia boosted their scores from 2016. 

Hoover said researchers were concerned that some of the more populous states saw their scores decline. There are a number of reasons for those decreases, according to Hoover, as varying state policies and populations can impact preparedness. 

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Similar concerns were noted in 2016's index, which also gave Alaska the lowest state score for preparedness. 

Hoover said that healthcare delivery is one domain where the nation hasn't really "moved the needle" on better preparing for emergencies. Mental healthcare and behavioral health are crucial areas for improvement, she said, especially when considering the potential mental health challenges that can follow a major disaster. 

Continued improvement will require stakeholders to come together and work in tandem, she said. 

"[Health security] is a job we all share," Hoover said. "And we should work together to think about how we can strengthen it." 

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