Jan 13 2013





A list has been released by 24/7 Wall Street of the seven states that are least prepared for a disaster. Ironically, New Jersey is one of the seven in this study that was completed before Hurricane Sandy. The definition of disaster includes not only natural events but also terrorism or health emergency's.

1. Montana

-Score: 3
-All-hazards preparedness funding: $5,884,938 (down 11.9%)
-Pct. change in public health funding:-21.0%

Much of Montana’s limited preparedness for public health disasters can probably be explained by a lack of funding, according to TFAH. Total all-hazards preparedness funding dropped 11.9% between 2011 and 2012, one of the largest drops of all states. To exacerbate the problem, the 21% drop in state public health was the worst of all states. Montana is among the minority of states that has not been accredited by the Emergency Management Accreditation Program. In addition, only 76.8% of infants ended up getting immunized for whooping cough, lower than all but a handful of states. This is despite the fact that Montana has an incidence rate of the disease nearly four times that of the country as a whole

2. Kansas

-Score: 3
-All-hazards preparedness funding: $10,309,363 (up 2.8%)
-Pct. change in public health funding:-6.0%

Kansas is one of just two states that met only three of the 10 TFAH standards for disaster readiness. Among the state’s shortcomings are its lack of a climate change adaptation plan, no accreditation by the Emergency Management Accreditation Program, and the fact that the state did not have staffing levels available at health labs to adequately deal with a disease outbreak. State officials in Kansas have taken issue with the state’s place in the ranking, arguing, among other things, that changes in the formula for federal funds hurt rural states such as Kansas. But while federal all-hazards preparedness funding was up, state funding actually declined by 6%.

3. New Jersey

-Score: 4
-All-hazards preparedness funding: $25,586,974 (down 1.4%)
-Pct. change in public health funding: -1.3%

Among New Jersey’s shortcomings was the fact that public health funding declined, the state was ill-equipped to staff a public health lab in an emergency and it lacked a climate change adaptation plan. New Jersey’s disaster preparedness was recently, and continues to be, tested with Superstorm Sandy. Levi, from TFAH, pointed out that New Jersey was able to handle the disaster well given the tireless efforts of state employees, medical personnel and volunteers. But TFAH noted in the report that even as the initial disaster has faded away, those affected by the storm, including many New Jersey residents, continue to face disaster risks. Some of the problems pointed out by the group include unsafe drinking water, carbon monoxide poisoning and asbestos exposure

4. Nevada

-Score: 4
-All-hazards preparedness funding: $10,105,858 (up 3.8%)
-Pct. change in public health funding:-5.1%

Although Nevada’s all-hazards preparedness funding was up 3.8% in 2012 compared to the prior year, its public health funding fell more than 5%, the third straight year of decline. Nevada had the lowest reported rate of infants receiving immunization for whooping cough at just 75.2%, although the state had a lower incidence rate of the disease compared to the country as a whole. Like many states, Nevada lacks a complete climate change adaptation plan. However, Nevada did well in response time in the case of a public health crisis. It took just 14 minutes to notify and immediately gather staff in these cases, which is significantly faster than the majority of states.

5. Hawaii

-Score: 4
-All-hazards preparedness funding: $6,818,950 (down 4.3%)
-Pct. change in public health funding: 0.1%

Hawaii was by far the worst state in emergency operations coordinating capability. It took state officials 221 minutes to notify and immediately gather staff in the case of a public health crisis, more than three times longer than any other state in the country. Hawaii was also among one of just 14 states to not have enough staffing at state health labs to deal with a health disaster. Not all was bad for Hawaii, though. The state was just one of two to meet an HHS goal of immunizing 90% of infants between the ages of 19 and 35 months for whooping cough. The only state to perform better was Nebraska, with a 92.3% immunization rate.

6. Georgia

-Score: 4
-All-hazards preparedness funding: $26,701,047 (up 2.3%)
-Pct. change in public health funding: 1.2%

The good news for Georgia residents is that it was among the minority of states that increased its public health funding budget. However, Georgia was weaker than most states in a number of areas. Similar to many states with low scores, and unlike the majority of states, Medicaid in Georgia doesn’t cover flu shots without co-pays for those under 65. Georgia also doesn’t have a law requiring that child-care facilities have a multi-hazard evacuation plan. Another failure is that it can’t adequately staff its state health laboratory for 60 hours a week for six to eight weeks in a row in the case of an emergency.

7. Colorado

- Score: 4
- All-hazards preparedness funding: $15,489,507 (up 3.6%)
- Pct. change in public health funding: -3.9%

Colorado is among a small minority of states where Medicaid isn’t required to cover flu shots with no co-pay, leaving a large proportion of the population exposed to potential illnesses. In addition, the state does not have enough staffing capacity at its state health laboratories to deal with a potential breakout of an infectious disease. Less than one-third of other states share these distinctions. Colorado is one of just 14 states where public health funding has decreased for three consecutive years. The only indicator where Colorado fared better than the majority of states was that it participates in the Nurse Licensure Compact, one of just 24 states to do so. This program allows nurses registered in participating states to practice in all other participating states and could help Colorado obtain the medical staffing necessary in case of a public health emergency.