State Report Cards Show Shortcomings in H1N1 Flu Preparedness

Dec. 20, 2009— -- Although states have made substantial progress in preparing for public health emergencies, the H1N1 pandemic has revealed remaining deficiencies, according to a new report.

Of 10 key indicators of preparedness, 20 states achieved six or fewer. The worst performer, Montana, fulfilled only three, according to an assessment by the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation.

Seven states -- Arkansas, Delaware, New York, North Carolina, Oklahoma, Texas, and Vermont -- tied for the highest score of nine out of 10.

The unexpected emergence of pandemic H1N1, coupled with shrinking state budgets in a crumbling economy, exposed problems with the public health infrastructure, including a lack of real-time coordinated disease surveillance and laboratory testing, outdated vaccine production techniques, limited hospital surge capacity, and a smaller public health workforce, the report stated.

It urged increases in funding for preparedness and efforts to solidify the public health infrastructure, even in the face of waning H1N1 activity.

"As the second wave of H1N1 starts to dissipate, it doesn't mean we can let down our defenses," said Richard Hamburg, deputy director of TFAH, in a statement. "In fact, it's time to double down and provide a sustained investment in the underlying infrastructure, so we will be prepared for the next emergency and the one after that."

The 10 indicators and how states performed in 2009: