Come plague, storm or bomb, most U.S. states unprepared: report

By Sharon Begley NEW YORK, Dec 19 (Reuters) - If you're someone who worries about how first responders and hospitals in your town would perform after a hurricane like Sandy, a Joplin tornado, an anthrax mailing, an outbreak of bird flu or other health threat, a new study has some pointers: stay away from Kansas and Montana. But you might want to consider moving to Maryland, Mississippi, North Carolina, Vermont or Wisconsin. On Wednesday, two nonprofit groups released "Ready or Not?", a 79-page analysis of public health preparedness - that is, the ability of hospitals, health departments and others to prevent and respond to emergencies ranging from bioterrorism to influenza outbreaks to catastrophic weather. It's a grim reckoning. The assessment is based on how many of 10 key benchmarks a state met, such as whether it holds drills to make sure public health workers can respond quickly to, say, a catastrophic release of radiation, and whether its labs can work overtime to identify a mystery disease. This year, thirty-five states met fewer than seven of the 10 benchmarks. Only five met eight of 10. In 2010, in contrast, more states made the grade: 17 met at least nine benchmarks and 25 met seven or eight. No state met fewer than five. In the new report, Maryland, Mississippi, North Carolina, Vermont and Wisconsin scored highest, meeting eight out of 10 preparedness benchmarks. Kansas and Montana brought up the rear, meeting three. Alabama, Arkansas, California, Delaware, Nebraska, New Hampshire, New Mexico, New York, North Dakota and Virginia met seven of the 10 criteria. "We have not paid sufficient attention to the everyday threats" such as influenza and food poisoning and extreme weather, said Dr. Jeffrey Levi, president of the Trust for America's Health, which produced the report with the Robert Wood Johnson Foundation. There's a reason for that, say experts on preparedness. After the Sept. 11 attacks and the anthrax mailings of 2001, public health preparedness became synonymous with being ready for bioterrorism. Starting in 2002, states began receiving upward of $1 billion a year from the federal government - $13.6 billion so far - to prevent and respond to public health emergencies. "But it was all about anthrax and other bioterrorism instead of the other things that might come over the transom, such as bird flu," said health policy analyst Art Kellerman of RAND, a Santa Monica, California-based think tank, who was not involved in the report. Because the federal money came with tight restrictions - a state health employee working on, say, early-detection systems for a bioterror attack was prohibited from working on anything else - "you had a shifting of attention and resources away from preparing for all hazards to biodefense only," Kellerman said. "It was like we built a biodefense skyscraper at the same time that we took the concrete out of the foundation." http://www.reuters.com/article/2012/12/19/usa-health-preparedness-idUSL1E8NIEHA20121219