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Report Assesses States’ PHE Readiness, Makes Recommendations

A new Trust for America’s Health (TFAH) report that assesses states’ readiness to respond to health emergencies and provide ongoing public health services provides data and recommendations policymakers can use to increase the nation’s capacity to tackle a variety of public health emergencies.

The report includes a special section on the intersection between community resilience, emergency preparedness, and health equity, encouraging stakeholders to consider how health disparities affect emergency preparedness. It also includes resources that can help stakeholders navigate how health disparities affect emergency preparedness.

State Performance

The report tiers states and the District of Columbia (D.C.) into three performance levels (high, middle, and low) for health emergency preparedness, based on key performance indicators:

  • Incident Management.
  • Public Health System Comprehensiveness.
  • Institutional Quality.
  • Institutional Quantity.
  • Water Security.
  • Workforce Resiliency and Infection Control.
  • Countermeasure Utilization.
  • Patient Safety.
  • Health Security Surveillance.

19 states and D.C. landed in the high-performance tier, 16 states in the middle-performance tier, and 15 states in the low-performance tier:

Performance Tier States
High Tier CO, CT, DC, DE, FL, GA, KS, ME, MD, MA, MS, NJ, NC, OH, PA, UT, VT, VA, WA, WI
Middle Tier AK, AL, AR, CA, IA, ID, IL, IN, MO, ND, NE, NH, NY, RI, SC, TX
Low Tier AZ, HI, KY, LA, MI, MN, MT, NM, NV, OK, OR, SD, TN, WV, WY


The report’s findings highlight that states performed well regarding public health funding, accreditation in public health and/or emergency management, and laboratory testing capacity. Despite these successes, most states exhibited the need to improve patient safety and immunization rates and build comprehensive public health systems.

Policy Recommendations

Based on the findings, TFAH outlined extensive policy recommendations spanning federal, state, and local jurisdictions. The recommendations are based on seven priority areas, ranging from providing stable funding for public health security to promoting health equity in preparedness planning.

The recommendations included the following:

  • Expand strategies to strengthen the public health workforce and rebuild trust within communities.
  • Increase investment in foundational public health infrastructure and related programs.
  • Improve the collection of disaggregated demographic data collection.
  • Support initiatives to prevent, detect, and contain antimicrobial resistance.
  • Integrate health care delivery into emergency preparedness and response.

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.



About the Author

Faridat Animashaun is a policy analyst at America's Essential Hospitals.

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