U.S. health security preparedness improved, but some regions lagging
Equal protection an unmet priority
Two thirds of states saw improvement, but the authors of the report point out that Maryland, the highest-scoring state at 8.0, scored 25 percent higher than the lowest-scoring states, which were Alaska and Nevada, both at 6.4. In general, states in the Deep South, Southwest, and Mountain West lagged behind Northeast and Pacific Coast states.
The report notes that twelve states had stagnant or declining health security from 2016 to 2017, even as the nation’s profile showed modest improvement. Each state’s situation is unique, those with higher poverty levels generally have fewer public and private resources, and states grapple with many competing demands. States experiencing economic losses from past disasters also scored lower, which the group said likely reflects the challenge of diverting resources away from preparedness to cover recovery activities.
Also, the report found that health security is stronger in states that have achieved higher rates of health insurance coverage among residents.
Glen Mays, who leads a research team from the University of Kentucky that worked on the index, said in the press release that five years of continuous gains is remarkable progress, “But achieving equal protection across the US population remains a critical unmet priority.”
Specific gains and other weak spots
Since the index began in 2013, the largest gain has been achieved in community planning and engagement, which was the weakest area when researchers first began the yearly task of reviewing the nation’s health security. As of 2017, the measure improved by 22.4 percent—more than any other domain.
The biggest year-over-year gain in 2017 was in incident management, clocking in at 8.8 nationally, reflecting a 6 percent improvement from 2016. Researchers said the progress is the result of a decade of training government agencies, health professionals, and community leaders in the incident command process.
Another bright spot was the expanding membership and reach of preparedness coalitions, which have risen steadily since 2013, the group found.
An area of concern nationally, however, was little improvement in healthcare delivery dimensions. The team said the pressures of adjusting to shifts in health insurance coverage and new health delivery models while operating in an uncertain health policy environment make it hard for health systems to focus their attention and resources on community health security needs.
Recommendations for moving ahead
Today’s report came with eight main recommendations for closing state and regional gaps and continuing improvement for the nation.
For example, the authors said each state and community needs people to monitor the health security enterprise as a whole to mobilize and coordinate actions. They recommend that states develop and promote the position of health security strategist to fill that role.
Another recommendation is to enhance health security data sources, systems, and metrics. The authors noted that existing systems are not often shared and or linked to other relevant health security data sources. “To this end, state and federal stakeholders should create a standing committee and process for identifying unmet data and measurement needs across the U.S. health security enterprise and for developing data acquisition and exchange platforms that can address unmet needs,” the team wrote.
Other recommendations revolved around preparedness planning, engaging the private sector, surge funding, stepped-up federal funding for establishing a robust health security infrastructure, and flexibility for allocating resources based on local needs.
— Read more in Strengthening national health security and preparedness helps build a culture of health (NHSPI, April 2018); and Summary of Key Findings (NHSPI, April 2018)
