Community/ Public / Population Health

When the disaster strikes, is America “ready or not”?

As the disaster in Japan continues to unfold, it is a reminder that here in the U.S., preparedness and response to a major event must remain a priority. But are we ready to handle even a localized emergency, let alone a catastrophic natural disaster and subsequent nuclear event like those in Japan?

There is no clear answer to that question. The Trust for America’s Health, a public health advocacy organization released its eighth annual report, ”Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism.” At a recent briefing, which ANA attended, several emergency preparedness experts discussed the report, and what national, state, and local officials can do to better prepare our nation for a disaster event.

The report outlines each state’s level of preparedness. Over the last decade, the U.S. has made strides in public health preparedness. The report recognized the significant progress made in almost a decade of funding to improve how our nation prevents, identifies, and contains new disease outbreaks and bioterrorism threats in response to the aftermath of natural disasters, September 11, 2001, and the anthrax attacks.

But the news is not all good. Severe budget cuts to federal, state, and local governments are now leaving public health departments in a position in which they are understaffed and are devoid of the basic capabilities required to respond to a disaster. In fact, the report found that 33 states and the District of Columbia cut public health preparedness funds in the last two years. The report’s authors expressed their concern about the decrease in federal, state, and local funding for public health protection from diseases, disasters, and bioterrorism.

The report’s key findings include the following:

  • Only seven states cannot currently share data electronically with health care providers
  • Ten states do not have an electronic syndromic surveillance system that can report and exchange information to rapidly detect disease outbreaks
  • Half of states do not mandate all licensed child care facilities have a multi-hazard, written evacuation and relocation plan
  • Only four states report not having enough staffing capacity to work five, 12-hour days for six to eight weeks in response to an infectious disease outbreak, such as novel influenza A H1N1
  • Only one state decreased their Laboratory Response Network for Chemical Threats (LRN-C) chemical capability from August 10, 2009 to August 9, 2010.

Since 2005, federal funding for public health preparedness has been reduced by 27 percent. In addition to this reduction in funding, another $72 million has been cut from Public Health Emergency Preparedness grants and $35 million has been cut from the Academic Centers for Public Health Preparedness and Advance Practice Centers.

The Trust for America’s Health organization is concerned about the impact these reductions will have on our nation’s public health emergency preparedness and the vulnerable position in which it places the country. The trust further encourages public and legislative support for continued funding for public health protection and disaster preparedness.

National preparedness is a core issue for ANA. Recognizing that health care providers, especially nurses, will be central to any major event, ANA participates in policy development at the national level to promote better coordination and communication during all phases of an emergency response.
Even though many states and localities are in severe budget crises, it is imperative that public health preparedness activities remain a priority. The unfolding events in Japan serve as a stark reminder that even an industrialized nation with an international reputation for disaster preparedness can still struggle to cope with extreme events. The U.S. should not sacrifice preparedness for the sake of balancing a budget. During a disaster, an effective response depends on the planning done in the months and years beforehand.

Katie Brewer, MSN, RN, and Karen Siska, BSN, RN. Katie Brewer is a senior policy analyst at ANA. Karen Siska is the deputy director of the Bureau of Family Health Services at the Anne Arundel County, MD, Department of Health.

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