While the globe enters the third year of the COVID-19 pandemic, a report from Trust for America's Health finds that only about half of the U.S. population is served by a comprehensive local public health system.

The report, Ready or Not 2022: Protecting the Public's Health from Diseases, Disasters and Bioterrorism, measures U.S. states' degree of crisis preparedness to respond to a wide spectrum of health emergencies and to provide ongoing public health services, including disease surveillance, seasonal flu vaccination, safe water and expanded healthcare services during emergencies. It tiers states and the District of Columbia into three performance levels: high, middle and low, based on 10 factors contributing to emergency management and disaster preparedness.

U.S. states ranked by emergency preparedness

The high-preparedness tier included 17 states and Washington, D.C, with Alabama, Illinois, and Pennsylvania among the named states. Texas, Michigan and California ranked in the middle tier along with 17 other states, and Indiana, Louisiana and Hawaii were among the 13 total states included in the low tier.

Healthcare access plays a large role in crisis management

In addition, the report found:

• A majority of states had plans in place to expand healthcare and public health laboratory capabilities in an emergency.
• Most states are accredited in the areas of public health, emergency management or both.
• A large majority of Americans who receive their household water through a community water system had access to safe water.
• Only 28% of hospitals, on average, earned a top-quality patient safety grade during the year.

"The major takeaway of this report is that underinvestment in the nation's public health system, and attacks on its authority, have had deadly consequences during the COVID-19 pandemic. Action and investment are urgently needed. This report's findings can help federal and state officials identify gaps in public health preparedness and the steps needed to better protect lives and the economy during the next health emergency," said J. Nadine Gracia, MSCE, President and CEO of Trust for America's Health.

Uncover the report's security and emergency preparedness policy recommendations here.