States' Infection-Fighting Abilities Examined

Infectious disease protection in US states explored in new report that suggests modernizing systems

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) A new national scorecard has rated how the country is doing in terms of fighting infectious disease, and it seems that some states have been outshining others.

The report looked at a number of different factors, including vaccination rates, funding and laboratory capabilities.

New Hampshire was found to be the best prepared for fighting infectious diseases, but major gaps were found across the country in terms of preventing illness.

"Talk to your doctor about vaccine schedules."

This report, led by Jeffrey Levi, PhD, executive director of the non-profit Trust for America’s Health, used 10 indicators aimed at measuring strengths in the ability to fight infectious diseases. These indicators included factors like stable state public health budgets, meeting vaccination goals and sufficient laboratory capabilities for tracking outbreaks of new diseases.

Dr. Levi and colleagues assessed each state in terms of these 10 indicators and found some disparities.

The highest score, achieving eight out of 10 indicators, was seen in New Hampshire, meaning the state was quite well prepared to fight infectious diseases.  Three states — Georgia, Nebraska and New Jersey — shared the lowest score, achieving two out of 10 indicators.

The most common score seen was the middle-ground with five out of 10 indicators achieved — 14 states shared this score.

The report also uncovered a number of less than exemplary statistics.

For one, Dr. Levi and colleagues reported that only one fourth of US states had at least half of their population vaccinated to protect against the seasonal flu — a statistic that goes against the Centers for Disease Control and Prevention's (CDC) recommendation that everyone over the age of 6 months be vaccinated annually.

Flu vaccinations weren't the only vaccine being under-utilized. The report also found gaps in human papillomavirus (HPV) vaccinations and whooping cough vaccinations.

It was reported that Medicaid programs in one third of US states do not cover HIV screening as a routine test. "Knowing HIV-status is important to help get individuals into treatment and stop the spread of the disease," the report explained.

The report also noted that one third of US states do not require healthcare facilities to report healthcare-associated infections to a central agency like CDC. These infections can turn very serious and spread quickly.

Gaps were also uncovered on the administrative, as opposed to clinical, side of things.

"Only 37 state public health laboratories and Washington, D.C. report having a plan and capability to handle a significant surge in testing over a six to eight week period in response to an outbreak that increases testing over 300 percent — which is what could be needed during a major new disease outbreak," the report explained.

Furthermore, funding for public health dropped from the 2011-12 fiscal year and the 2012-13 fiscal year in two thirds of US states.

Some steps to move forward were offered in the face of these findings, including taking precautions to counter antibiotic resistance and researching new methods for treating these antibiotic-resistant infections.

Dr. Levi and colleagues also suggested that the country increase vaccination numbers and screenings for common diseases while modernizing public health laboratories and the surveillance of infectious diseases.

The authors of this report noted that the findings and state scores are not intended to judge the performance of specific health departments, but rather to examine the state of affairs on a larger scale that includes many competing factors.

This report, released December 18, was a joint project of Trust for America’s Health and the Robert Wood Johnson Foundation.

Review Date: 
December 18, 2013
Last Updated:
December 19, 2013