In the event of a natural disaster, like hurricanes in the Gulf Coast or the Coronavirus outbreak across the country, state and federal governments can declare a state of emergency that deploys response teams to address the disaster at hand. State of emergency releases emergency funds and human resources to help those affected. It's often local and state disaster teams that are deployed during these emergencies. How well prepared is your state for a public health and natural disaster?
Key findings:
- Virginia, Connecticut and Colorado are most prepared for public health disasters.
- Wyoming, Arkansas and West Virginia are least prepared for public health disasters.
- Natural disasters have increased 165% in the United States over the last 40 years.
- The National Academies of Science, Engineering and Medicine estimate pandemics could have a $6 trillion dollar impact on the global economy in the 21st century.
- The CDC estimates a global disease outbreak could cost the United States billions in lost trade and tourism.
Our team analyzed data from Trust for America's Health report, "Ready or Not." We evaluated six factors from the report that estimate how prepared a state is for public health and natural disasters. We took a composite ranking of the following factors in each state to determine overall public health and natural disaster preparedness. States that are considered to be the most prepared for disease and natural disasters are ranked from highest (1st) to lowest (50th).
Hospital preparedness programs
Percent of hospitals participating in health care coalitions, 2017
Public health funding
Percentage change, FY 2018-19
Water security
Percent of population who used a community water system in violation of health-based standards, 2018
Paid time off
Percent of employed population with paid time off, 2019
Seasonal flu vaccinations
Seasonal flu vaccination rate for people ages 6 months and older, 2018–19
Patient safety
Percentage of hospitals with "A" grade, fall 2019
| Rank | State | Hospital Preparedness | Public Health Funding | Water Security | Paid Time Off | Flu Vaccination | Patients Safety |
|---|---|---|---|---|---|---|---|
| 1 | Virginia | 100% | 4% | 2% | 58% | 54.7% | 56% |
| 2 | Connecticut | 100% | 4% | 3% | 64% | 56.8% | 33% |
| 3 | Colorado | 100% | 3% | 1% | 56% | 51.6% | 38% |
| 4 | Vermont | 100% | 4% | 1% | 56% | 51.9% | 33% |
| 5 | Washington | 100% | 1% | 1% | 60% | 53.8% | 33% |
| 6 | Rhode Island | 100% | 9% | 38% | 56% | 60.4% | 43% |
| 7 | Hawaii | 100% | 6% | 0% | 59% | 50.2% | 25% |
| 8 | Oregon | 100% | 27% | 16% | 63% | 48.3% | 48% |
| 9 | Minnesota | 100% | 7% | 1% | 52% | 52.7% | 23% |
| 10 | Nevada | 100% | 40% | 0% | 55% | 37.8% | 26% |
| 11 | Maryland | 89% | 2% | 1% | 61% | 57.1% | 23% |
| 12 | Massachusetts | 82% | 10% | 11% | 59% | 58.9% | 42% |
| 13 | Illinois | 88% | 16% | 1% | 55% | 45.4% | 43% |
| 14 | Maine | 94% | 3% | 1% | 51% | 48.8% | 59% |
| 15 | Mississippi | 100% | 8% | 7% | 63% | 42.0% | 31% |
| 16 | North Carolina | 95% | -2% | 2% | 51% | 54.9% | 47% |
| 17 | Kansas | 96% | 9% | 8% | 56% | 50.7% | 27% |
| 18 | South Dakota | 100% | 2% | 1% | 44% | 54.4% | 10% |
| 19 | Delaware | 100% | 2% | 1% | 48% | 50.7% | 20% |
| 20 | Texas | 80% | 8% | 7% | 68% | 47.9% | 38% |
| 21 | Wisconsin | 98% | 0% | 5% | 56% | 50.9% | 38% |
| 22 | Utah | 100% | 0% | 2% | 45% | 45.9% | 56% |
| 23 | Oklahoma | 95% | 12% | 13% | 55% | 51.3% | 25% |
| 24 | Michigan | 90% | 17% | 3% | 49% | 46.1% | 41% |
| 25 | Idaho | 98% | -3% | 1% | 51% | 43.6% | 45% |
| 26 | Missouri | 87% | 1% | 0% | 53% | 50.0% | 28% |
| 27 | North Dakota | 100% | 9% | 16% | 51% | 51.1% | 0% |
| 28 | Tennessee | 91% | 4% | 3% | 53% | 48.2% | 34% |
| 29 | Pennsylvania | 86% | 2% | 13% | 51% | 54.2% | 46% |
| 30 | Ohio | 25% | 7% | 2% | 49% | 50.4% | 39% |
| 31 | Nebraska | 95% | -4% | 3% | 57% | 54.2% | 13% |
| 32 | Iowa | 80% | -1% | 3% | 60% | 54.8% | 9% |
| 33 | New Jersey | 82% | 3% | 11% | 52% | 50.5% | 45% |
| 34 | Alaska | 100% | 1% | 7% | 60% | 44.1% | 0% |
| 35 | Montana | 83% | -3% | 8% | 58% | 48.7% | 44% |
| 36 | Georgia | 97% | 2% | 8% | 59% | 43.1% | 26% |
| 37 | California | 70% | 10% | 12% | 56% | 47.4% | 36% |
| 38 | Louisiana | 100% | 3% | 16% | 53% | 41.6% | 31% |
| 39 | Florida | 73% | 1% | 1% | 54% | 40.9% | 37% |
| 40 | New Mexico | 71% | 3% | 8% | 61% | 49.9% | 12% |
| 41 | South Carolina | 56% | 5% | 2% | 45% | 46.8% | 37% |
| 42 | Alabama | 95% | -5% | 3% | 55% | 48.3% | 23% |
| 43 | Kentucky | 93% | 4% | 10% | 48% | 49.6% | 26% |
| 44 | New Hampshire | 47% | -6% | 3% | 54% | 52.0% | 31% |
| 45 | New York | 86% | -1% | 45% | 61% | 51.9% | 7% |
| 46 | Indiana | 75% | 5% | 2% | 50% | 47.9% | 17% |
| 47 | Arizona | 72% | 2% | 1% | 48% | 45.6% | 14% |
| 48 | West Virginia | 97% | -2% | 16% | 55% | 48.2% | 5% |
| 49 | Arkansas | 81% | -3% | 6% | 45% | 48.8% | 35% |
| 50 | Wyoming | 92% | -6% | 1% | 47% | 40.7% | 0% |
Economic and insurance impacts of public health and disaster preparedness
Each state's overall preparedness in response to a public health and natural disaster is a critical factor in saving lives and reducing economic losses. Response times and containment efforts reduce the impact on individuals' physical and financial health. One of the biggest public health issues tied to economic impacts we've seen from the Coronavirus outbreak is the lack of paid time off and uninsured people.
When a sect of the workforce doesn't have paid time off, they face a hard decision of not earning a paycheck or risking their health to work. Without the insurance of paid time off, people often opt to put food on the table and risk their health. This puts the spread of diseases like Coronavirus at a higher risk when workers don't have the insurance of staying at home while earning a paycheck. More people working with the public is a primary cause of disease spreading.
Bureau of Labor Statistics found just 30% of workers in the lowest 10% of wages have access to paid sick days, compared to 93% of workers in the highest 10% of wages. The same low income workforce that lacks paid time off typically doesn't have proper health insurance in the event they do become sick. In 2018, 27.9 million nonelderly people were uninsured in the United States. People without health insurance often forego a doctor's visit when symptoms are present. This all-too-common instance of sick uninsured people going to work plays a key role in the spread of disease. Vaccination from other common diseases like influenza is associated with people having insurance to cover a vaccination. Having the insurance benefit of paid time off and health insurance to cover hospital stays is a massive economic factor in how well prepared we are to handle a disaster. The CDC estimates these kinds of outbreaks can cost billions in lost revenue and end up costing millions of people their jobs.
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