Report: Arkansas not disease-ready

Arkansas is the least prepared state in the nation for an infectious disease outbreak, according to a report released Thursday by the Trust for America's Health and the Robert Wood Johnson Foundation.

The report outlined 10 indicators each state should meet to be prepared for an outbreak. Arkansas was the only state to meet just two of the indicators. Indicators included issues such as vaccination rates and the state's budget for public health programs.

Dirk Haselow, Arkansas Department of Health epidemiologist, said that the public should be cautious of drawing conclusions from the report because it simplifies preparedness into "essentially 10 yes-or-no questions."

"I think on the basis of this scale we came in last," Haselow said. "I don't think that is true. With that being said, we agree with a majority of the report. Much of the challenges, frankly, relate to the financial commitment we have for these programs."

Jeff Levi, Trust for America's Health executive director and the report's author, agreed that the report is not comprehensive and not a perfect index.

"These are 10 issue areas, policies or outcomes that we think are reflective of what it takes to be able to protect people from disease," Levi said. "I think it is a predictor to some of the challenges that will be faced."

Increasing or maintaining the state's budget for public health services is one indicator Arkansas does not meet, Levi said. Funding is most likely the most important indicator, he said.

"For the last three years, the public health budget in Arkansas has been cut," Levi said. "I think that is to some degree the core indicator."

The report does not look at the state's entire budget for public health but at funding for public health programs focused on preparedness, according to the report. For instance, it does not include Medicaid funding.

Twenty-two states either decreased or maintained funding for public heath services last year, the report states. Nine of those states saw a decrease for two years in a row. Another nine states, including Arkansas, have received a cut in public health funding for three years, it states.

Haselow said it is typical that funding will fluctuate for public health services.

"After 9/11 there was an enormous influx of money into public health," Haselow said. "The money has since dropped back off. Now with [the] Ebola [outbreak] there has been a lot of interest to bolster that money again."

Levi said decreasing funds could make it hard for a state to meet the other indicators reviewed in the report. This includes funding for public awareness about the importance of getting vaccinated, he said.

Arkansas is one of 15 states that did not have 90 percent of children between ages 19 and 35 months vaccinated with three doses of the hepatitis-B vaccine, the report states. The state had vaccinated 88.6 percent of children between those ages.

The state also failed to vaccinate half of its population for the 2013-14 seasonal flu, the report shows. However, 34 other states also did not meet this indicator. Arkansas had the highest rate among the 34, at 49.8 percent.

Haselow said the report doesn't show that Arkansas has improved its flu vaccination rate in recent years. About 47 percent of Arkansas' population was vaccinated during the 2012-13 flu season and 42 percent were vaccinated during 2011-12.

The report states that Arkansas is one of 34 states that fell below the national standardized infection ratio for health care-acquired bloodstream infections in 2012. It also was one of 40 states that did not decrease health care-acquired infections between 2011 and 2012.

Haselow said Arkansas would have met the standards in the report for health care acquired infections if data from 2013-14 was used, he said.

Some information in the report should be of interest to Arkansans, Haselow said, including the lack of a climate change adaptation plan. The report says the plans can help states prepare for possible increases in infectious diseases because of climate change.

"We do need to start putting this on our radar," Haselow said.

Arkansas Department of Health officials have planned two meetings to review the report and discuss ways to address some of the issues, Haselow said.

"Many of these will require some evaluation and investigation to see what we can do," Haselow said.

Arkansas did meet two of the indicators in the report. It received one point for performing training events to evaluate the speed with which testing laboratories can respond to an emergency situation. It also received a point for testing all E. coli cases within four days.

To view the report in full visit healthyamericans.org/reports/outbreaks2014

NW News on 12/19/2014

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