In an annual report on health emergency preparedness, 35 states and Washington, D.C. scored a six or lower on 10 key indicators of public health preparedness.

The report found that while there has been significant progress in improving public health preparedness in the past ten years, persistent gaps remain in the country's ability to respond to health emergencies ranging from bioterrorist threats to serious disease outbreaks to extreme weather events.

In the report, Kansas and Montana scored lowest: 3 out of 10: and Maryland, Mississippi, North Carolina, Vermont, and Wisconsin scored the highest: 8 out of 10. Connecticut was among the 6 out of 10 group.

Investments made after 9/11, the anthrax attacks, and Hurricane Katrina led to dramatic improvements, say researchers, but now budget cuts and complacency are the biggest threats the nation faces.

The report suggests a number of recommendations, including:

  • Reauthorize the Pandemic and All-Hazards Preparedness Act
  • Provide ongoing support to communities so they better cope with and recover from emergencies
  • Address antibiotic resistance
  • Update the nation's food safety system
  • Modernize strategies to detect and respond to problems

Ready or Not? Protecting the Public from Diseases, Disasters, and Bioterrorism was issued by the Trust for America's Health and the Robert Wood Johnson foundation. Read the full report