Louisiana is the least-prepared state in the nation to respond to a major health emergency or disaster, according to this year’s National Health Security Preparedness Index.
The report, released Monday night and compiled by the national Robert Wood Johnson Foundation, shows Louisiana and a cluster of other states, mostly in the South, have not kept pace with the rest of the nation in becoming more prepared to respond to health emergencies. Louisiana has even taken some steps backward.
Louisiana’s biggest problem is health care delivery, a category in which it has taken a 9 percent hit since the index first came out in 2013. Many metrics go into the category, including the number of physicians; the number of hospital beds; the level of staffing at nursing homes; the availability of mental and behavioral health services; and the number of people who have to travel more than 50 miles to a trauma center or more than 100 miles to a burn center.
The state’s overall score in health security preparedness is 5.6 on a 10-point scale, below the national average of 6.7. But in health care delivery, the state scored just 3.1 while the national average is 5.1.
As the state navigates sweeping changes in the way it delivers health care, particularly to the poor, University of Kentucky health policy professor Glen Mays said such broad changes may have affected the health care delivery score.
“Those sort of large-scale changes in our health care system have the potential to weaken the system,” said Mays, who directs the foundation’s Systems for Action Research Program.
Another area where Louisiana followed a national trend of losing ground was in environmental and occupational health. The category outlines environmental risks, particularly with contaminants in water and food, and the ability of a state to respond. The drinking water crisis in Flint, Michigan, is an example.
Louisiana scored 5.1 in that category; the national average was 6.4.
But the state did have a strong increase of 7 percent in incident information and management, which is how well Louisiana has done in implementing protocols to respond to future emergencies.
Louisiana now has a score of 7.6 in that category, though it’s still below the national average of 8.4.
“It’s not all a bad picture here, for Louisiana in particular. There are places where the state has made important gains in preparedness that can be very reassuring to Louisiana residents,” Mays said. “And it shows that it’s possible to make gains.”
Louisiana’s scores stayed relatively flat in other categories, such as its ability to send out health supplies and equipment — which could range from vaccines to protective suits — where needed during a disaster. Scores were also flat in the state’s ability to detect and analyze potential health threats before they arise and in the state’s ability to bring together groups to plan how they would act together during a crisis.
Maryland was the highest-ranking state in the nation, with an overall score of 7.6 and with above-average scores in each subcategory. But Mays was quick to point out that all the states need to make strides in different areas.
A pocket of states in the Deep South — Louisiana, Arkansas, Mississippi, Alabama and Georgia — as well as Oklahoma all rank below the national average in health security.
Mays said despite the states being clustered together, each has a different reason for its ill-preparedness. He did say, though, that many of the poorly rated states have fewer resources for health care preparedness while many also have higher risk factors for health emergencies.
Mays said he hopes states use this year’s index as a guide to which areas they need to improve and how to do so. The researchers took into account more than 100 measures, among them flu vaccine rates, presence of flood inspection programs, participation in public health drills and hazard planning in public schools.
He said no one action will be the cure-all for Louisiana, just as no one agency in the government or private sector can address all of the state’s needs. But he also said the solutions do not have to be as large scale as building new hospitals or hiring more doctors.
Instead, he said, the solutions take willingness for collaboration and recognition that the problem is a national one as well.
“We can’t just expect Louisiana, on its own, to put in place all of the protections the state needs,” Mays said.