Threats to health security are on the rise, but Kentucky has improved its ability to deal with natural disasters and disease outbreaks, according to an assessment released Tuesday.
However, the state slipped in a ranking of its ability to maintain the security and safety of water supplies, in part because of an increase in violations of health and reporting standards at public water systems, according to the lead researcher.
And nationwide, gaps in preparedness and protection are increasing between states, the study found.
“Health security is improving at an uneven pace across the United States, leaving large and growing segments of the American population under-protected,” the study said.
The assessment is called the National Health Security Preparedness Index. It is funded by the Robert Wood Johnson Foundation and carried out by a team at the University of Kentucky led by Glen P. Mays of the Department of Health Management and Policy.
The index analyzes 140 measures — everything from the number of pediatricians to the percentage of bridges in good or fair condition.
The goal is to track progress in preparing for, responding to and recovering from the health impact of disasters, disease outbreaks and terrorist attacks, identifying areas that policymakers and others can work to improve.
Threats are on the rise, not just from extreme weather but from diseases such as Zika; growing resistance to antibiotics; people not getting vaccinated; global travel; aging infrastructure; and cyber security vulnerabilities, the report said.
In the face of those threats, Kentucky and the country have improved in overall preparedness to deal with emergencies, researchers found.
Kentucky ranked 7.1 out of 10 in the 2018 index, the same as the nation.
The state ranked above the national average in some categories, including health security surveillance, defined as the ability to detect and monitor health threats and to identify where hazards start and spread so they can be contained.
The state is a leader in its ability to spot disease outbreaks, benefiting from good laboratory facilities and data collection, monitoring by hospitals and a strong public health system, Mays said.
The state improved or kept pace from 2013 to 2018 in all but one of the six broad areas the researchers assess, slipping back only in a category called environmental and occupational health.
The index defines that as maintaining the security and safety of water and food supplies, testing for hazards and contaminants in the environment, and protecting workers and emergency responders from hazards.
One reason the state slipped was that the percentage of people served by public water systems with no reported violations of health, testing and reporting standards dropped from 94 percent to 84 percent, Mays said.
John Mura, spokesman for the Energy and Environment Cabinet, said the state’s water supply is safe and reliable. The state requires water systems to closely monitor quality and data show the systems have an outstanding compliance record, he said.
Water systems in the state reported 226 health-based violations in more than 82,000 samples in 2016, a compliance level of more than 99.7 percent, Mura said.
Mays said a drop in flood-insurance coverage among people living in areas at risk of flooding and a decline in the percentage of employees with a paid time-off benefit contributed to the decline in that ranking as well.
The assessment said in Kentucky, as in most states, less than 60 percent of the people who live in flood-prone areas are in communities that take part in a program that lets residents earn discounts on flood insurance.
The other areas in the index are community planning and engagement; deploying people, supplies, money, and information where they are most effective; ensuring access to high-quality medical services; and storing and deploying medical products that protect against diseases and toxic agents.
“These are measures that make it more likely that more of us in Kentucky make it through unscathed” in an emergency, Mays said.
Nationwide, the ability to manage response to emergencies remained the strongest area, at 8.8 of 10, the report said.
Health care delivery remained the lowest-ranked category.
Significant differences remain among states and regions, the report said.
The percentage of people living in states with below-average preparedness rankings rose to 43 percent in 2017, from less than 20 percent in 2014, the report said.
The gaps are worrisome because they leave some communities more vulnerable than others to emergencies, the report said.
“Five years of continuous gains in health security nationally is remarkable progress,” Mays said. “But achieving equal protection across the U.S. population remains a critical unmet priority.”
Kentucky Emergency Management recommends everyone have an emergency plan. See details at https://kyem.ky.gov/Preparedness/Pages/default.aspx.