Vermont Ranks First For Health Security Preparedness

By Marc Arnold

For the second year running, Vermont scored highest among the 50 states and District of Columbia in public health protection readiness, according to the latest results from the National Health Security Preparedness Index. Funded by the Robert Wood Johnson Foundation, the index measures the nation’s ability to keep people safe and healthy in the event of epidemics, foodborne disease outbreaks, terrorism and other large-scale public health emergencies.

Overall, Vermont scored 7.7 out of 10 points, compared to the national average of 6.8. The National Health Security Preparedness Index methodology involves collecting, aggregating and measuring existing state-level preparedness data from a wide variety of sources. The index then computes a range of key measures for all 50 states that, taken together, display the broadest and most comprehensive national- or state-level preparedness.

The index’s measures are grouped into one of six domains representing broad areas of preparedness activity. First, health security surveillance entails actions to monitor and detect health threats and to identify where hazards start and spread so that they can be contained rapidly. Next, community planning and engagement involves actions to develop and maintain supportive relationships among government agencies, community organizations and individual households and to develop shared plans for responding to disasters and emergencies.

The third domain is called information and incident management, which includes measures to deploy people, supplies, money and information to the locations where they are most effective in protecting health and safety.

Next, healthcare delivery encompasses actions that ensure access to high-quality medical services across the continuum of care during and after disasters and emergencies. The fifth domain is countermeasure management, which comprises efforts to store and deploy medical and pharmaceutical products that prevent and treat the effects of hazardous substances and infectious diseases, including vaccines, prescription drugs, masks, gloves and medical equipment.

The last domain, environmental and occupational health, is composed of actions intended to maintain the security and safety of water and food supplies, to test for hazards and contaminants in the environment and to protect workers and emergency responders from health hazards while on the job.

Vermont was rated higher than the national average in the first five index domains and matched the national average in environmental and occupational health.

Although a great tool for public health policy makers, the index results are not intended for ranking states. According to the report, states face varying threats and therefore should apply common preparedness principles in locally relevant ways.

Even with national plans in place for assisting with emergencies, such as FEMA, each state should be ready for any eventuality.
“All emergencies are local,” commented Pam Berenbaum who works as Professor of the Pracictice of Global Health and Coordinator of Global Health programs at the College. “The same storm plays out differently in Vermont than it does in upstate New York or New Hampshire.”

Despite improvements in nearly two-thirds of states, significant inequities in preparedness exist across the nation. Generally, states in the Deep South and Mountain West regions — many of which face elevated risks of disasters and contain disproportionate numbers of low-income residents — lag behind Northeast and Pacific Coast states.

Originally developed by the Centers for Disease Control and Prevention as a tool to drive dialogue to improve health security and preparedness, the index remains a collaborative effort involving more than 30 organizations. State health officials, emergency management experts, business leaders, nonprofits, researchers and others help shape the index each year through its National Advisory Committee and expert workgroups.

“I was very pleased to see that the biggest improvement for Vermont was in the Community Planning and Engagement domain, because that is where the most powerful response is located,” Berenbaum said.

Developing and maintaining supportive relationships among community organizations and individual households for responding to disasters and emergencies is an area that the Index is committed to improving.

The National Health Security Preparedness index has launched a Preparedness Innovator Challenge to collect and spread best practices for using the Index to improve preparedness. Through July 31, users will submit their stories about how they used index findings as a tool to focus efforts and, ultimately, improve health security in their communities.

For more information about the National Health Security Preparedness Index, or the Preparedness Innovator Challenge, visit