Some of the nation’s most exposed states to climate disasters, including half of the hurricane-battered Gulf Coast and wildfire-ravaged California, are laggards in health emergency planning and preparedness, according to a new national index.

The findings from the Robert Wood Johnson Foundation come amid what researchers say is a general improvement in U.S. health security over the last six years based on 129 measures. They include condition of critical infrastructure, hazard planning in nursing homes, numbers of health emergency workers and volunteers, and health care access.

“The scores indicate the ability to protect the health security of Americans from incidents like newly emerging infectious diseases, terrorism and extreme weather conditions at the state and national levels,” according to experts at the University of Kentucky College of Public Health who prepared the index.

Yet the National Health Security Preparedness Index, which is scored on a 10-point scale, places three Gulf of Mexico states—Louisiana, Mississippi and Texas—in the bottom tier for health security in 2019. Two neighboring Gulf states—Alabama and Florida—climbed toward the national average after making improvements in health security and planning over the previous year.

Experts were quick to draw the connection between climate and health security.

“Certainly, we’re seeing increasing hazardous events related to climate, both globally and right here in the U.S.,” said Glen Mays, a professor of public health who leads the research effort at Kentucky’s College of Public Health.

“That’s why we want to see improvement in some of these states’ protective capabilities,” he added. “We need to accelerate the pace of improvement and help all regions get stronger. The frequency and intensity of disasters is increasing, and we are all at risk.”

Alonzo Plough, chief science officer at the Robert Wood Johnson Foundation, sounded a similar concern, pointing to the disparity in health security both within and between states.

“We are seeing some promising national numbers when it comes to our nation’s ability to cope with health emergencies,” Plough said in a statement. “Disasters like recent major hurricanes show that to take the next step in increasing our preparedness levels, we must focus on improving equity within our efforts.”

The index shows the United States as a whole scored a 6.7 on the 10-point scale of health emergency preparedness, an improvement of 3% over 2018. Massachusetts led the nation with a score of 7.4, followed by the District of Columbia, Maryland and Nebraska at 7.3. Overall, 11 states plus the District of Columbia were found to exceed the national average, while 22 states met the average.

That leaves 17 laggards, including states that are subject to extreme events ranging from tornadoes and storm surges to droughts and massive wildfires.

They include Oklahoma and Washington state at 6.5, California and Hawaii at 6.3, and Alaska, which ranked last in the index with a score of 5.9.

Mays said California’s relatively poor showing was due to a combination of factors, including the state’s challenges in responding to what have become perennial wildfires alongside coastal storms, riverine flooding and drought.

Alaska, too, is exposed to risks from rising seas and floods. But its health security score is also affected by the state’s abundance of rural and remote populations that lack ready access to health care facilities.

Overall, the researchers found that health security levels improved at a relatively slow pace for many states in 2018, particularly given recent increases in the frequency and intensity of disasters in the United States.

At the current rate of improvement, the nation as a whole will require 10 additional years to reach a strong health security level of 9.0 based on the index scale. Conversely, if the United States were to improve at the rate achieved by the five fastest-improving states, the threshold could be reached in less than six years.

The report found that the United States was generally performing well on metrics of health security surveillance and incident and information management, but many states are failing in areas of health care delivery and community planning and engagement.

“States and communities have a responsibility to be prepared to respond to health emergencies, and to recover quickly from them,” said Nancy Messonnier, acting director of the Centers for Disease Control and Prevention’s Center for Preparedness and Response. “Having a comprehensive index helps states see where cross-sector investments and cooperation are paying off and where more effort is needed.”

Reprinted from Climatewire with permission from E&E News. E&E provides daily coverage of essential energy and environmental news