In the world of preparedness and response, 2017 was marked by several historic and catastrophic incidents. Hurricanes took center stage causing severe flooding, infrastructure damage, injury, and in some cases, loss of life, in Texas, Florida, Puerto Rico, the US Virgin Islands and throughout the Caribbean and gulf coast. The western United States also contended with a particularly difficult wildfire season; the Thomas Fire was reported to be the largest in modern California history, scorching over 270,000 acres, destroying thousands of buildings and homes, and killing at least one firefighter. Although natural disasters dominated the headlines, public health officials continued to monitor and address the impacts of Zika virus; the CDC reports that in 2017 there were nearly 1,000 cases in the continental US and territories. And throughout the United States, local health departments and their partners responded to more localized extreme weather events (e.g., winter storms, flooding, drought), disease outbreaks, and contaminated food and water supplies.

With this as a backdrop, in December, the Trust for America’s Health, a non-profit, non-partisan organization, released its Ready or Not? Protecting the Public’s Health from Diseases, Disasters and Bioterrorism report which examines the nation’s readiness to respond to public health emergencies. Overall, the report finds that “…considerable progress has been made to effectively prepare for and respond to public health emergencies of all types and sizes…” however, that those accomplishments are threatened by reactionary and decreasing financial investment in public health preparedness and response systems.

The Ready or Not? report highlights areas of overall success, such as upgraded public health laboratories, improved plans and capacity for dispensing medical countermeasures, enhanced surveillance capabilities, and a better trained public health workforce. Alongside those successes, the report identifies several opportunities for improvement in the areas of biosurveillance, public health and healthcare surge capacity, and planning for vulnerable populations, among others. Many of these gaps are directly tied to sustained investment and prioritization of funding for the public health preparedness workforce and systems.

Local health departments are the “boots on the ground” in preparing for, responding to, and recovering from all types of emergencies and as such, have a critical role in ensuring the health and safety of communities. As the organization representing more than 3,000 local health departments across the country, NACCHO supports sustained and sufficient funding for state and local preparedness systems, and a public health emergency response fund to help local public health agencies rapidly respond to public health emergencies.