139: New Report on Public Health Readiness

Dara Lieberman, Director of Government Relations for the Trust for America’s Health, explains the organization’s “Ready or Not 2022” report assessing states’ readiness to protect public health during emergencies; Brian Lentes, ASTHO’s...

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Dara Lieberman, Director of Government Relations for the Trust for America’s Health, explains the organization’s “Ready or Not 2022” report assessing states’ readiness to protect public health during emergencies; Brian Lentes, ASTHO’s Senior Director for Public Health Infrastructure, says jurisdictions are considering the best public health infrastructure models; ASTHO invites listeners to join a conversation about the public health workforce with Dr. Bruce Perry at its latest Insight and Inspiration event on March 23rd; and Assistant Secretary of Health Admiral Rachel Levine is among USA Today’s 2022 Women of the Year.

Trust for America’s Health Report: Ready or Not 2022 – Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism

ASTHO Resource: Public Health Infrastructure and Systems Improvement

ASTHO Insight and Inspiration Event: Dr. Bruce Perry

USA Today: Women of the Year 2022


ASTHO logo



This is Public Health Review Morning Edition for Wednesday March 16th, 2022. I'm Robert Johnson.

Now, today's news from the Association of State and Territorial Health Officials.


A new report calls for urgent investment in public health infrastructure and approaches that address the social determinants of health. The Trust for America's Health has released its Ready or Not 2022 report assessing states' readiness to protect public health during emergencies.

Dara Lieberman is the organization's director of government relations. She explains the report in today's morning conversation.

This new report evaluates the nation's readiness to protect public health. What did you find?


Well, the major takeaway of this year's report is the need for urgent investment in public health; we need a public health system that's able to provide protection to all communities during an emergency. And the decades of underfunding of public health have really made the system vulnerable, and we've seen the consequences of that throughout the pandemic.


The report includes rankings of states. Can you explain those rankings and give us the highlights?


Sure. The report is really not intended to evaluate any one agency or program. We use 10 indicators that include the roles of public health, but also healthcare, emergency management, policymakers, and other sectors. And it's intended to be a checklist, so these are all actionable data points and they're steps that states can really make progress on.

This year, we found that 17 states and the District of Columbia were in the high tier, 20 states were in the middle, and 13 states were in our lower tier. So, we had some movement—we had 16 states move down a level as compared to last year's report.


So, you're tracking that movement to see where people have gained ground or maybe lost some ground.


Yeah, we've tried to keep the data stable over the last few years so that states can see how they're making progress, especially in relation to their neighbors.


What's been the reaction so far?


So, our report is really intended to shine a spotlight on the consequences of neglect. We've unfortunately been doing a report on the issue of health security for the last 20 years, and we've seen a lot of progress in our nation's preparedness across a lot of public health capabilities. But what we haven't seen is a subsequent progress in the way we're funding public health.


Of course, the last couple of reports have occurred during the pandemic. How has that affected the results, the findings that you share with everyone?


Well, it certainly influenced the amount of coverage that the report gets. There's increased media attention as our report came out just at the early stages of the pandemic in 2020, and again in 2021.

But you know, the data points themselves are really all hazards data, so it's not necessarily analogous to how a state might perform during a pandemic. We do think there's capabilities that all states need to have, of course, that helped for both a pandemic and a natural disaster, such as data, such as hospital surge capacity, things like that.


Do the states respond to this data? Have you got any stories of how they've taken it and used it to make something happen?


A lot of health officials take these reports to their governors and say, "This is why we need to be investing in public health preparedness. You know, we can't just invest in these systems in the middle of an emergency." So, that's something that the state health officials and others can take to their elected officials.


How about members of Congress? Do they look at it?


Sure. We do share this broadly with policy makers in Congress and in federal agencies, and we'll hold a congressional briefing later this spring to highlight the findings of the report.


Overall, the goal of the report is?


Well, a few different goals of the report.

One is to move policy. There are things that policy makers at the state can do such as guaranteeing paid sick leave for workers in the state. That's something that also could be done at the federal level, to move Congress to invest in these systems, not just during an emergency, but invest in CDC and public health preparedness and public health infrastructure.

But it's also important that the media understands that we don't just need to pay attention to these issues when we're in a crisis as large as the pandemic.


The report is available online. Look for a link in the show notes.


ASTHO helps its members address infrastructure needs. Brian Lentes is ASTHO's senior director for public health infrastructure. He tells us how jurisdictions are approaching the topic.


Yeah, agencies are really been trying to identify what are good models of public health infrastructure, and where can they then improve their efforts based on best practices or evidence-based practices. And moving forward, public health infrastructure is a key focus moving out of the COVID-19 pandemic stage, and really trying to make sure that we're able to improve the infrastructure practices so that it improves our overall population health services and really sets up good processes for all different functions of health agencies


Find links to an ASTHO webpage with helpful resources in the show notes.


Also, you still have time to sign up for ASTHO's latest Insight and Inspiration event. Don't miss the chance to hear Dr. Bruce Perry discuss COVID-19 impact on the public health workforce. He tells leaders how they can create positive experiences for their teams struggling with moral injury.

The online event is set for Wednesday, March 23rd at 4:00 PM Eastern time. Sign up using the link in the show notes.


Finally today, assistant secretary of health Admiral Rachel Levine is among USA Today's 2022 Women of the Year. The former ASTHO president is one of several women making the list, including Vice President Kamala Harris, advocate Melinda French-Gate, and Olympian Simone Biles.


Before we go, we want to remind you to leave us a rating and a review—they help raise our profile, and that makes it easier for new listeners to find us online. Also, if you follow the show, you'll never miss a single report. You can do all of this on the channel you're listening to right now.


That'll do it for today's newscast. We are back tomorrow morning with more ASTHO news and information.

I'm Robert Johnson. You're listening to Public Health Review Morning Edition. Have a great day.

Dara Lieberman MPP

Director, Government Relations, Trust for America’s Health

Brian Lentes MPA

Senior Director, Public Health Infrastructure, ASTHO