Iowa has slipped in an annual state-by-state report that tracks the level of our public health emergency preparedness.

The Hawkeye State achieved a score of just four out of a possible ten measures of preparedness for diseases, disasters, and bioterrorism. Dara Lieberman, director of government relations at Trust for America’s Health, says Iowa now ranks with 14 other states in the middle tier.

“The year before, Iowa was in the high tier,” Lieberman says. “We didn’t find specific backsliding by the state this year but we did find that other states gained more ground. One area where the state could certainly improve is that Iowa cut its public health budget for the last several years.”

Funding for public health was either stable or increased in 43 states, while the report says Iowa cut that funding by 3% between fiscal years 2019 and 2020.

“We think it’s an important measure because we can’t just be funding public health after an outbreak begins,” Lieberman says, “but we need to have the workforce, system and tools in place ahead of time so that we can make the population healthier as well as both the preparedness and emergency response systems that we need for an event like this.”

While all 50 states have made improvements in their emergency preparedness, she says they all have room for further strengthening of their public health response programs.

“The one area where Iowa is a bit of an outlier is the number of hospitals that are participating in health care coalitions, they could certainly improve that,” Lieberman says. “We also found that only 16% of acute care hospitals in the state were achieving the highest patient safety grades.”

There are a couple of categories where Iowa continues to excel on the national report. “We found that the percentage of workers who used paid time off was above average in the state, and that’s an indication that workers can stay home when they’re sick, we know there’s wide variation in given industries of how acceptable that is,” Lieberman says. “And Iowa was also above average in its seasonal flu vaccination rates.”

To see the full report, called “Ready or Not: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism,” visit the Trust for America’s Health website.