How Ready Is NJ to Handle Public Health Emergencies? The Latest Results

Annual survey places New Jersey among states with the best health care and emergency response systems
Credit: PEO, Assembled Chemical Weapons Alternatives via Creative Commons (BY 2.00)
Dealing with a public health emergency

Whether it’s an influx of coronavirus carriers or another Superstorm Sandy, a new nonprofit report finds New Jersey is in a relatively good position to handle the next public health emergency.

An annual survey released Wednesday by The Trust for America’s Health shows that New Jersey is among a top tier of 17 states considered to have the best health care and emergency response systems, along with the training and capacity to protect residents against communicable diseases, natural disasters and other calamities.

Officials at the Trust — a national research and advocacy group focused on public health and injury prevention — said the Garden State has ranked in the top third of states for the last several years, a significant improvement from 2013, when it came in as one of the seven lowest-scoring states. (The report is funded in part by the Robert Wood Johnson Foundation, which also provides financial support to NJ Spotlight.)

Ready or Not 2020: Protecting the Public’s Health from Disease, Disasters and Bioterrorism” assessed all states and the District of Columbia on ten “preparedness indicators,” including the quality of hospitals, use of seasonal flu vaccines and public access to clean drinking water. Other categories considered national accreditations of state systems, public health surveillance systems, and collaborative agreements designed to boost the capacity of the health care workforce. Public health programs include those focused on preventing and controlling communicable diseases, improving maternal health, preventing injuries and improving access to care.

“The increasing number of threats to Americans’ health in 2019, from floods to wildfires to vaping, demonstrate the critical importance of a robust public health system. Being prepared is often the difference between harm or no harm during health emergencies and requires four things: planning, dedicated funding, interagency and jurisdictional cooperation, and a skilled public health workforce,” said John Auerbach, the Trust’s president and CEO.

Must be able to handle multiple threats

While the report does not mention coronavirus directly, Auerbach told The Hill last week that its emergence underscores the need for a robust public health system with the capacity to handle multiple threats at the same time. (Although no one here has tested positive for it, New Jersey appointed a task force to coordinate the state response to the coronavirus, established a public hotline and has provided detailed updates to public health officials.)

“While this year’s report shows that, as a nation, we are more prepared to deal with public health emergencies, we’re still not as prepared as we should be. More planning and investment are necessary to saves lives,” Auerbach said.

The 2020 report highlights several “notable incidents” now impacting public health, like the nationwide rise in e-cigarette use and the emergence of vaping-associated lung injuries, which have sickened more than 1,000 people and contributed to at least 50 deaths, including one in New Jersey. It notes that several states moved to restrict the sale of these products, but it did not take into account the flavor ban signed by Gov. Phil Murphy earlier this year.

The Trust also flagged the emergence of a drug-resistant fungus, Candida auris, which has infected patients in New Jersey, New York and Illinois. And researchers noted that some residents of Newark were ordered to drink bottled water after high lead levels were discovered in parts of the city’s public water system. (Schoolchildren in Camden have been drinking bottled water for years based on similar concerns.)

Overall, 11% of Garden State residents depend on public water systems that have violated health standards, according to the report; the percentage is the same in Massachusetts. While 40 states had lower rates of citizens depending on substandard water, New Jersey is better off than its neighbors. In Pennsylvania, 13% are served by tainted water supplies, as are 45% of those in New York State.

Stamp of approval

The 2020 report notes New Jersey is one of 28 jurisdictions to have the stamp of approval of two important national bodies, the Public Health Accreditation Board and the Emergency Management Accreditation Program, both of which help health care professionals to plan and prepare for public health threats. Accreditation by the public health board alone involved a three-year interactive review process, which was completed in 2017.

The Trust used data compiled by the Leapfrog Group, a nonprofit advocate for patient safety and quality outcomes, to identify which states had the highest percentage of A grades on its latest hospital report. New Jersey tied with Idaho in seventh place last year in the Trust report. In both states, 45% of the hospitals received the top ranking from Leapfrog; the average nationwide was 30%.

In addition, the Trust found that more than eight in 10 of the Garden State’s acute-care facilities participate in collaborative agreements with other hospitals to try to ensure there is workforce capacity in a public health disaster.

When it comes to funding for public health programs, 39 states, including New Jersey, and Washington, D.C. increased the level of support last year. But with only 3% growth, the Garden State was far from the biggest spender, the Trust found. Eight states increased public health investment by double digits, including a 27% hike in Oregon and a 40% boost in Nevada.

Researchers also assessed access to paid sick leave, a policy that’s relevant to controlling the spread of disease by enabling workers to stay home when they are contagious and gives families more options when it comes to accessing preventive care. Nationwide, 55% of employees on average are eligible for paid time off, while in New Jersey 52% of workers are eligible, according to the Trust.

New Jersey was among the 48 states (plus Washington, D.C.) to get credit for having a public health laboratory system with a plan to address a two-month surge in testing needs; only Utah and Vermont are without this capacity, the report found. And while the Garden State last year joined 32 others in a collaborative licensing agreement to allow nurses to work in more than one jurisdiction — in an effort to increase capacity — the report noted this compact has yet to take effect.

The report notes the Trust was unable to get flu vaccination rates from New Jersey and Washington, D.C., but found immunization rates continued to rise nationwide. However, less than half of all residents over ages 6 months were inoculated last year — considered the best defense against the potentially deadly influenza virus — far below the target level of 70%.

According to the federal Centers for Disease Control and Prevention, which also collects vaccine rates, nearly 73% of children ages 6 months to 17 years in New Jersey got the flu shot last year, while the national average  for this age group was 62.6%. The most recent adult data was from 2018, during which more than 42% of New Jerseyans ages 18 and over were immunized, versus just over 37% nationwide for this age group.