The Worst States for Infectious Disease

This time of year, the seasonal flu is the disease worrying most of us. 

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But it’s far from the only bug that can affect personal and public health throughout the winter. Pneumonia is also a lurking threat, as are more routine respiratory infections and colds.

Year-round, deadly antibiotic-resistant superbugs, preventable sexually transmitted diseases, emerging contagious viruses and the impact of climate change on public health are concerns, according to the Trust for America’s Health new rankings of the best and worst states for fighting infectious diseases.

The report, compiled with support from the Robert Wood Johnson Foundation, finds that a majority of states have five or fewer key indicators of infectious-disease preparedness, even as climate change increases the rates of some diseases and fuels new outbreaks.

Three states tied for the lowest score, achieving just two out of 10 possible indicators. Want to know how your state ranks? Click through to find out.

New Hampshire

New Hampshire is the most-prepared state in the country, the report indicated, with 8 out of 10 markers of infectious disease preparedness complete. It won points for its complete public health plan to adapt to climate change and strong state funding for public health services.

Connecticut

The Constitution State met 7 out of 10 indicators. It’s one of only two states (plus D.C.) to meet the U.S. Department of Health and Human Services goal of vaccinating at least 90 percent of 19- to 35-month-olds against whooping cough — a childhood disease making a comeback due to lagging vaccination rates.

Delaware

Delaware also met 7 out of 10 indicators and is the other state, besides Connecticut, to vaccinate at least 90 percent of 19- to 35-month-olds against whooping cough.

Minnesota

Minnesotans met 7 out of 10 indicators, also winning points for vaccination rates — at least half of the state’s residents (ages 6 months and older) received the seasonal flu shot for the 2012-2013 season.

New York

New York also met 7 out of 10 indicators, missing points for whooping cough vaccination rates, flu shot rates and consistent levels of public health funding.

North Carolina

The Tar Heel state met 7 out of 10 indicators. North Carolinians are missing a complete plan to respond to the public health challenges of climate change, however.

Oregon

Oregonians met 7 out of 10 indicators, missing points for vaccination rates.

Rhode Island

Rhode Island met met 7 out of 10 indicators, missing one point because its public health lab did not evaluate the functionality of its continuity of operations plan (COOP) via a real event or an exercise.

Washington

The last state to meet 7 out of 10 indicators, Washington lost points for whooping cough vaccination rates, flu shot rates and consistent levels of public health funding.

California

On to the next tier: California met 6 out of 10 indicators, the first state on the list to not require the HPV vaccine for teens, fund HPV vaccination efforts or educate the public about the HPV vaccine.

Colorado

The Rocky Mountain State also met 6 out of 10. It lacks a complete plan to combat the public health impact of climate change — though its natural features may make it more vulnerable to climate-related disasters.

Washington, D.C.

The nation’s capital met 6 out of 10 indicators, gaining a point for its high rates of whooping cough vaccination.

Hawaii

Hawaii scored 6 out of 10 indicators — not bad for the recently named healthiest state in America, according to a separate Trust for America’s Health ranking.

Maryland

Marylanders checked 6 out of 10 indicators, though it’s the first state on the list not to cover routine HIV screening under its Medicaid program.

Missouri

Missourians met 6 out of 10 indicators, lagging in vaccination rates, public health funding and completed climate change adaptation plans.

Pennsylvania

Pennsylvania met 6 out of 10 indicators. 

Tennessee

Another state missing a climate change adaptation plan, Tennessee still met 6 out of 10 indicators.

Virginia

The last state in the 6-for-10 category, Virginia lost a point for not covering routine HIV screening under its Medicaid program.

Alaska

On to the next category: Alaska met half of the 10 key indicators, missing a state public health lab plan to respond to an outbreak that requires a 300 percent increase in patient testing, among other markers.

Florida

The Sunshine State also hit 5 out of 10, missing points for vaccination rates, consistent public health funding and a lack of coverage for HIV testing under Medicaid.

Illinois

Illinois met 5 out of 10 indicators.

Iowa

Iowa hit 5 out of 10 indicators. It’s the first state on the list not to require healthcare facilities to report healthcare-associated infections — a problem because of the increasing rates of antibiotic-resistant infections stemming from hospitals and senior care facilities. 

Louisiana

Louisiana missed half of all indicators, including a completed plan for climate change adaptation.

Maine

Maine met half of the 10 key indicators, missing a state public health lab plan to respond to an outbreak that requires a 300 percent increase in patient testing, among other markers.

Massachusetts

Massachusetts met half of the 10 key indicators, also missing a state public health lab plan to respond to an outbreak that requires a 300 percent increase in patient testing, among other markers.

Michigan

The Great Lakes State met half of the 10 key indicators, becoming the second state on the list not to require that healthcare facilities report healthcare-associated infections.

New Mexico

New Mexicans don’t have a climate change adaptation plan in place, and they’re lagging on some vaccination rates. But they still met half of the 10 key indicators.

Oklahoma

Oklahoma’s state profile is almost identical to New Mexico’s: It doesn’t have a climate change adaptation plan in place, and it’s lagging on some vaccination rates, but the state still meets half of the 10 key indicators.

South Carolina

The Palmetto State met half of all indicators, lagging on HPV vaccine coverage for teens and HIV testing coverage under Medicaid, among other issues.

South Dakota

The Rushmore State hit 5 out of 10 indicators, missing a consistent level of funding for public health services and a climate change adaptation plan, among other issues.

Vermont

Vermont met 5 out of 10 indicators. 

Wisconsin

The last state to meet at least half of the 10 indicators is Wisconsin.

Alabama

Alabama is one of 19 states to meet fewer than half of the positive public health indicators.

Indiana

Indiana met 4 out of 10 indicators; it doesn’t have a plan in place for climate change, among other issues.

Kansas

Kansans missed all six of the top indicators, including those for vaccination rates and education, consistent public health funding and climate change adaptation plans.

Kentucky

Kentucky also missed all six of the top six indicators.

Mississippi

The newly named unhealthiest state in the U.S. by the Trust for America’s Health, Mississippi met 4 out of 10 indicators. 

North Dakota

North Dakota met 4 out of 10 indicators, winning points for Medicaid coverage of routine HIV screenings, consistent public health funding and HPV vaccination education. 

Ohio

Ohio also met 4 out of 10 indicators. 

Texas

Texans hit 4 out of the 10 indicators. 

Utah 

Utah met 4 out of 10 indicators, gaining a point for the capacity to assure the timely transportation (pick-up and delivery) of samples 24/7/365 days to the appropriate public health lab, an important measure for fighting disease outbreaks.

West Virginia

West Virginia is the last state to meet 4 out of 10 indicators. 

Arizona

On to a new tier: Arizona met just 3 out of 10 positive indicators. 

Arkansas

Arkansans also met 3 out of 10 indicators. 

Idaho

The Gem State met 3 out of 10 indicators, gaining a point for its ability to handle a significant surge in testing during a six- to eight-week period in response to an outbreak that increases testing more than 300 percent.

Montana

The Big Sky State covers routine HIV screening under its Medicaid program, one of three indicator points it gained.

Nevada

Nevada won a point for its HPV vaccination policies, another for its mandate that healthcare facilities report healthcare-associated infections and a third for Medicaid coverage of routine HIV testing.

Wyoming

Wyoming met 3 out of 10 indicators, the last state to do so.

Georgia

Georgia met only 2 out of 10 indicators in a three-way tie for the worst state for infectious disease preparedness. 

Nebraska

Nebraska met only 2 out of 10 indicators — but in a bright spot, it was one of only 12 states to vaccinate at least half of its population for the seasonal flu.

New Jersey

Tied for the worst state with only 2 out of 10 indicators, New Jersey won its points for a mandate that healthcare facilities report healthcare-associated infections, and the ability to assure the timely transportation (pick-up and delivery) of samples 24/7/365 days to the appropriate public health lab (a measure completed by 46 states).

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