H1N1 exposed fragile public health system

WASHINGTON, Dec. 15 (UPI) -- The H1N1 flu outbreak has exposed serious underlying gaps in states' ability to respond to public health emergencies, two U.S. non-profit groups say.

A report by the Trust for America's Health and the Robert Wood Johnson Foundation said the economic crisis is straining an already fragile public health system.

Twenty states scored six or less out of 10 key indicators of public health emergency preparedness and nearly two-thirds of states scored seven or less.

Eight states tied for the highest score of nine out of 10: Arkansas, Delaware, New York, North Carolina, North Dakota, Oklahoma, Texas and Vermont. Montana had the lowest score at three out of 10, followed by Alaska, Arizona, Florida, Idaho, Maine and Washington.

"State and local health departments around the country are being asked to do more with less during the H1N1 outbreak as budgets continue to be stretched beyond their limits," Michelle Larkin, senior program officer at the Robert Wood Johnson Foundation, said in a statement.

Overall, the report said the investments made in pandemic and public health preparedness during the past several years dramatically improved U.S. readiness for the H1N1 outbreak, but decades of chronic underfunding meant many core systems were not at-the-ready.