2016年全国突发公共卫生事件防范水平不断提高
“In order to keep Americans safe, we need to know how well equipped every state in the nation is to prevent and manage widespread health emergencies,” said Risa Lavizzo-Mourey, MD, president and CEO of the Robert Wood Johnson Foundation, which funds and directs the Index. “Every sector needs a yardstick to clearly show where progress is being made and where improvement can occur. America’s health security is no exception.”
Using more than 100 different measures—ranging from flu vaccination rates, number of hospitals and presence of food inspection programs; to infrastructure and planning measures such as participation in drills by public health laboratories, percentage of people covered by wireless 911 and hazard planning for public schools—the Index provides a composite score that reflects the most comprehensive picture of health security preparedness available.
The Index found that the nation’s health protections are not distributed evenly across the United States, with a preparedness gap of 36 percent between highest and lowest states in 2015. A total of 18 states achieved Preparedness Index levels that significantly exceeded the national average in 2015, with many of these leading states located along the Eastern seaboard or clustered in the Upper Midwest and Southwestern United States. Conversely, 16 states lagged significantly below the national preparedness level in 2015, including clusters of states in the Deep South and Mountain West regions.
Some states with comparatively low levels of preparedness are located in geographic regions that face elevated risks of disasters, indicating a need for focused improvements in high-risk and low-resource areas.
- Laboratory testing capabilities relevant to Zika have trended upward but are not universally available across the United States.
- Laboratory testing capabilities relevant to drinking water have trended downward in the Index.
- Fully compliant public drinking water systems trended downward.
- Changes in employment patterns and practices have mixed effects on health security.
"State and local public health agencies are on the front lines in responding to public health emergencies,” said Dr. Stephen Redd, director of the U.S. Centers for Disease Control and Prevention (CDC’s) Office of Public Health Preparedness and Response. “The Index is a tool that can help us all see where investments since 2001 to build public health emergency response capacity have paid off and where more investment and work is needed."
Based on a model informed by experts in public health, emergency management, government, academia, health care and other sectors, researchers collect, aggregate and measure preparedness data from a wide variety of sources. The final measures fall into six categories, each of which is assessed independently.
- Incident and Information Management, or the ability to mobilize and manage resources during a health incident, scored 8.4 on the 10-point scale, the highest-scoring domain in the 2016 Index and a 2.4 percent improvement since the Index began in 2013.
- Health Security Surveillance, or the ability to collect and analyze data to identify possible threats before they arise, scored 7.5, an improvement of 7.1 percent since 2013.
- Countermeasure Management, or the ability to mitigate harm from biologic, chemical or nuclear agents, scored 7.0, an improvement of 6.1 percent since 2013.
- Environmental and Occupational Health, which measures the ability to prevent health impacts from environmental or occupational hazards, scored 6.4, a decline of 4.5 percent since the Index began, but flat compared to last year.
- Community Planning and Engagement, which measures how communities mobilize different stakeholders to work together during times of crisis, scored 5.4, an improvement of 8.0 percent since 2013.
- Health Care Delivery, which includes the state of health care systems during everyday life, as well as in emergency situations, scored 5.1, a decline of 1.9 percent since 2013, but flat compared to last year.
“Health security is a shared responsibility across many different sectors and stakeholders—not just government, and not just health care,” said Glen Mays, PhD, of the University of Kentucky, who leads a team of researchers who manage the Index. “By combining 134 measures from more than 50 different sources, we gain a more complete picture of preparedness as a whole that can inform future directions and priorities.”
Originally developed by the CDC as a tool to drive dialogue to improve health security and preparedness, the Index remains a collaborative effort, involving more than 35 organizations. Feedback from state preparedness directors, state health officials and others helps shape the Index each year.
For more information about the National Health Security Preparedness Index, visit www.nhspi.org.
新泽西州普林斯顿大学-对卫生安全和准备情况的年度评估显示,国家在管理紧急情况方面准备相对充分,尽管具体州在某些措施上的表现可以改进。罗伯特·伍德·约翰逊基金会公布了2016年的调查结果国家卫生安全防范指数该报告显示,美国在防灾准备方面的得分为6.7分(满分为10分),自该指数三年前开始编制以来提高了3.6%。
“为了保证美国人的安全,我们需要知道美国每个州在预防和管理广泛的卫生紧急情况方面的装备有多好,”罗伯特伍德约翰逊基金会总裁兼首席执行官Risa Lavizzo-Mourey医学博士说。该基金会资助和指导该指数。“每个行业都需要一个标准,以清楚地显示在哪些方面取得了进展,哪些方面可以改进。美国的卫生安全也不例外。”
使用100多种不同的衡量标准——从流感疫苗接种率、医院数量和食品检验项目的存在;基础设施和规划措施,如参与公共卫生实验室的演习、无线911覆盖的人口百分比和公立学校的灾害规划,该指数提供了一个综合得分,反映了现有卫生安全准备的最全面情况。
该指数发现,全国的健康保护在美国各地分布不均,2015年最高和最低的州之间的准备差距为36%。2015年,共有18个州达到了显著超过全国平均水平的备灾指数水平,其中许多州位于东部沿海或集中在美国中西部和西南部。相反,2015年有16个州明显落后于国家准备水平,其中包括南部腹地和西部山区的一些州。
一些备灾水平相对较低的州位于灾害风险较高的地理区域,这表明需要在高风险和资源匮乏地区进行重点改进。
- 与寨卡病毒相关的实验室检测能力呈上升趋势,但在美国各地并不普遍。
- 与饮用水有关的实验室检测能力在该指数中呈下降趋势。
- 完全符合要求的公共饮用水系统呈下降趋势。
- 就业模式和做法的变化对卫生保障产生了复杂的影响。
美国疾病控制与预防中心(CDC)公共卫生准备与应对办公室主任斯蒂芬·里德博士说:“州和地方公共卫生机构站在应对突发公共卫生事件的第一线。”“该指数是一个工具,可以帮助我们所有人看到自2001年以来为建立公共卫生应急能力而进行的投资在哪些方面取得了成效,在哪些方面需要更多的投资和工作。”
根据公共卫生、应急管理、政府、学术界、卫生保健和其他部门专家提供的模型,研究人员从各种来源收集、汇总和衡量备灾数据。最终的衡量标准分为六类,每一类都是独立评估的。
- 事件及资讯管理即在健康事件中动员和管理资源的能力,在10分制中得到8.4分,是2016年指数中得分最高的领域,自2013年该指数开始以来提高了2.4%。
- 健康安全监察即收集和分析数据以在威胁出现之前识别可能的威胁的能力,得分为7.5,自2013年以来提高了7.1%。
- 对策管理,即减轻生物、化学或核制剂危害的能力,得分为7.0,自2013年以来提高了6.1%。
- 环境与职业健康该指标衡量的是防止环境或职业危害对健康影响的能力,得分为6.4,自该指数开始编制以来下降了4.5%,但与去年持平。
- 社区规划及参与衡量社区在危机时期如何动员不同利益相关者共同努力的指标得分为5.4,自2013年以来提高了8.0%。
- 提供保健服务包括日常生活和紧急情况下的医疗保健系统状况,得分为5.1,自2013年以来下降了1.9%,但与去年持平。
“健康安全是许多不同部门和利益相关者的共同责任——不仅仅是政府,也不仅仅是医疗保健,”肯塔基大学的格伦·梅斯博士说,他领导了一个管理该指数的研究小组。“通过结合来自50多个不同来源的134项措施,我们可以更全面地了解整体准备情况,从而为未来的方向和优先事项提供信息。”
该指数最初是由疾病预防控制中心开发的,作为推动对话以改善卫生安全和防范的工具,它仍然是一项合作努力,涉及超过35个组织。每年,来自州防备主任、州卫生官员和其他人的反馈有助于形成该指数。
有关国家卫生安全防范指数的更多信息,请访问www.nhspi.org.
About the Robert Wood Johnson Foundation
For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are working with others to build a national Culture of Health enabling everyone in America to live longer, healthier lives. For more information, visit www.ottomotal.com. Follow the Foundation on Twitter at www.ottomotal.com/twitter or on Facebook at www.ottomotal.com/facebook.
" data-isabstract="false" class="cmp-text">关于罗伯特伍德约翰逊基金会
40多年来,罗伯特·伍德·约翰逊基金会一直致力于改善健康和医疗保健。我们正在与其他国家合作,建立一种全国性的健康文化,使每个美国人都能活得更长、更健康。欲了解更多信息,请访问www.ottomotal.com.在Twitter上关注基金会www.ottomotal.com/twitter或者在Facebook上www.ottomotal.com/facebook.