Food safety in the United States is being jeopardized by surveillance and workforce cutbacks and other gaps in the public health system, a new study from the nonpartisan Trust for America’s Health (TFAH) concludes.

The wide-ranging “Ready or Not?” report–an annual assessment for the past eight years– evaluates the public health system’s ability to handle contagious diseases, disasters, and bioterrorism.


“There is an emergency for emergency health preparedness in the United States,” the report states.  “The severe budget cuts by federal, state, and local governments are leaving public health departments understaffed and without the basic capabilities required to respond to crises.”

TFAH warns cutbacks are leading to everything from fewer restaurant inspections to less surveillance capacity for discovering which pathogens are making people sick.

There are 50,000 fewer public health workers today than 20 years ago–and one-third of current workers are eligible to retire within five years, the report says.  It calls for policies that ensure a sufficient number of adequately trained epidemiologists, physicians, nurses, and other health workers to respond to public health threats.

The study says the U.S. lacks a coordinated, national approach to biosurveillance, noting major variations in how quickly states collect and report data needed to respond to  bioterrorism or disease outbreaks.

Among its key findings, the report found that 21 states were not able to rapidly identify disease-causing E. coli O157:H7, and submit the lab results within four days in 90 percent of the cases during 2007-08.

The 21 states that failed that test were Georgia, Hawaii, Idaho, Indiana, Iowa, Kansas, Maine, Massachusetts, Missouri, Montana, Nebraska, Nevada, New Hampshire, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, and West Virginia.

Seven states–Alabama, Montana, Nevada, New Hampshire, New Mexico, Ohio, and South Carolina–were not able to share data electronically with health care providers.

Those gaps are significant, the report explains, because “the ability to rapidly detect and determine the extent and scope of foodborne disease outbreaks–and other infectious disease outbreaks or bioterrorism attacks–is crucial to minimizing the impact of these outbreaks on the public’s health.”

The report notes that the federal Centers for Disease Control and Prevention (CDC) in Atlanta requires state public health labs to be able to use pulsed-field gel electrophoresis (PFGE) protocols to rapidly identify specific pathogens.  

CDC asks that state labs submit results within four days so the Pulse-Net database can be used to detect and help stop disease outbreaks.  CDC works on as many as 1,400 foodborne disease outbreaks annually.

Public health funding has been cut in each of the past two years by 18 states, and during the last year by 33 states.  About 23,000 jobs have been eliminated since January 2008 by local health departments.  Since 2005, federal funding for public health preparedness has been reduced by 27 percent.  At this point, however, only Hawaii, Iowa, Montana, and the District of Columbia report not having enough lab staff to work five 12-hour days for six to eight weeks.  

The 52-page “Ready or Not” report was funded by the Robert Wood Johnson Foundation.  Former U.S. Sen. Lowell Weicker, Jr. is TFAH’s president.