The paper examined Georgia's public health system by reviewing documents from the state, federal agencies and nonprofit groups. Information from those documents depict the system as lacking sufficient money and, at times, basic competencies, the study found.
Georgia recently tied for sixth-worst among 56 states and territories when federal officials evaluated readiness for public health emergencies and it ranks 39th among the states in public health spending per resident despite having the nation's ninth-largest economic output.
In another troubling ranking, the state's public health laboratory could identify the sources of fewer than four in 10 foodborne illness outbreaks from 2004 to 2006. That was the 35th-lowest rate in the country.
The federal Centers for Disease Control and Prevention is based in Atlanta, two miles from the state's main public health lab in Decatur. State officials say the CDC siphons its top epidemiologists and lab technicians, and the proximity to the federal agency has served to highlight rather than alleviate Georgia's shortcomings.
"People tend to think of Georgia as being in the CDC's backyard," said Jeffrey Levi, executive director of the Trust for America's Health, a Washington-based nonprofit public health group. "You'd think that they'd make this a model health department."
Instead, Georgia is known among public health experts for, as Levi put it diplomatically, its "challenges."
Georgia was the epicenter of a nationwide outbreak of salmonella poisoning that originated in a Blakely peanut processing plant. Then came what is expected to be the first wave of swine flu. And last week the state's public health division came under new management as part of an overhaul of Georgia's human services and health care agencies.
In January, three months before the swine flu became a global threat, the U.S. Department of Health and Human Services gave the White House a report on whether states and territories were prepared for just such a pandemic.
It covered 28 key areas, such as maintaining the food supply, distributing vaccines and keeping transportation systems running.
The 56 states and territories had an average of 9.2 "inadequate" ratings. Georgia had 16.
According to the report, the state isn't ready to manage large numbers of fatalities caused by a pandemic and wouldn't be able to provide health care.
Dr. Rhonda Medows, who is the state's new chief health officer, described the pandemic preparedness report as a "benchmark" against which progress can be measured.
Health officials say the state has been hurt by less funding. Legislators have cut appropriations to several areas, especially epidemiology and lab services.
Even without cuts, Georgia spends relatively little on public health: $18.33 per resident, compared to the national median of $33.71.
"Something's got to be done," said Russ Toal, president of the Georgia Public Health Association and an associate professor at Georgia State University. "The system is stressed."
A 2006 state audit found the state lab was so hammered by cuts that it hadn't found time to study whether it could handle a surge of tests during an emergency. A lack of readiness, auditors said, "could result in increased illness or fatalities."
From 2004 to 2006, the lab identified the pathogen causing foodborne illnesses in just 38 percent of cases, according to a study by the Trust for America's Health. The national average was 44 percent.
Georgia goes further than many other states in restricting submissions to its state lab. It is one of 24 that do not require private labs to send in samples associated with foodborne illnesses, such as salmonella.
"You catch more if specimens are required to come in," said executive director of the Association of Public Health Laboratories Scott Becker, who generally praised Georgia's performance. "The problem is who pays for those specimens to come in."
http://accesswdun.com/article/2009/7/221597