Ready or Not 2026: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism

Trust for America’s Health (TFAH) new report, Ready or Not 2026, evaluates U.S. public health emergency preparedness across 10 indicators, including workforce mobility, funding stability, laboratory surge capacity, paid sick leave access, and community infrastructure.

It finds preparedness is uneven across states, with 20 in a high-performance tier, 17 plus the District of Columbia in a middle tier, and 13 in a low tier. Strengths include widespread Nurse Licensure Compact adoption (41 states), strong accreditation participation, and near-universal laboratory surge planning.

Key gaps include declining federal workforce and funding stability, reduced state public health investments in 12 states, low flu vaccination coverage, and persistent inequities in paid sick leave access. Read the TFAH report here.