Ready or Not 2025: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism

As the Nation grapples with a multistate measles outbreak, bird flu, and an increasing number and intensity of weather-related events this annual TFAH report measures states' preparedness for public health emergencies and makes recommendations to strengthen the nation’s public health system and improve emergency readiness.

News Release from Trust for America’s Health

(Washington, DC – March 27, 2025) – Ready or Not 2025: Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism, measures states’ readiness for a range of health emergencies based on 10 indicators, including healthcare system readiness, state public health funding, public health laboratory surge capacity, employee access to paid time off, and community water system safety.

The report places states and the District of Columbia into three performance tiers for emergency preparedness. This year’s report placed 21 states and DC in the high-performance tier, 16 states in the middle-performance tier, and 13 states (including Hawaii) in the low-performance tier.

Table 2: State Public Health Emergency Preparedness -- State Performance, by scoring tier, 2024

Performance Tier -- States -- Number of States

High Tier
CO, CT, DC, DE, FL, GA, ID, MA, MD, ME, MO, NC, NH, NJ, OH, PA, RI, UT, VA, VT, WA, WI
21 states and DC

Medium Tier
AL, AR, AZ, CA, IA, IL, IN, KS, KY, ND, NE, NY, OK, SC, TN, TX
16 states

Low Tier
AK, HI, LA, MI, MN, MS, MT, NV, NM, OR, SD, WV, WY
13 states

read … FULL REPORT

read … HAWAII REPORT

SA: Hawaii is ranked low for emergency readiness | Honolulu Star-Advertiser

Big Q: How would you rate Hawaii on disaster/public health preparedness? | Honolulu Star-Advertiser