The U.S. may be one of the most powerful countries in the world, but when it comes to protecting their health, Americans may be more vulnerable than one might think.
"There's a whole host of diseases that we all just assume is a part of our past and they're actually reemerging as very much part of our present," says Dr. Jeffrey Levi, executive director of the nonprofit, nonpartisan Trust for America's Health (TFAH).
The organization Tuesday published a report card for all 50 states and Washington, D.C., analyzing 10 key indicators related to the treatment and prevention of infectious diseases, including HIV, seasonal flu and whooping cough.
On a scale of 1 to 10 -- with 10 being the highest positive ranking -- the majority of states scored 5 or lower. New Hampshire took the top rating with a score of 8. Georgia, Nebraska and New Jersey ranked lowest, each with a score of 3.
The purpose of the analysis, which relied on both publicly available and government data, is to use key findings to address the emergence and reemergence of specific infectious diseases.
U.S. News offers five key takeaways from the report:
1. HIV prevalence among gay men is increasing
There are 1.1 million people living with HIV/AIDS in the U.S., and the report says new infections among gay men accounted for most of the nearly 50,000 new HIV diagnoses in 2011.
"Almost half the people with HIV don't even know their status," Levi says. "Many who do know their status are not in care or are not virally suppressed."
Through its research, the TFAH found that one-third of U.S. states do not cover HIV screening under their Medicaid programs. This means that young men who are helped through public insurance programs may be less likely to be tested for the disease. And the need for developing creative messaging to raise awareness about HIV and HIV risk factors among a new generation of gay men is critical.
"We need to be doing more than the traditional education campaigns," Levi says. "We need to think about what are the factors that contribute to their risk-taking."
Such factors include being mentally ill, using drugs, being unemployed and being uninsured, Levi says.
2. Hospital-acquired infections are a significant problem.
About one in 20 people who are hospitalized contract a hospital-acquired infection (HAI). Patients who have invasive surgery, a catheter or receive a lengthy course of antibiotics are at greater risk for HAIs. Roughly 99,000 people died from HAIs in 2002, the most recent year for which figures are available, according to the report.
However, a third of states still do not require hospitals to report these infections. Under the Affordable Care Act, as providers move away from fee-for-service payments and toward charging for positive patient outcomes, hospitals will have stronger incentives for reducing hospital-acquired infections.
3. Whooping cough is still a danger.
More than 2 million American children under 3 years old do not receive all of the vaccinations recommended by the Department of Health and Human Services. These children are at risk for diseases like whooping cough and measles, both of which are completely preventable and both of which have reemerged in the last few years. Only two states - Connecticut and Delaware - have met the recommended requirement of vaccinating 90 percent of children ages 19 months to 35 months.
4. New and old threats.
As of Nov. 12, 2013, there were 153 cases in nine countries of potentially deadly infection by Middle East respiratory syndrome coronavirus (MERS-CoV), according to the report. Camels and humans reportedly both can be infected, although there have been no cases in the U.S. thus far.
The U.S., meanwhile, has seen the highest rate of West Nile virus cases since 2003, as well as the worst outbreak of malaria since the 1970s. In addition to climate change, international travel and imported foods can contribute to the reemergence of diseases that appeared to have been eliminated, according to the report.