How Does the Index Measure Health Security Preparedness?

The National Health Security Preparedness Index collects, aggregates and measures existing state-level preparedness data from a wide variety of sources. The Index then computes a range of key measures for all 50 states and the District of Colombia that, taken together, display the broadest and most comprehensive national or state level picture of health security available today. The Index is updated each year to better reflect the multitude of factors that impact America’s health security and preparedness.

What's New

The 2017 Index release retains the framework of the previous releases: it still includes 6 domains and allows for comparing and tracking improvements over time through the inclusion of comparable annual results back to the baseline year of 2013. For the first time, the 2017 release adds data for the District of Columbia alongside the 50 states. This Index release assesses 139 total measures across 19 sub-domains. Nine item measures are NEW to the Index 2017 release, with data added for all four years as available. One item measure that appeared in the 2016 Index release has transitioned to Foundational Measure status in 2017 release. Seven item measures saw changed specifications in 2017 release, as recommended by the Association of Public Health Laboratories, which fields the survey that constitutes the data source for the re-specified measures. Four 2016 release measures were removed from the 2017 Index release, either due to data no longer being available or to a change in responsible entity for a specific function.

Recent Index updates provide greater clarity about strengths and weaknesses, as well as the ability to track improvements and declines in health security and preparedness over time.

Full details of the Index methodological approach for 2017 release are available here.


The National Health Security Preparedness Index tracks the nation’s progress in preparing for, responding to, and recovering from disasters and other large-scale emergencies that pose risks to health and well-being in the United States. Because health security is a responsibility shared by many different stakeholders in government and society, the Index combines measures from multiple sources and perspectives to offer a broad view of the health protections in place for nation as a whole and for each U.S. state.

Full details of the Index methodological approach for the 2017 release are available for download here.

Suggest New Measures

To continuously improve the Index, stakeholders are invited to recommend new measures for inclusion, to recommend changes to existing measure definitions and specifications, and to recommend deletion of existing measures from the Index.

Recommendations for new measures that reflect social, economic, and/or environmental dimensions of preparedness and resiliency are especially encouraged, as these constructs are currently under-represented in the Index structure. The Index gives priority to measures that can be constructed from existing, low-cost data sources such as surveys, records, registries, documents, images, sensors, or other automated monitoring systems. We are especially interested in measures that make use of novel electronic data sources such as data from web search engines, social media, satellite imagery, and commercial transactions. Measures that have been previously validated and that provide both national-level and state-level estimates of preparedness and resiliency are of primary interest.

If you have suggested new measures to consider for future releases of the Index, click here.