Louisiana, North Carolina, Virginia along with New Hampshire and Wisconsin are among the five states that scored a perfect 10 in the "Ready or Not? 2008" assessment by the Robert Wood Johnson Foundation and the Trust Fund for America's Health.  The latter is a Washington-based public health research organization.

The states with the lowest scores are Arizona, Connecticut, Florida, Maryland, Nebraska and Montana. Seven states scored a nine. Ten states scored an eight. Fourteen states and the District of Columbia scored a seven. Eight states got a six.

The sixth annual report analyzes whether states are well-prepared in 10 different categories, including food safety and the ability to detect disease outbreaks. In addition, the report finds that major gaps remain in many critical areas of preparedness, including rapid disease detection, and food safety. Federal funding for state and local preparedness has been cut more than 25 percent compared to 2005 budgets.

"The 25 percent cut in federal support to protect Americans from diseases, disasters, and bioterrorism is already hurting state response capabilities," said Jeff Levi, executive director of the non-profit Trust.

The report found the five states have an adequate plan to distribute emergency vaccines and antidotes from the Strategic National Stockpile, a national storehouse of medical supplies. They all have public health labs that can handle a flu pandemic, an Internet-based disease tracking system and laws that reduce liability for health care volunteers in a public health emergency.

Nevertheless at least 41 states either faced budget shortfalls this year or expect to face them next year, according to the Center on Budget and Policy and Priorities. Over half those states had already cut spending, used reserves, or raised revenues to balance their budgets for the current fiscal year.

Some serious 2008 health emergencies include a Salmonella outbreak in jalapeño and Serrano peppers that sickened 1,442 people in 43 states; the largest beef recall in history in February; Hurricanes Gustav and Ike; severe flooding in the Midwest; major wildfires in California in June and November. The report also offers a series of recommendations for improving preparedness

Overall the report said that current economic problems could erode the progress made by the country since 9/11 in preparing for disasters with plans to deal with bioterrorism, rapid disease detection and a plan to ensure food safety.

"The economic crisis could result in a serious rollback of the progress we’ve made since September 11, 2001, and Hurricane Katrina to better prepare the nation for emergencies,” said Jeff Levi. Moreover the administration of President George W. Bush has also stressed responsibility on the part of state and local governments and has said repeatedly that the federal government will not bail out states after disasters.