By Lara Jakes Jordan, The Associated Press
WASHINGTON -- Rural health officials believe they are woefully unprepared to respond to a possible terror attack on food supplies, nuclear power facilities or other targets.
A survey of health officials in 26 states also found that most rural areas would not be prepared for a bioterror attack or have the resources to handle a surge of people fleeing urban areas under assault.
The study, sponsored in part by the Harvard School of Public Health and the University of Pittsburgh, comes as the Homeland Security Department is proposing awarding federal aid to states and localities based on the level of threats they face. Small and rural states fear such an approach would dramatically cut funding for their emergency responders.
The survey, which will be released Tuesday, was obtained in advance by The Associated Press.
“I don’t think anyone in rural America is asking for the kinds of resources that urban America is getting,” said Michael Meit, director of the University of Pittsburgh’s Center for Rural Health Practice in Bradford, Pa. “We just want to make sure that rural areas aren’t forgotten about, and that we’re getting enough resources to be prepared at an adequate level.”
“There are specific, direct targets in rural America,” he said.
The survey took a second look at 26 states that ranked among the highest and lowest in a 2003 assessment of bioterrorism preparedness. It also examined which states received funding from the Cities Readiness Initiative, a pilot program by the U.S. Centers for Disease Control and Prevention to respond to large-scale public health emergencies, such as bioterror or nuclear attacks.
Eighteen of the states surveyed were defined as rural by the U.S. Census Bureau, while eight were defined as urban.
Of the rural states, 18 percent received high rankings for bioterrorism preparedness and 6 percent received the readiness funding. By comparison, 63 percent of the urban states ranked high on the preparedness list, and 75 percent got the funding.
The survey listed a number of vulnerabilities unique to rural areas. It noted that water supply and energy sources, including nuclear plants, usually are based in rural communities. Militia activities are more common in rural areas, as is the potential for farm terrorism, the survey said, noting: “One cow down can paralyze an entire beef industry.”
Infectious disease specialists tend to live and work around major medical centers in cities, the survey said. Meanwhile, the $27 million CDC program to distribute vaccines from the Strategic National Stockpile, pulled money from rural areas to fund 21 cities.
CDC spokesman Von Roebuck declined to comment on the survey but said the pilot program was meant to determine how best to distribute the national stockpile during an emergency.
“You’re looking at areas, and sure they’re urban, but they also have urban reach,” Roebuck said. “They’re cities that are next door to other areas. You’re looking at how you could distribute something quite quickly and take those lessons from the city areas and also apply those to other parts of the country.”
Under Homeland Security’s budget proposal for the 2006 fiscal year, each state would receive a minimum of $2.6 million in federal grants. Of a total $3.5 billion set aside for all grants to states and localities, more than $2 billion would be awarded based on risk.
The mayors of the nation’s three largest cities are keeping a wary eye on the funding as well. Last week, Mayors Michael Bloomberg of New York, James Hahn of Los Angeles and Richard M. Daley of Chicago urged Homeland Security Secretary Michael Chertoff to ensure big cities receive enough money.
“As you know, terrorists have targeted major population areas in the past and can be expected to do so again,” the mayors said in a letter to Chertoff.
“With so much at stake, and given the Herculean efforts being made to protect our cities, distributing homeland security money based on politics rather than risk _ and risk alone _ is unconscionable and dangerously wrong,” the mayors said.
Chertoff has said the risk assessments will not be based solely on population.
“I quite agree we need to move away from a population-driven or size-of-state-driven model,” Chertoff said under questioning earlier this month by Sen. Susan Collins, R-Maine.
“We ought to be focused on risk,” Chertoff said.
Collins and Sen. Joe Lieberman, D-Conn., pushed an amendment through the Senate last week to increase Homeland Security’s budget by $855 million _ largely to ensure small and rural states don’t feel a funding cut.
“There needs to be some equality in preparedness,” said Rep. John Peterson, R-Pa., who endorsed the survey with Sen. Tim Johnson, D-S.D. “If you let the cities, they will have all the preparedness. That is a mistake.”
Also involved in the study was the Maine Center for Public Health, the University of Pittsburgh, the University of North Carolina, Texas A&M University and the University of Minnesota.
The survey grew out of a September conference of rural public health officials in St. Paul, Minn.