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The US as a whole had a score of 7.1 out of 10 for 2017, nearly a 3% improvement.
The annual index found worrying discrepancies among states that create widening gaps, especially in low-income areas and those vulnerable to public health emergencies.
TFAH rated 26 states and Washington, D.C., as 6 or lower on a 10-point scale.
The report showed some weak spots, including a persistent and varied gap in readiness among states.
Grants to support emergency preparedness for local public health agencies and hospitals equal about $840 million.
The score suggests the nation has substantial health security but also room to improve.
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