A fresh assessment from the Trust for America's Health (TFAH) reveals that fewer than half of U.S. states are adequately equipped to handle a health emergency, raising concerns as the nation prepares to host the 2026 FIFA World Cup. The annual report, released Thursday, ranks 20 states in the “high” tier, 17 states and Washington, D.C., in the “middle tier,” and 13 states in the “low tier.”
World Cup Readiness Gaps
The United States is set to host 78 World Cup matches across 10 states from June 11 to July 19. Among those host states, five earned a “high” rating, four landed in the “middle” range, and Texas scored “low” on the preparedness scale. The findings underscore a patchwork of readiness as international crowds converge on American soil.
Researchers evaluated states based on 10 indicators, including public health funding, community water system safety, healthcare workforce mobility, and access to paid sick leave. The report arrives amid a surge in infectious disease outbreaks, with the U.S. experiencing its most severe flu season in nearly a decade and the highest annual measles case count since 1991.
Experts Warn of Strains
Dr. J. Nadine Gracia, TFAH's president, highlighted during a Thursday media briefing that rising disease outbreaks, coupled with dwindling federal funding and public health staffing, place national “preparedness at risk.” She stressed that large-scale events like the World Cup demand robust, coordinated systems. “The federal public health system remains under strain,” Gracia said, noting the influx of international travel and crowds will test the country's ability to respond.
Dr. Jennifer Nuzzo, director of the Pandemic Center at Brown University, echoed these concerns. She warned that the World Cup is an “enormous event” that typically requires over a year of planning, but state and local partners lack sufficient resources and federal guidance. “Our poor state and local partners have been left without sufficient resources or guidance from the federal government,” Nuzzo said, describing the situation as one of “increasing fragility” in the public health system.
Nuzzo noted that the number of serious outbreaks has “quadrupled” since her center began tracking them 18 months ago. “This is quite a staggering situation,” she said, pointing to multiple concurrent emergencies. “We are basically drinking from the fire hose right now.”
Hantavirus Outbreak Adds Urgency
The report's release coincided with news of a hantavirus outbreak on a cruise ship, where three people have died from suspected infection. The World Health Organization confirmed five of eight suspected cases as the Andes virus, a strain capable of limited human-to-human transmission. The ship, which departed from Ushuaia, Argentina, on April 1, has been docking off West Africa, with nearly 150 people still isolating onboard.
Dr. Tedros Adhanom Ghebreyesus, WHO director general, said the public health risk remains “low” but acknowledged the outbreak as a reminder of the need for perpetual vigilance. Nuzzo added, “This is not the next pandemic, but it certainly is a reminder of the need for perpetual readiness.” Health officials are still tracking passengers who left the ship during earlier stops, with four states now monitoring cruise ship passengers after the outbreak.
The findings come as voters increasingly prioritize health costs over other concerns, according to recent polling that shows health costs top MAHA voters' concerns, outpacing vaccine and food fears. The TFAH report underscores that without sustained investment, the U.S. may struggle to meet the demands of mass gatherings and emerging threats alike.
