Illinois Ranks in the Top Tier of States for National Emergency Preparedness

Illinois has been named a “high-performance” state for emergency preparedness, the highest ranking a state can receive, in a newly released report by Trust for America’s Health. The annual report evaluates states on their ability to respond to various public health emergencies using ten key indicators including incident management, patient safety, and health security surveillance, among other measures.

This year, Illinois received a top tier ranking after being ranked in the middle performance category in 2025. The advancement reflects improvements driven by ongoing investments in emergency preparedness infrastructure, workforce preparation, and response systems. The state previously achieved high-performance rankings in 2020 and 2022.

In the report, states are categorized into three tiers: high, middle, and low performance. This year, 20 states including Illinois earned a high-performance designation followed by 17 states and the District of Columbia in the middle-performance tier, and 13 states in the low-performance tier.

Illinois’ rise in the rankings reflects a multi-year effort to strengthen preparedness, including the following Illinois Department of Public Health (IDPH) efforts:

• A US$1.5 million investment to upgrade two state hospitals to serve as Elite Special Pathogen Treatment Centers for high-consequence pathogens.
• A $45 million investment in major upgrades to modernize public health data systems.
• The development of an after-action report and a Public Health Emergency Preparedness Response Playbook in the aftermath of COVID-19.
• The devotion of significant workforce resources to developing preparedness plans and training staff and partners on the execution of those plans.
• Membership in the World Health Organization’s (WHO) Global Outbreak Alert and Response Network (GOARN) following the federal government’s withdrawal from WHO.
• Protection of access to vaccines by creating and publishing science-based vaccine guidance for Illinoisans, requiring state-regulated insurers to cover vaccines recommended by the department.
• Expansion of children’s access to receive immunizations at pharmacies.
• Adoption of the science-based 2026 child and adolescent immunization schedule issued by the American Academy of Pediatrics, in response to federal changes to immunization guidance that were not backed by scientific evidence.
• Strengthening of the Illinois Immunization Advisory Committee (IL-IAC), adding more experts to conduct robust review of available evidence about immunizations and make recommendations to IDPH.

Overall, the report finds that national preparedness depends not only on state-level capacity, but also on strong and stable federal systems, sustained intergovernmental coordination, and long-term investment in public health infrastructure.

Areas of strong performance include:

Nurse Licensure Compact: As of early 2026, 41 states have adopted the Nurse Licensure Compact, improving states’ ability to rapidly mobilize nursing personnel across state lines during emergencies.

Public Health and Emergency Management Accreditation: Most states are accredited by the Public Health Accreditation Board and/or the Emergency Management Accreditation Program, strengthening coordination, accountability, and emergency response capabilities.

Public Health Laboratory Surge Capacity: Nearly every state has a written plan in place to expand laboratory testing capacity during a prolonged public health emergency.

Community Water System Safety: Most residents continue to receive water from community water systems that meet health-based safety standards, though important risks and inequities remain.

The report offered these recommendations for improving emergency preparedness:

• Provide stable, flexible, and sufficient funding for public health preparedness, workforce, and data modernization to help ensure every state has the systems needed to protect residents.
• Restore the federal public health workforce and capabilities reduced in 2025.
• Reauthorize the Pandemic and All-Hazards Preparedness Act.
• Strengthen outbreak and pandemic readiness by supporting immunization, public health surveillance, and antimicrobial resistance efforts.
• Adopt strategies and accountability metrics in all levels of government to incorporate community resilience and health equity into preparedness.
• Accelerate development, stockpiling, and distribution of vaccines, therapeutics, diagnostics, and other medical countermeasures.
• Bolster healthcare system readiness, including cross-state credentialing and investment in Health Care Readiness programs.
• Expand preparedness for extreme weather and environmental health threats.

The full report is available online.