How prepared are Americans for public health emergencies? Twelve communities weigh in.

Since the terrorist attacks of 11 September 2001, emergency preparedness has become a top priority in metropolitan areas, and some of these areas have received considerable federal funding to help support improvements. Although much progress has been made, preparedness still varies across communities, with the larger ones exhibiting stronger response capabilities, and some weaknesses are evident, particularly in the areas of communications and workforce education. Experience with other public health emergencies, strong leadership, successful collaboration, and adequate funding contributed to high states of readiness. Important challenges include a shortage of funding, delay in the receipt of federal funding, and staffing shortages.