COVID-19 put a spotlight on America’s public health system, revealing both strengths and weaknesses. Although the worst of the pandemic has passed, challenges remain.
In 2025, the U.S. faced a startling measles outbreak, the worst in 25 years. Thousands of cases emerged from a virus that had once been declared eliminated. Vaccine rates for measles have slipped below healthy levels nationwide. Alarmingly, pediatric flu deaths in 2025 reached their highest levels in two decades, with nearly 90% of affected children not fully vaccinated.
Recent outbreaks, including a hantavirus case on a cruise ship and a rise in Dengue fever, show how public health issues are evolving. The first human death from avian flu adds to the list of concerns.
Meanwhile, climate change is reshaping our world. Extreme heat, now the deadliest weather event in the U.S., causes more fatalities than hurricanes or floods. Interestingly, heat waves last 46 days longer than they did in the 1960s.
The 2026 Ready or Not report from Trust for America’s Health underscores the state of public health. It evaluates how prepared health departments are, using a scorecard that looks at various factors, including vaccinations and workforce resilience. Only 20 states ranked as “high performance,” but even these showed areas needing improvement. Thirteen were classified as “low performance,” reflecting issues like inadequate public health investments and poor vaccination rates.
Federal funding has historically supported public health budgets. However, as these funds dwindle, state investments will become increasingly vital. Low vaccination rates are correlated with spikes in illnesses like measles and flu; last year’s flu vaccination rate was just 44%, far below the recommended 70%. The American Public Health Association recently warned that changes to vaccine recommendations could pose risks to families.
As climate risks rise, states must reassess their vulnerabilities and plan accordingly. The Centers for Disease Control and Prevention offers frameworks to help with this. They emphasize the need for the Department of Health and Human Services to establish a dedicated office for climate-related health impacts.
Overall, public health in the U.S. is at a crossroads. As we learn from past experiences, our ability to adapt and respond to emerging challenges will be crucial.
For more information, you can read the 2026 Ready or Not report.
