A report released Wednesday by Trust for America's Health (TFAH) found that California scored eight out of 10 on key indicators of public health preparedness. 

The report, Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism, examines the nation's ability to respond to public health emergencies, tracks progress and vulnerabilities, and includes a review of state and federal public health preparedness policies.

The report found that 26 states and Washington, D.C., scored a six or lower. Alaska and Idaho scored lowest at three, and Massachusetts scored the highest at 10, with North Carolina and Washington State scoring 9’s. 

States were scored on indicators such as their public health funding commitment, climate change readiness and rates of health care-associated infections. California's score was dinged for not vaccinating at least half its population for the seasonal flu and for not having a formal program for getting private sector health care staff and supplies into restricted areas during a disaster.

According to the report, the nation is often caught off guard when a new threat arises, such the Zika outbreak or a bioterrorist threat, which then requires diverting attention and resources away from other priorities. 

"Health emergencies can quickly disrupt, derail and divert resources from other ongoing priorities and efforts from across the government," said Rich Hamburg, TFAH interim president and CEO. "Many areas of progress that were made after 9/11 and the anthrax attacks to improve health security have been undercut. We aren't adequately maintaining a strong and steady defense, leaving us unnecessarily vulnerable when new threats arise."

View the full report.