A report released Thursday by Trust for America’s Health and the Robert Wood Johnson Foundation says that Hawaii scores six out of 10 on key indicators related to preventing, detecting, diagnosing and responding to outbreaks like Ebola, Enterovirus and antibiotic-resistant “superbugs.”

That puts us behind Maryland, Massachusetts, Tennessee, Vermont and Virginia, which tied for the top score with eight out of 10 indicators.

Same goes for California, Delaware, Nebraska, New Hampshire, North Dakota, Pennsylvania and Wisconsin, which each have scores of seven out of 10.

Ebola.

Trust for America’s Health

But half of all states and Washington, D.C., scored five or lower out of 10 key indicators related to outbreaks. Arkansas has the lowest score at two out of 10.

The indicators were developed in consultation “with leading public health experts based on data from publicly available sources or information provided by public officials,” according to the report.

The report, Outbreaks: Protecting Americans from Infectious Diseases, finds that the recent Ebola outbreak “exposes serious underlying gaps in the nation’s ability to manage severe infectious disease threats.”

“Over the last decade, we have seen dramatic improvements in state and local capacity to respond to outbreaks and emergencies. But we also saw during the recent Ebola outbreak that some of the most basic infectious disease control policies failed when tested,” Jeffrey Levi, PhD, executive director of the Trust for America’s Health, said in a press release.”

Levi added, “The Ebola outbreak is a reminder that we cannot afford to let our guard down.”