Montana 2024 Epidemiology and Laboratory Capacity for Prevention and Control of Emerging Infectious Diseases(ELC) Application - Health equity and health disparities are major concerns in Montana. The state of Montana is geographically the 4th largest state in the country but has a small population. Montana’s population is listed as 1.1 million people. In Montana, for every square mile there is less than 7 people, which makes us the 48th most densely populated state in the country. In fact, when population is viewed at the county level, 23 of our 56 counties are considered frontier counties. Frontier refers to a 19th century Census Bureau standard of an area west of the 98th meridian with fewer than 2 persons per square mile. Residents in some rural communities must travel more than 100 miles to get care for simple medical examinations such as mammography scans or MRIs. The population in Montana is predominantly white. According to the Census Bureau nearly 88% of the population is white, 6% is American Indian/Alaska Native, 4% is Hispanic, 1% is Asian/Pacific Islander, and less than 1% is black. Montana is home to 7 different tribal reservations, but our Indian Health Services (IHS) are constantly fighting against underfunding and understaffing. Our Montana Indians have poorer health, higher disease rates, lower life expectancy and more difficulty obtaining healthcare. Data suggests nearly 40% of Montana’s American Indians are uninsured. Many are ineligible for IHS because they do not live on a reservation and/or are not a member of a federally recognized tribe. In addition to an uneven ethnic population, Montana’s population tends to be older than the national average. Many of our rural counties are predicted to experience a larger increase in retirement-age dependency ratio than counties with large cities. The older population in Montana is likely to impact social welfare programs, including health care systems, more than in many other states, as Montana is projected to have the fifth highest percentage of state population aged 60+ in 2030. As the total and relative population over age 60 expands in Montana, health care and social service providers will need to continue to adapt to fully care for the needs of the population. The Montana Department of Public Health and Human Services (MT DPHHS) is the largest department in our state’s government. MT DPHHS employs roughly 3,000 employees, whose mission is to serve Montanans in their communities to improve health, safety, well-being, and empower independence. The ELC Cooperative Agreement resides within the Public Health and Safety Division (PHSD) of MT DPHHS. As it relates to the ELC Cooperative Agreement, the PHSD bureaus involved in managing the Montana ELC Program are the Epidemiology and Scientific Support Bureau (ESSB) and the Laboratory Services Bureau (LSB). The State of Montana has a decentralized public health system, which means the local health jurisdictions are responsible for investigating outbreaks of concern and the individual cases. The state trains the local health jurisdictions to investigate new cases and/or clusters of illnesses, to conduct contact investigations, and, if necessary, to quarantine and monitor close contacts of cases. The state has developed tools for locals to use, including spreadsheets to track cases, contacts, clusters, and test results, guidance documents for locals to reference during investigations, and the state has updated the NEDSS Base System used by local and state public health officials to monitor cases and transmit data to CDC. As stated in our workforce assessment, retaining our employees is our highest priority and greatest concern. During the pandemic MT ELC Team added many positions. These positions are imperative to the success of our public health efforts in the laboratory, communicable disease epidemiology, surveillance and informatics, and infection prevention sections. Retaining these employees without the ELC COVID-19 funding is a major concern for Montana.
