If an infectious disease outbreak hits New Jersey, or another hurricane makes landfall here, would the state be caught completely off-guard?

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In the Trust for America’s Health report released Tuesday, “Ready or Not? Protecting the Public from Diseases, Disasters and Bioterrorism,” New Jersey achieved six of 10 key indicators of public health preparedness.

Thirteen states are more prepared for the worst-case scenario, the report finds. Eleven other states, plus the District of Columbia scored a six out of 10. Alaska met the mark on just two indicators.

New Jersey is listed as one of 31 states that failed to increase or maintain funding for public health from fiscal year 2015 to fiscal year 2016. The Garden State was on the other side of this finding in TFAH's report last December.

Since 2002, federal funding to support preparedness has been cut by more than half, the report noted.

"The fundamental finding is the country is not investing enough to maintain the strong basic capabilities at the state and community level to respond and plan for these threats to public health," said Paul Kuehnert with the Robert Wood Johnson Foundation, which funded the report.

New Jersey is also listed as one of 24 states that do not participate in an Enhanced Nurse Licensure Compact, which allows nurses to have a single multistate license that permits them to practice in all compact states without an emergency declaration.

The Garden State also misses out on the climate change indicator — one of 36 states that are not members of the United States Climate Alliance, a bipartisan coalition committed to reducing greenhouse gas emissions.

Along with the majority of states, New Jersey is also cited for its lack of a paid sick leave law.

New Jersey fell short in last year's report, but met the mark this time for its flu vaccination rate among those aged 6 months and older. Twenty states, including New Jersey, vaccinated at least half of this population from July 2016 to May 2017.

The state lands on the positive side of two indicators related to public health laboratories. The report also notes New Jersey's health department has been accredited nationally, and more than 70 percent of hospitals are meeting core elements devoted to stemming the inappropriate use of antibiotics.

New Jersey is one of 33 states that saw its overall preparedness score increase on the National Health Security Preparedness Index between 2015 and 2016.

The indicators analyzed by the report varies from year to year. New Jersey achieved eight of the 10 indicators in 2016 and six out of 10 in 2015.

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Contact reporter Dino Flammia at dino.flammia@townsquaremedia.com.