WASHINGTON (AP) - A new report names the District of Columbia and three states as understaffed in the event of an infectious disease outbreak.

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The report by the Trust for America's Health was released Tuesday and is the eighth annual report from the organization. This year, Washington scored a 7 out of 10 on preparedness for public health emergencies. That score was better than 11 other states and tied with seven others. Last year, D.C. got an 8 out of 10.

Hawaii, Iowa, Montana and D.C. were also judged to be understaffed for a long-term outbreak. The group reported not having enough staff to work five 12-hour days for six to eight weeks.