Communities, Preparedness, and Community Preparedness
June 28, 2016
June 28, 2016 - When I first entered the preparedness field a few years ago, I remember being confused by the idea of ‘all-hazards’ planning. Seemed like a tall order, asking communities to plan for all hazards. But after learning what the approach really meant – the notion that some aspects of life, including public health and healthcare, are affected by nearly any hazard, and so should be accounted for in all plans – I understood why Federal, state, and local preparedness planning has embraced the approach.
With communities across the country facing myriad hazards – from Zika, to a predicted active hurricane season, to wildfires, floods, and record heat – our team decided to investigate to what extent the all-hazards approach is embraced at the individual level by polling a sample of Americans representative of the population on their attitudes and actions towards preparedness. While we shared our high level findings last month, I was eager to explore some of the finer points the data revealed, particularly as they relate to healthcare and public health preparedness planning.
While the results reaffirmed our perceptions it also revealed some surprising points, with all being important considerations for public officials. Some of the key demographic-specific findings included:
- Most concerning disasters: The American population as a whole is most concerned about a natural disaster affecting their community. However, important stratifications around this concern exist, including:
- A trend upward with age - concern for natural disaster trends upwards with age, with 36% of 35 - 54 year olds and 40% of 55+ year olds being most concerned about a natural disaster affecting their community, compared with 20% of 18 - 34 year olds being most concerned about a natural disaster.
- The proportion of Americans in the Northeast most concerned with a natural disaster affecting their community (18%) is less than both the American population (32%) and other regions (33% in Midwest, 40% of South and 30% of West). Conversely, the proportion of Americans in the Northeast most concerned about an outbreak of a commonly occurring disease, such as flu, is higher in the Northeast (10%) than the American population (6%) and other regions
- Among those most concerned about a terrorist attack, the proportion of Hispanics is nearly double that other races (24%, compared to 12% of Whites, 13% of Blacks, 11% other*, and 14% of the general American population).
- Trusted preparedness information sources: As we noted in our major findings, though the greatest proportion of Americans cited police and fire departments (30%) as their most trusted source of information for preparing and managing health conditions during a disaster, these departments will often be busy with response operations. Other important findings and implications on where Americans turn for health preparedness information included:
- The relatively and consistently low among all demographics (between 3 - 4%) proportion of Americans that cited pharmacists as their most trusted source of information. This was striking for several reasons, including the fact that pharmacists have been found to be among the most trusted healthcare professions in past surveys.
- The proportion of Americans citing local government leaders as their most trusted source of information is sometimes two times as high in the Northeast, with 13% of Americans in the regions citing them as their most trusted source, compared to 5% of those in the Midwest, 9% in the South, and 7% in the West.
- Emergency Evacuation Plans: Nearly half (47%) of American families do not have any evacuation plans in place for a natural disaster. Important demographic differences exist among those that do, including:
- Varying regional differences, with 30% and 28% of those in the Midwest and South, respectively, having a plan in place, compared to the 18% and 20% of those in the Northeast and West, respectively.
- Significant racial differences, with 6% of Black families, compared to 17% of White and 11% of Hispanic families, having a pre-determined location to gather and meet. Similarly, 9% of Black families, compared to 20% of White and 16% of Hispanic families, maintaining an emergency survival kit.
Complete interpretation – and full incorporation – of the implications of these findings of course requires more than a blog entry. However, the findings reminded me that ‘communities’ are not just defined by geography. Attitudes and actions on preparedness vary by geography, yes, but also by race, age, education, etc. – the list could go on and on. And as all communities use, and are affected by, public health and healthcare, these findings remind me of the imperative to both ask and listen to communities when developing plans that are intended for them. Because planning for communities cannot effectively happen without asking and listening to them, a reality I think can get lost in the policy process. As Healthcare Ready continues to represent communities’ voices in the planning process, these findings will ground me in asking myself first who makes up the community and second, that representing their voice means asking and listening to them.