Limited English Proficiency Populations & Racial and Ethnic Minorities

The Promising Practices

Public Health Promotores

City of El Paso Department of Public Health
El Paso, TX

Vulnerable Populations Action Team

Seattle King County Public Health
Seattle, WA

When Words Are Not Enough

Woodside Fire Protection District
Woodside, CA

Emergency, Community and Health Outreach (ECHO)

Association of Minnesota Counties
St. Paul, MN

Kentucky Outreach and Information Network (KOIN)

Cabinet for Health and Family Services
Frankfort, KY

New Mexico Tribal Outreach for Pandemic Planning

New Mexico Department of Health
Santa Fe, NM

North Carolina Pandemic Flu Program

Old North State Medical Society
Durham, NC

Overview

Racial and ethnic minorities and Limited English Proficiency (LEP) populations are vulnerable in a public health emergency for several reasons:

  • Lack of material and social resources needed to navigate a disaster;
  • Higher rates of disability and poor health, making some in this group more reliant on others;
  • Greater likelihood of cultural or linguistic isolation, which affects both perceptions of risk and communication; and
  • Low levels of trust in traditional sources of public health information.

Often, racial and ethnic minorities and LEP populations encounter a number of these difficulties simultaneously. As a result, these groups are vulnerable to the immediate impact of an emergency and less able to rebound after the threat has passed, putting them at risk for longer-term ill effects.

Strategies and Resources for Addressing the Public Health Emergency Needs of Minorities and LEP Populations

Why is this group at greater risk? How can planners help this group? What resources are available to help?
Low levels of income, education, and wealth
  1. Create evacuation plans that do not rely on individual resources such as car ownership, or personal finances for temporary housing
  2. Provide pre-made home disaster kits for low-income populations that include critical items such as food, water, a small radio, and batteries
  3. Plan for longer-term food, shelter, clothing, and medical needs of recovering minority populations
  4. Communicate information about legitimate disaster-related resources to reduce the risk of the population falling victim to fraudulent recovery services
Poor health, disabilities, and inadequate health insurance coverage
  1. Create registries of disabled populations to facilitate advance planning for their needs
  2. Equip shelters with appropriate medications, medical supplies, and facilities to address the short term needs of these populations
  3. Conduct tabletop and other training exercises with scenarios focused on minority disabled or chronically ill patients
  4. Seek information on the unique needs and concerns of minority and LEP populations from community based organizations that serve their interests
Cultural and linguistic isolation
  1. Construct preparedness and response programs in a manner that is consistent with cultural differences in living arrangements, family structure, and behavioral norms
  2. Translate materials into the languages spoken in the local community
  3. Identify the steps citizens must take to protect themselves in an emergency
  4. Communicate in more than one medium: translate TV and radio messages as well as print and the Internet
  5. Tailor messages to persons with low literacy by using audio and visual aides
  6. Rely on existing communication/social networks and people to convey critical public health information
  7. Develop programs to train and deploy health promoters and medical interpreters as messengers of public health information
Low-trust
  1. Coordinate efforts with representatives of minority populations in planning sessions to build trust and open a dialog for exchanging critical information
  2. Clarify when and how citizenship affects access to aid
  3. Identify trusted messengers and information networks and use them to convey public health warnings and directives