RAND Gulf States Policy Institute Newsletter | Web version

Follow OCR on Twitter
February 2019

RAND Gulf States Policy Institute

From the Director

Docks destroyed at a marina by Hurricane Florence on 9/13/18 in Oriental, NC

Two firefighters stand alongside bulldozer in California
Woolsey Fire. Photo by Erin Donalson/Getty Images.

Recently, wildfires in California took the lives and properties of our fellow citizens. We at RAND, both here in the Gulf States and from our home office in Santa Monica, California, send our sympathies. Researchers, ever asking questions about how to improve policy decisions, turn our attention to how these fires might have been prevented and how the citizenry might have been better prepared. We in the Gulf States might have some lessons to share, even though the risk of nature’s fury here is different in, well, nature. There are many aspects to emergency preparedness and response, but one that is often overlooked is the ruthless toll on older adults.

The tragic news of the California fires reminds me of how older adults suffered through past hurricanes in our region and of the steps public agencies have taken to make sure this outcome is not tragically repeated. The development of a New Orleans special needs registry, for example, allows first responders to quickly locate and evacuate older adults and others who need assistance or help them shelter in place.

The registry is an invaluable move in the right direction, but alerting first responders is only one part of a larger community resilience plan. What else can we do? What is resilience, and how does it relate to our older neighbors?

In this issue of the RAND Gulf States newsletter, I am pleased to introduce you to the first-of-its-kind evaluation of resilience-building efforts targeted at older folks and an interactive toolkit that can help those involved in aging-in-place support and disaster resilience efforts to come together to improve the ability of older neighbors to withstand and recover after a disaster. I spoke with Joie Acosta, Ph.D., who many of you might know from her work on community resilience planning in our region, about this project and why resilience planners and responders in our region in particular need to continue our efforts to plan for the needs of older adults during a catastrophic event.

Please don’t hesitate to call on us. Wishing you a safe, healthy, and prosperous New Year. Happy Mardi Gras!

Gary Cecchine

Researcher Spotlight

Q&A with Joie Acosta

Below is my discussion with Joie Acosta about her work with older adults, community partners, and disaster resilience. Joie Acosta is a senior behavioral/social scientist at RAND.

Joie D. Acosta

She provides managerial, research, evaluation, and technical expertise on projects related to implementation science; positive youth development; community resilience to disasters; and mental health. She discusses some of the opportunities and challenges related to helping older adults prepare for and recover from natural and other kinds of disasters. She also recommends a few ways public agencies and medical and public services can improve outcomes for older adults facing dire, sudden situations.

1. Why is the resilience of older adults specifically so important to talk about?

There are three reasons. First, the number of older adults—those ages 65 and older—is growing in this country. By 2050, we can expect older adults to make up at least 25 percent of the population.

Second, most older adults now are not prepared for disasters and have challenges that hinder immediate response and later recovery. Many are unable to receive messages sent by public health departments. Some are socially or geographically isolated. Some deal with chronic health problems; cognitive decline; or limited mobility, hearing, and eyesight, and that can make even daily living a challenge.

Finally, we can expect the frequency and intensity of weather-related disasters to increase in the coming years.

Add these three factors up, and you can see that we need to be proactive about this. Improving older adults’ preparedness and ability to recover after an event can help reduce tragic outcomes that could profoundly affect this large population of concern.

2. What did you look at in your study?

We examined two increasingly popular “aging-in-place” initiatives that offer promising strategies to help older adults thrive in the places they live.

We first looked at AARP “age-friendly” communities. These communities are formed by local governments and community groups who partner together to improve the social connections of older adults in a city or county. The second strategy we looked at are “villages.” These are more grassroots and volunteer-driven organizations that offer dues-paying members within a specific neighborhood—or in rural areas, a cluster of counties—access to programs and services, such as health education, social gatherings, transportation, and bookkeeping.

For the study we interviewed coordinators of “age-friendly” communities, village leaders, community leaders, and public health staff. We also conducted a survey of older adults who were connected with a village to assess their preparedness and compared them with those who were not connected to a village, whether they take part in the initiatives or not.

3. What did you find out?

Overall, we found that aging-in-place initiatives do not emphasize disaster preparedness and resilience, and older adults participating in them are more concerned with day-to-day living than a disaster event that may or may not occur next month.

However, we also found that there are a lot of opportunities to improve the situation—opportunities that will not necessarily require significant additional resources or time. For example, many of the public health departments serving aging-in-place initiatives offer general preparedness and resilience training that is not tailored specifically to the needs and capabilities of older people. They could tailor the training they already offer to emphasize the skills older adults need to remain safely at home in times of disaster. Even health departments serving areas that do not have these initiatives might consider this.

Moreover, communication networks through aging-in-place participants and their families, public agencies, and helpful organizations can be improved upon to address resilience and preparedness so that older adult responses are more rapid and prepared when a crisis hits.

4. How are these findings relevant to the Gulf States region specifically?

Like other parts of the country, the number of older adults living here is growing. But the region faces unique threats that make disaster preparedness and resilience for older adults really important. Flooding has always been a danger and will get worse if the sea level continues to rise and the number and danger of hurricanes keeps increasing. Older adults, whether they are participating in aging-in-place initiatives or not, will need to be prepared to act and to have the support in place to help them.

There is also another less-talked-about crisis that could occur. Communities might depopulate as flooding and related business sectors change, such as fishing and energy. The pace of this change might be increased for communities that lack resilience. Working-age people might move away, which would leave behind more vulnerable community members, including older adults.

Building the resilience of older adults in the region now could help them continue to age successfully in their homes and communities when disaster strikes.

5. You talked about how aging-in-place initiatives and public health organizations can work more closely to develop resilience among older adults. What can others do?

So many people and organizations can work together to improve older adult resilience.

Policymakers at the state and community levels can agree to plan for and fund realistic goals related to disaster preparedness and recovery. Older adults should not only be considered in planning, they also should be considered as assets with rich social networks.

Health care coalitions and health and social services agencies, such as home care, dialysis centers, nursing homes, and hospice care have regular contact with older people and can take on more roles and responsibilities if they are funded to do so. They can coordinate to provide vital services in case of a disaster, or at least make sure the people they serve will have access to their services.

Finally, researchers can continue to evaluate existing community resilience practices to identify which are the most promising for improving the outcomes of older adults. Older adult resilience is a fairly new field of inquiry.

Our work is a start, but I look forward to helping a national effort move forward, and we can learn a lot from the experiences of the Gulf States.

The RAND Gulf States Policy Institute provides objective analysis to federal, state, and local leaders in support of evidence-based policymaking and the well-being of individuals throughout the U.S. Gulf States region. We invite your suggestions for researchers, projects, centers, and funding or collaboration opportunities to highlight in future issues. Write to director Gary Cecchine at Gary_Cecchine@rand.org.

Follow RAND

Privacy statement

RAND Corporation

RAND Corporation. 1776 Main Street, Santa Monica, CA 90401-3208.
RAND® is a registered trademark.