Enhancing Public Health Emergency Preparedness for Special Needs Populations

A Toolkit for State and Local Planning and Response

by Jeanne S. Ringel, Anita Chandra, Malcolm V. Williams, Karen A. Ricci, Alexandria Felton, David M. Adamson, Margaret Weden, Meilinda Huang

This Article

RAND Health Quarterly, 2011; 1(3):19

Abstract

Experiences from recent emergencies, such as Hurricanes Katrina and Rita, have shown that current emergency preparedness plans are inadequate to address the unique issues of special needs populations. This article shares details about a toolkit meant to assist state and local public health agencies improve their emergency preparedness activities. It distills the most relevant strategies, practices, and resources from a variety of sources, including peer-reviewed research, government reports, the trade literature, and public health leaders, to identify priority populations and critical strategies. The contents include potential strategies for addressing special needs, summaries of promising practices implemented in communities across the country, information on how to select one or more practices that will work in a specific community, information on how to determine whether a practice is working, and a Web-based Geographic Information Systems (GIS) tool to identify and enumerate those with special needs in communities across the United States. Used together, the toolkit and the GIS tool are intended to provide a comprehensive resource to enable public health planners to account for special needs populations in their emergency preparedness efforts.

For more information, see RAND TR-681-DHHS at https://www.rand.org/pubs/technical_reports/TR681.html

Full Text

What Is the Purpose of the Toolkit?

Public health emergency preparedness planning for special needs populations (e.g., individuals with disabilities, children) is critical for public health departments because individuals who might need special attention are often the most difficult to reach before, during, and after an event. As we have learned from emergencies over the past few years, our current plans are inadequate to meet the needs of these populations, and often these populations are the most negatively affected.

To help state and local public health departments develop emergency preparedness plans to address the unique issues of special needs populations living within the community, the toolkit distills the most relevant strategies, practices, and resources from a variety of sources, including peer-reviewed research, government reports, and the trade literature, to identify priority populations and critical strategies for addressing their needs.* The toolkit also highlights several practices that local public health agencies have found to be effective for enhancing preparedness planning and response for special needs populations, the challenges they have faced in implementing those practices, and the strategies they have employed to overcome those challenges. Many of the strategies, practices, and resources provided could be useful to other emergency response agencies and applicable to any emergency response.

What Is in the Toolkit?

The toolkit contains the following:

  • Background and context information for the importance of incorporating special needs populations into public health emergency planning, response, and recovery, with attention to populations that are often overlooked, such as children and people with disabilities
  • Potential strategies to address special needs
  • Summaries of promising practices implemented in communities across the country
  • Information on how to select one or more practices that will work in a specific community
  • Information on how to determine whether a practice is working
  • The RAND Web-based Geographic Information Systems (GIS) tool to identify and enumerate special needs in communities across the United States (http://www.rand.org/health/projects/special-needs-populations-mapping.html). Used together, the toolkit and the GIS tool are intended to provide a comprehensive resource to enable public health planners to account for special needs populations in their emergency preparedness efforts
  • A list of selected resources to enhance public health emergency preparedness for special needs populations is available at http://www.rand.org/health/projects/special-needs-populations-mapping/promising-practices.html.

Strategy, Practice, Resource: What's in a Name?

The toolkit presents program information on several different levels. First, it provides information on the specific vulnerabilities of the special needs populations included in the toolkit. It then provides strategies that local public health agencies might use to address these vulnerabilities. The strategies tend to be rather general. Therefore, where possible, it also presents information on specific practices that have been implemented in health departments across the country. The practices included in the toolkit were selected because we felt they best exemplified the tools necessary to address the specific vulnerabilities identified. In addition, the toolkit offers information on the wide range of resources available to local public health agencies. This information provides guidance for efforts to implement strategies and practices to better incorporate populations with special needs into their public health emergency preparedness planning and response activities. Resources include links to publications, organization Web sites, checklists, templates for memorandum of understanding (MOU), sample risk-communication messages, and many other items that public health agencies may find useful.

Who Should Use the Toolkit?

The toolkit is meant to assist state and local public health agencies improve their current emergency preparedness activities. In addition, other emergency response agencies and community-based and/or non-governmental organizations can use this toolkit to enhance their programming for these populations.

How Is the Toolkit Organized?

The toolkit is organized into several sections to meet the needs of diverse audiences. It is designed to be modular and Web-based, so that users can read from start to finish or pull out the specific sections in which they are most interested. For example, local public health officials who are less familiar with preparedness for special needs populations may choose to read the whole toolkit to learn more about which populations have special needs, what contributes to their vulnerabilty, how to locate these populations in their community, and what the potential strategies are for addressing these vulnerabilities. On the other hand, to enhance existing programs or overcome challenges in current preparedness planning and response activities, local public health officials with greater expertise in preparedness for special needs populations can quickly access the information on strategies, practices, and resources for a particular population.

A Note on Terminology

Across organizations, disciplines, and research literatures, there is no agreed-upon terminology for describing populations that are at increased risk during a public health disaster. These populations are sometimes described as vulnerable, at-risk, or special needs. While each of these terms captures the notion that some populations will have greater difficulty accessing needed services in an emergency, none is perfect. We adopted the term “special needs,” to correspond to the CDC's most recent definition of this group. However, we consider these terms to be equivalent and, at times, use them interchangeably throughout this document.

Note

* The focus of the toolkit is limited to emergency preparedness and response planning for non-institutionalized community residents.

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