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APHA: We're not prepared for a 'public health crisis'
Most Americans are not prepared to adequately respond to a public health crisis and many who think they are prepared really aren't. Those are some of the findings of a survey funded by the American Public Health Association (APHA) as part of National Public Health Week.
The survey found that only 27% of American families would be fully prepared with adequate food, water, medications, and other supplies if they were forced to stay in their homes for three days or quickly evacuate their homes in response to a public health emergency. Some 87% of the national respondents realize they are not as prepared as they should be, but many people still believe they are more prepared than they really are. Of concern to public health officials is that 40% of the people said they were more prepared in the recent past (particularly after Sept. 11, 2001), but they have allowed their level of planning and preparation to drift and deteriorate.
"These findings indicate we still have a long way to go to improve the nation's readiness for public health emergencies," says APHA executive director Georges Benjamin, MD, FACP, FACEP. "No one can predict where the next national disaster, major storm, or disease outbreak will strike, but when it does, it is likely to disrupt basic services, leaving people without electricity, water, food, or needed medications, and we all need to be prepared."
APHA said the survey findings reveal a deeper understanding of why Americans are so ill-prepared and suggest clear strategies for closing the gaps. "The findings help us understand both the nonrational and rational processes at work for most citizens," the report said. "The nonrational side includes the 38% of the public who say that among the reasons they have not planned is that they simply would rather not think about what would happen in a public health crisis, as well as the 44% who do not believe in worrying about things that may or may not happen in the future."
Rationally, according to the survey, many people believe that they are more prepared than they actually are. Among the 27% of the public who believe they are very or fairly well prepared for a public health crisis, fewer than half (48%) actually meet the basic standard of having a three-day supply of food, water, and medications, first aid, and other basic supplies.
Crisis definition needs to change
Persuading more people to become prepared, the researchers said, will take defining a public health crisis in a way that motivates people to action. Rather than a dictionary definition of a public health crisis that only 27% of the public believe is very or somewhat likely to strike their communities, the survey results suggest the importance of defining a public health crisis by its likely causes.
"To make Americans see the importance of planning for a public health crisis, it is important to broaden the discussion to include the potential that severe storms, hurricanes, tornados, blizzards, or outbreaks of common or exotic infectious diseases, and many other disasters have to cause a public health crisis in their community," the report declared. "The public is twice as likely to worry about a natural disaster (37%) as a public health crisis (18%). They may not really know what a public health crisis is, but they have experience with major storms and they readily accept that storms or other emergencies could cause disruptions in basic services such as electricity, water, transportation, and grocery and drug stores, leading to a public health crisis.
At a Washington, DC, briefing releasing the survey results and hosting a panel discussion on preparedness, Dr. Benjamin said APHA wants to reinvigorate the public and inspire them to retake the first step toward preparedness.
With so few people having the basic three-day supply of essentials available, he said people are allowed to have longer plans for preparedness but the basics need to be taken care of first. "Let's make sure we're prepared for some basic things like snowstorms, ice storms, and some of the things that you've actually experienced in the last couple of months," Dr. Benjamin said.
Looking at how people view the concept of a public health crisis, Dr. Benjamin said terminology is important. "We need to connect the dots so that we educate Americans about preparing for health emergencies and relay our message so that we'll motivate them to improve steps toward preparedness."
The survey took a special look at vulnerable populations, Dr. Benjamin said, such as mothers with children, the homeless, hourly wage workers, food banks, and schools, and assessed their levels of preparedness. "Interestingly enough," he commented, "overall most of these vulnerable subgroups mirrored the lack of preparedness of the general population, but in the public health community we know that these communities and these groups are especially challenging. We know when we simply try to go out for vaccination programs how challenging they are. We can get to the 80% mark and then we try to get that last 20% and it takes extraordinary effort and extraordinary modern resources to get to those populations. Why should preparedness planning be any different from that?"
He cited several examples: Some 58% of mothers with children ages 5 and younger don't have a three-day supply of water on hand for their family, only 61% of people with chronic health conditions have at least a two-week supply of medications, only 18% of employers said they could continue to pay their workers if there was a break in operations, only 15% of hourly workers have saved enough money to buy needed goods for their families if their income were cut off.
"The good news is that it's not hard to prepare," Dr. Benjamin said. APHA has released an on-line assessment and checklist people can use to determine their level of preparedness and become better prepared. He said communities should look at making these tools more available and also at building community checklists through work that has been done by the Department of Health and Human Services. "I think that by putting those two tools together, communities and individuals can assure themselves that they're prepared," he said.