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Americans Murky on Emergency Preparedness

Survey finds many would turn to nontraditional help, have little faith in government, and aren't prepared

THURSDAY, Dec. 15, 2005 (HealthDay News) -- Americans will turn to nontraditional sources, such as the clergy, for information and assistance during an emergency.

At the same time, many Americans are not confident about national policies for emergency preparedness. And while most Americans feel they are prepared for an emergency, many are not.

These are some of the findings from a survey presented Wednesday at the meeting of the American Public Health Association in Philadelphia.

The research was conducted by the Center for Preparedness Research, Education and Practice at Temple University.

Since Sept. 11, 2001, the country has been preoccupied with improving disaster readiness and disaster responses. Much of this effort has focused on coordination and communication among emergency responders, such as police and firefighters.

Somewhat less effort has been focused on how to include the public, said the study authors, and Hurricane Katrina was a good example of the consequences of poor communication with the public.

"The preparedness issue has been in the news for a number of years," said study co-author Sarah Bass, an assistant professor of public health at Temple. "There's a lot of funding that's going to it right now, but we didn't really know too much about public opinion about these particular things."

Part of the problem may be the different opinions on how communication should be handled.

"There's a constant tension between the people who feel that the strategy should be to communicate as much as possible before an event, to minimize the public's anxiety during any kind of disaster, and the contrary opinion that it's a security issue," said Scot Phelps, a paramedic who is program director of emergency and disaster management at the School of Public Affairs & Administration at Metropolitan College of New York. For example, if the government announces that smallpox vaccinations will be taking place at the local public school, terrorists could disrupt the effort, he explained.

This report was based on a telephone survey in the fall of 2004 in which 1,500 families throughout Pennsylvania were questioned about their attitudes and practices concerning emergency preparedness.

When asked who they would turn to in the event of an emergency, almost all respondents pointed to television and radio outlets. More surprising was the finding that 50 percent of respondents said they would go to their clergy for information. Almost two-thirds (62 percent) said they would turn to the Red Cross or Salvation Army, while 59 percent said they would turn to a public health agency.

"It was really interesting to find out that almost 60 percent wanted to get information from public health departments. A lot of times, public health departments are not in the forefront of messages," Bass said. "The other was the clergy piece. I think the clergy has been underutilized."

Many respondents were not completely comfortable with national policies on preparedness and homeland security, with 25 percent to 35 percent saying new Homeland Security laws did not make them feel safer, and 47 percent expressing concern that the new laws would involve a loss of privacy. One-quarter of respondents were not confident in their family's or the government's level of preparedness.

Almost three-quarters (73 percent) of respondents knew where to get professional help with anxiety and stress after an emergency event, and the majority were aware of national efforts to improve response to disaster events. Fewer were aware of state efforts in the same direction.

While most (72 percent) believed they were personally prepared for emergencies, they actually weren't. Pennsylvanians had only done three or four of nine possible actions to make themselves prepared. Most of the actions taken involved purchasing items. Only 31 percent had made a family plan, the survey found.

This finding echoes an earlier report that revealed that the U.S. government and most states are not prepared to protect the public's health in mass emergencies or acts of bioterrorism. This report gave the federal government a D+ for post-9/11 public health emergency preparedness. More than half the states got a score of five or less out of 10 possible points for key indicators of health emergency preparedness.

"Only 26 percent of Pennsylvania residents knew that Pennsylvania had an emergency preparedness guide. That's pathetic," Phelps said. "Until we create a system where preparedness is part of the normal fabric of life, we're always going to be at risk." Phelps suggested that seventh graders in public schools be required to write their family's emergency plan. "We could get 100,000 households prepared each year."

In the current survey, there was, overall, a low level of general anxiety across the state, with post-traumatic stress disorder (PTSD) measured in 8.7 percent of the sample. The lifetime prevalence of PTSD among American adults has been reported at 7.8 percent.

Interestingly, respondents were most concerned that food or water would be deliberately contaminated.

"That was very surprising because it has never happened here," Bass said. "It wasn't talked about after 9/11 as a possibility whereas smallpox and anthrax really were, and anthrax wasn't a top concern."

Far fewer were concerned about exposure to anthrax via the mail, although this did happen in nearby New York and New Jersey. Respondents were not overly concerned that a terrorist event or natural disaster would affect their communities in the next two years.

Among the respondents, 41 percent reported direct or indirect exposure to a natural disaster in the past two years and 10.5 percent knew someone affected by the events of 9/11. Less than 1 percent reported exposure to anthrax. The study designers made sure to include respondents from the area where Flight 93 came down on Sept. 11, 2001.

So, what should be done with this information?

"We need to develop some strategies to proactively think about how do we get the information that's needed out to the public before a disaster actually occurs, and to do it in a few ways that are maybe not so traditional," Bass said. "Unfortunately, I think creation of communication plans gets pushed to the bottom. The way we communicate a risk is also extremely important and often doesn't get thought of. We really saw it in Katrina. We saw mass chaos, and I think that can easily occur in many disasters without an adequate communication plan."

More information

The U.S. Centers for Disease Control and Prevention has more on emergency preparedness.

SOURCES: Sarah Bass, Ph.D., assistant professor, public health, Temple University, Philaelphia; Scot Phelps, J.D., program director and associate professor, emergency and disaster management, School of Public Affairs & Administration, Metropolitan College of New York, New York City
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