Poll shows many unready for public health crisis

May 8, 2007 (CIDRAP News) – A recent survey sponsored by the American Public Health Association (APHA) indicates that about a third of Americans have made no preparations for a public health emergency and nearly 90% have prepared less than they think they should.

The APHA survey, released in April at an expert roundtable discussion during National Public Health Week, was recently posted on the association's Web site. The online survey was conducted in February by Peter D. Hart Research Associates, based in Washington, DC. It included 925 adults and sought the input of several specific groups, including mothers with children younger than 5, hourly wage workers, and adults who have chronic medical conditions.

The survey group also polled 120 employers and 150 school superintendents and interviewed a small group of regional food bank administrators and local food panty and soup kitchen managers.

Among the survey's key findings:

  • Thirty-two percent of the public have taken no special steps to prepare for a public health emergency that could leave them short of food, water, or medication.
  • An 87% majority said they knew they had not done enough and could do more to prepare for a public health emergency.
  • Forty percent of respondents said they had taken steps to prepare in the past, such as after the Sep 11 terrorist attacks, but had since let their plans lapse.
  • More than a quarter (27%) said they were prepared for an emergency, but only about half (14%) had the 3-day supply of food, water, and medication currently recommended by the American Red Cross for general disaster planning.
  • Close to half—46%—of respondents had not assembled a disaster supply kit.

Georges C. Benjamin, MD, executive director of the APHA, said in a press release that the survey findings show public health officials have a long way to go to prepare the nation for public health emergencies.

"No one can predict where the next natural 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," he added.

In the press release, the APHA said the survey shows that several vulnerable subgroups are lagging in their emergency preparedness efforts. For example, 58% of mothers with young children said they did not have a 3-day supply of water for their families, and only 61% of people with chronic health conditions had at least a 2-week supply of medication.

The 17-page survey report says the term "public health crisis" does not resonate with people, though respondents reported being are concerned about specific events, such as natural disasters, that might lead to one. Only 26% thought that a public health crisis would affect their family in the next year or two, but 57% thought a severe storm might strike their area in the next few years, 47% thought an infectious disease outbreak such as the flu is likely, and 43% believed a foodborne disease outbreak is likely.

In other findings, researchers reported that only 37% of employers believed that a public health crisis would affect their business during the next few years, and only 18% said they could continue paying their employees if business operations were interrupted. Though 63% of employees realized they might not be paid during a public health crisis, only 15% had saved enough money to provide for their families if such an event occurs.

School administrators generally reported a high level of preparedness in the form of evacuation, communication, and community sheltering plans, but few said they had enough drinking water or food to last students for 3 days.

Representatives of regional food distribution centers said they had devoted a lot of time and resources to preparedness planning, but those from local pantries or food shelves reported they were not prepared for public health emergencies, according to the APHA.

All groups that were surveyed said cost was a major barrier to their preparedness actions.

Greg Dworkin, MD, one of the editors of the FluWiki, an interactive pandemic planning Web site, told CIDRAP News he commends the APHA for commissioning the survey and said it's important to gauge the public's preparedness opinions from time to time, rather than making assumptions.

The survey results suggest that preparedness messages are getting through to the public, but that people are not following through with action, said Dworkin, who is chief of pediatric pulmonology at Danbury Hospital in Danbury, Conn. "That's a real problem: the public hears the information, but the next question is how they process it," he said.

Some public health officials are overly concerned that the public will overreact or panic if they use specific terms when referring to public health threats, but not using specific terms represents a missed opportunity, Dworkin asserted. "The message has to be crystal clear. Say 'pandemic' if that's what you mean," he said.

Also, it likely takes sustained, high-profile, and consistent messages to successfully persuade the public to prepare for public health emergencies, Dworkin said. "It's a marathon, rather than a sprint," he added.

See also:

APHA press release

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