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Trends in 2-1-1 calls reflect evolving community needs during public health emergencies (PHEs). The study examined how changes in 2-1-1 call volume after 2 PHEs (Hurricane Irma and the coronavirus disease 2019 [COVID-19] pandemic declaration) in Broward County, Florida, varied by PHE type and whether variations differed by gender and over time. Examining 2-1-1 calls during June to December 2016, June to December 2017, and March 2019 to April 2021, this study measured changes in call volume post-PHEs using interrupted time series analysis. Hurricane Irma and the COVID-19 pandemic were associated with increases in call volume (+81 calls/d and +84 calls/d, respectively). Stratified by gender, these PHEs were associated with larger absolute increases for women (+66 and +57 calls/d vs +15 and +27 calls/d for men) but larger percent increases above their baseline for men (+143% and +174% vs +119% and +138% for women). Calls by women remained elevated longer after Hurricane Irma (5 wk vs 1 wk), but the opposite pattern was observed after the pandemic declaration (8 vs 21 wk). PHEs reduce gender differences in help-seeking around health-related social needs. Findings demonstrate the utility of 2-1-1 call data for monitoring and responding to evolving community needs in the PHE context.
This study aimed to: (1) explore changes in the volume of calls to poison control centers (PCs) for intentional exposures (IEs) in Dallas County, Texas, overall and by gender and age, and (2) examine the association between 2 different public health emergencies (PHEs) and changes in IE call volume.
PCs categorize calls they receive by intentionality of the exposure, based on information from the caller. We analyzed data on PC calls categorized as intentional in Dallas County, Texas, from March 2019 – April 2021. This period includes the COVID-19 pandemic declaration (March 2020), a surge in COVID-19 cases (July 2020), and Winter Storm Uri (February 2021). Changes in IE call volume (overall and by age and gender), were explored, and interrupted time series analysis was used to examine call volume changes after PHE onset.
The summer surge in COVID-19 cases was associated with 1.9 additional IE calls/day (95% CI 0.7 to 3.1), in the context of a baseline unadjusted mean of 6.2 calls per day (unadjusted) before November 3, 2020. Neither the pandemic declaration nor Winter Storm Uri was significantly associated with changes in call volume. Women, on average, made 1.2 more calls per day compared to men during the study period. IE calls for youth increased after the pandemic declaration, closing the longstanding gap between adults and youth by early 2021.
Changes in IE call volume in Dallas County varied by gender and age. Calls increased during the local COVID-19 surge. Population-level behavioral health may be associated with local crisis severity.
This study aimed to examine factors associated with receipt of post-disaster support from network (eg, family or friends) and non-network (eg, government agencies) sources.
Participants (n=409) were from a population-based sample of Hurricane Sandy survivors surveyed 25-28 months post-disaster. Survivors were asked to imagine a future disaster and indicate how much they would depend on network and non-network sources of support. In addition, they reported on demographic characteristics, disaster-related exposure, post-traumatic stress, and depression. Information on the economic and social resources in survivors’ communities was also collected.
Multilevel multivariable regression models found that lack of insurance coverage and residence in a neighborhood wherein more persons lived alone were associated with survivors anticipating less network and non-network support. In addition, being married or cohabiting was significantly associated with more anticipated network support, whereas older age and having a high school education or less were significantly associated with less anticipated network support.
By having survivors anticipate a future disaster scenario, this study provides insight into predictors of post-disaster receipt of network and non-network support. Further research is needed to examine how these findings correspond to survivors’ received support in the aftermath of future disasters. (Disaster Med Public Health Preparedness. 2018;12:711-717)
To summarize ways that networks of community-based organizations (CBO), in partnership with public health departments, contribute to community recovery from disaster.
The study was conducted using an online survey administered one and 2 years after Hurricane Sandy to the partnership networks of 369 CBO and the New York Department of Health and Mental Hygiene. The survey assessed the structure and durability of networks, how they were influenced by storm damage, and whether more connected networks were associated with better recovery outcomes.
During response and recovery, CBOs provide an array of critical public health services often outside their usual scope. New CBO partnerships were formed to support recovery, particularly in severely impacted areas. CBOs that were more connected to other CBOs and were part of a long-term recovery committee reported greater impacts on the community; however, a partnership with the local health department was not associated with recovery impacts.
CBO partners are flexible in their scope of services, and CBO partnerships often emerge in areas with the greatest storm damage, and subsequently the greatest community needs. National policies will advance if they account for the dynamic and emergent nature of these partnerships and their contributions, and clarify the role of government partners. (Disaster Med Public Health Preparedness. 2018;12:635–643)
The purpose of this article was to describe how the Hospital Preparedness Program (HPP) and other health care coalitions conceptualize and measure progress or success and to identify strategies to improve coalition success and address known barriers to success.
We conducted a structured literature review and interviews with key leaders from 22 HPPs and other coalitions. Interview transcripts were analyzed by using constant comparative analysis.
Five dimensions of coalition success were identified: strong member participation, diversity of members, positive changes in members’ capacity to respond to or recover from disaster, sharing of resources among members, and being perceived as a trendsetter. Common barriers to success were also identified (eg, a lack of funding and staff). To address these barriers, coalitions suggested a range of mitigation strategies (eg, establishing formal memoranda of agreement). Both dimensions of and barriers to coalition success varied by coalition type.
Currently, the term health care coalition is a one-size-fits-all term. In reality, this umbrella term describes a variety of different configurations, member bodies, and capabilities. The analysis offered a typology to categorize health care coalitions by primary function during a disaster response. Developing a common typology that could be used to specify capabilities or functions of coalitions may be helpful to advancing their development. (Disaster Med Public Health Preparedness. 2015;9:690–697)
Despite the growing awareness that youth are not just passive victims of disaster but can contribute to a community’s disaster resilience, there have been limited efforts to formally engage youth in strengthening community resilience. The purpose of this brief report was to describe the development of a Youth Resilience Corps, or YRC (ie, a set of tools to engage young people in youth-led community resilience activities) and the findings from a small-scale pilot test.
The YRC was developed with input from a range of government and nongovernmental stakeholders. We conducted a pilot test with youth in Washington, DC, during summer 2014. Semi-structured focus groups with staff and youth surveys were used to obtain feedback on the YRC tools and to assess what participants learned.
Focus groups and youth surveys suggested that the youth understood resilience concepts, and that most youth enjoyed and learned from the components.
The YRC represent an important first step toward engaging youth in building disaster resilience, rather than just focusing on this group as a vulnerable population in need of special attention. (Disaster Med Public Health Preparedness. 2016;10:47–50)
An important shift in terminology has occurred in emergency preparedness, and the concept of community resilience has become ubiquitous. Although enhancing community resilience is broader than preparedness, and emphasizes a distinct set of activities and participants, the terms are often used interchangeably. The implications of this shift have not been fully explored. This commentary describes the potential promise and pitfalls of the concept of community resilience and recommends strategies to overcome its limitations. We believe that resilience has the power to dramatically change this field in immense, positive ways, but some important challenges such as confusion about definitions and lack of accountability must first be overcome. (Disaster Med Public Health Preparedness. 2013;7:603-606)
Although recent emergencies or disasters have underscored the vital role of nongovernmental (NGO) resources, they remain not well understood or leveraged. We intended to develop an assets framework that identifies relevant NGO resources for disaster preparedness and response that can be used to assess their availability at state and local levels.
We conducted a search of peer-reviewed publications to identify existing asset frameworks, and reviewed policy documents and gray literature to identify roles of NGOs in emergency preparedness, response, and recovery. A standardized data abstraction form was used to organize the results by NGO sector.
We organized NGO assets into 5 categories: competencies, money, infrastructure or equipment, services, relationships, and data for each of the 11 sectors designated by the Centers for Disease Control and Prevention in the 2011 preparedness capabilities.
Our findings showed that the capacity of each sector to capture data on each asset type needs strengthening so that data can be merged for just-in-time analysis to indicate where additional relief is needed. (Disaster Med Public Health Preparedness. 2013;0:1–6)
Nongovernmental organizations (NGOs) are important to a community during times of disaster and routine operations. However, their effectiveness is reduced without an operational framework that integrates response and recovery efforts. Without integration, coordination among NGOs is challenging and use of government resources is inefficient. We developed an operational model to specify NGO roles and responsibilities before, during, and after a disaster.
We conducted an analysis of peer-reviewed literature, relevant policy, and federal guidance to characterize the capabilities of NGOs, contextual factors that determine their involvement in disaster operations, and key services they provide during disaster response and recovery. We also identified research questions that should be prioritized to improve coordination and communication between NGOs and government.
Our review showed that federal policy stresses the importance of partnerships between NGOs and government agencies and among other NGOs. Such partnerships can build deep local networks and broad systems that reach from local communities to the federal government. Understanding what capacities NGOs need and what factors influence their ability to perform during a disaster informs an operational model that could optimize NGO performance.
Although the operational model needs to be applied and tested in community planning and disaster response, it holds promise as a unifying framework across new national preparedness and recovery policy, and provides structure to community planning, resource allocation, and metrics on which to evaluate NGO disaster involvement. (Disaster Med Public Health Preparedness. 2012;0:1–8).
US government programs and communications regarding citizen preparedness for disasters rest on several untested, and therefore unverified, assumptions. We explore the assumptions related to citizen preparedness promotion and argue that in spite of extensive messaging about the importance of citizen preparedness and countless household surveys purporting to track the preparedness activities of individuals and households, the role individual Americans are being asked to play is largely based on conventional wisdom. Recommendations for conceptualizing and measuring citizen preparedness are discussed.
(Disaster Med Public Health Preparedness. 2012;6:170–173)
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