Journal of Emergency Management最新文献

Background: When a disaster strikes, great damage may occur to the community and infrastructure in addition to injuries and loss of life. Hospitals are among the community centers that face great challenges during or after disas-ters. The purpose of this mixed-methods study was to evaluate the West Bank's Palestinian government hospitals' emergency preparedness plan.

Methods: A mixed-methods approach was applied at Palestinian government hospitals in the West Bank. The study targeted all healthcare providers and administrative personnel in the respective hospitals.

Results: A total of 298 participants responded to the study. The respondents included physicians (17.8 percent), nurses (45.3 percent), administrators (14.4 percent), and 22.5 percent from other categories. The analysis of variance test showed a significant impact on safety and security, availability of emergency management plans, readiness and training, emergency management disaster preparedness committee, communication, and warning and notification on disaster preparedness plans among West Bank government hospitals.

Conclusions: The degree of practice for safety and security measures by West Bank hospitals was high; the emergency management plan was a medium degree; the readiness and training of workers were at a medium degree; the disaster preparedness and emergency management committee was also at a medium degree; and finally, the de-gree of commitment of West Bank hospitals to communication procedures, warning, and notification in preparedness for disasters was medium.

Evidence shows that responses to health crises often worsen existing disparities. As the approval of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine for people 12 years and older became imminent in the spring of 2021, our institution sought to meet the urgent need to vaccinate the young people in our community facing inequities in pandemic response. In this report, we describe our institution's approach to responding to a rapidly emerging public health need and how we continue to leverage this framework to respond equitably to subsequent local health crises. We recognized that groups of children who had been most impacted by the detrimental effects of the pandemic would also face significant barriers to accessing coronavirus disease 2019 (COVID-19) vaccines. To identify this at-risk cohort, we partnered with our public health department and the school district to use data to identify the zone improvement plan (ZIP) codes with the lowest adult SARS-CoV-2 vaccination rates, schools most often closed due to COVID-19 outbreaks, and schools with the highest percentage of students undervaccinated against routine childhood diseases. We then partnered with our local school district and community organizations who were similarly committed to serving the children of our community (including museums, faith centers, and the zoo, among others), to develop and promote 50 COVID-19 vaccine clinic locations that were positioned to maximize access for populations of children at greatest need. Through these efforts, we administered 10,792 vaccinations to 6,981 unique patients. Of these, 8,503 were in Philadelphia with over one-third (37 percent) of vaccines given to people from our target ZIP codes, and non-White individuals represented 73 percent of the vaccine recipients. Key lessons included utilizing available data to select where care delivery sites would be positioned, integrating with other responding organizations to coordinate efforts and avoid overlap, providing care to the whole family (not just children) when able, and developing a robust monitoring structure with iterative change to maximize impact for our target populations. Key challenges included navigating the balance between low attendance clinics in high-risk areas or areas that were difficult to access while striving to be resource-efficient and maximize our impact on vulnerable populations. In conclusion, recognition of the potential for disaster response to worsen existing disparities in healthcare should lead managers to include a specific focus on equity in their planning. Our experience demonstrates that coordinated, intentional response can successfully minimize disaster impact on our most vulnerable populations.

Background: Psychosocial crisis management interventions do not sufficiently consider visually impaired and deaf individuals. There are difficulties in accessing the available interventions, and the effectiveness of these interventions seems questionable. The United Nations Convention on the Rights of Persons with Disabilities build on the premises of the inclusive participation in psychosocial intervention after disasters.

Objective: The objective of this study is to provide recommendations for psychosocial intervention for sensory-impaired individuals after disasters and to raise awareness for professionals working in the field of psychotraumatology.

Methods: A qualitative analysis of semistructured expert interviews and focus groups with professionals in psychotraumatology and sensory-impaired individuals was conducted. This research took place within the European Network for Psychosocial Crisis Management: Assisting Disabled in Case of Disaster (EUNAD), which is funded by the European Commission.

Results: There is a need for specific knowledge about how to meet the needs of individuals with sensory loss in order to provide psychosocial crisis management after a disaster. This aspect is not included in the existing psychosocial interventions.

Conclusion: The EUNAD recommendations are a start to fulfill the obligation to include sensory-impaired individuals in preparations for disaster interventions.

The Robert T. Stafford Act unintentionally marginalizes Alaska's Tribes and hinders their ability to exercise sovereignty following disasters. Although there has been significant academic analysis of the Alaska Native Claims Settlement Act since its passage in 1971, the monumental agreement that settled Alaska Native aboriginal land claims was not critically considered during the creation of the Stafford Act, nearly two decades later in 1988. The consequences have resulted in increased confusion and controversy as Alaska's Tribes attempt to exercise their sovereign option following emergencies and disasters. This paper is a summary of extensive research that explored the government-to-government relationship between Alaska's Tribes and the Federal Emergency Management Agency (FEMA). It is intended to illuminate statutory and programmatic shortcomings emanating from the Stafford Act when applied to Alaska Natives, their tribal governments, and the greater Alaska Native Community. Effects of these shortcomings include, but are not limited to, the inability of most Alaska Tribes to sustain participation in certain FEMA disaster programs; undetermined impacts on local health and community well-being; and an overarching sentiment of abandonment during times of greatest need. Parallels can also be drawn to other United States (US) Tribes, Indigenous US islands, and circumpolar communities. This paper will assist the reader in recognizing the unique governing structures found throughout Alaska and the negative impacts of the Stafford Act on Indigenous self-determination and sovereignty in the face of increasing disasters and a changing climate.

Over a quarter of adults in the United States live with a disability, increasing their risk for severe outcomes from coronavirus disease 2019 (COVID-19). Additionally, people with disabilities face continuous barriers in accessing COVID-19 vaccinations. Disabilityled organizations are catalytic partners for public health departments to reach and provide services to and build partnerships with people with disabilities. For this reason, the Centers for Disease Control and Prevention Foundation funded three disabilityled organizations, two nationally focused and one locally focused, to partner with state and local public health agencies to identify and address barriers to COVID-19 vaccination and emergency response planning in their communities. These partners identified key strategies for inclusion in emergency response and vaccination planning, including creating accessible materials and messaging, ensuring the accessibility of vaccination sites, and addressing the historical mistrust between people with disabilities and health systems. Through this funding, 59 partnerships between disabilityled organizations and disability or public health partners were formed with 26 memorandums of understanding being executed. This project provides actionable recommendations and illustrates that disabilityled organizations are key public health partners in planning for and implementing strategies that benefit people with disabilities and the community more broadly.

The National Risk Index (NRI) was created by the Federal Emergency Management Agency in 2021 to quantify county-level natural hazard risk. The NRI is presented as a percentile score from 0 to 100 and is calculated based on three components: (1) expected annual loss (EAL), the average economic loss resulting from natural hazards; (2) Social Vulnerability Index (SVI), the susceptibility of local population groups to the adverse impacts of natural hazards; and (3) community resilience, the local community's ability to prepare for and respond to natural hazards. We hypothe-sized that the EAL component unintentionally obscures rural versus urban differences in natural hazard vulnerability and preparedness. We tested our hypothesis using publicly available NRI data for all rural (nonmetropolitan) and urban (metropolitan) counties in the United States. We found that the population-weighted average rural county had an NRI risk score equal to 54.9 (89.1 for urban counties). Follow-up analyses suggested that differing NRI scores between rural and urban counties were driven by greater EAL in urban areas (USD 12 M and USD 347 M EAL for the population-weighted average rural county and urban county, respectively). In contrast, SVI was the strongest predictor in linear regression models of county-level premature mortality rate and years of life lost (p < .001 in both models). We conclude that the NRI primarily communicates the potential economic loss of counties due to natural disasters and under-estimates public health-related vulnerability and resilience. Community planners unaware of this finding may mistakenly overlook the needs of rural communities, leaving rural residents unnecessarily vulnerable to natural disasters. This imbalance could also lead to inequitable distribution of disaster planning resources across rural and urban counties, particularly if policymakers and individuals in charge of emergency preparedness rely on the NRI to identify areas at greatest risk.

Trauma-informed practice in emergency management can aid professionals in addressing inequity and building trusting relationships with vulnerable and marginalized communities. As the field of emergency management begins to utilize principles of trauma-informed practice used by adjacent fields, it is useful to explore the benefits of cultivating a strong and positive psychological sense of community (PSOC) with engaged community partners, particularly those who have past experience with structural or systemic inequity, prejudice, and/or discrimination. Crafting trauma-informed policies and activities at every point in the emergency management cycle, practiced in active collaboration with community members, will help build a trusted community connection that can lead to smoother response and recovery efforts with communities that have historically struggled with equitable access. This paper reviews the elements of a strong, positive PSOC and principles of trauma-informed practice as they can be applied by emergency managers. These principles can further be applied to internal agency policies to support emergency managers who may themselves also experience trauma or burnout in the course of their careers.

This article documents a disability-inclusive study conducted in partnership with disabilityled -community-based organizations in survey development and distribution. Information collection focused on the lived experiences of people with disabilities, their perceived impact, and their future expectations. Survey results from 413 individuals with disabilities document the disaster or personal crisis-related experiences and their subsequent impacts. Results from a selection of survey questions were identified for further exploration and their potential impact on disability-inclusive planning, response, and recovery, with a view to identifying potential variables that impact the disproportionate impact of disasters on people with disabilities. Perspectives provided by survey respondents, who were exclusively people with disabilities, overlapped with but did not necessarily align with what is known about emergency and disaster response systems. Study outcomes supported current recommended practices for inclusive planning with people with disabilities. The study supports the premise that accessibility, programmatic inclusion, and effective communication impact the lived experience of people with disabilities in disasters and warrant additional inquiry. Furthermore, the equitable and valued involvement of people with disabilities and disabilityled organizations is essential in disaster research, policy, and practice that does not leave anyone behind. Research can, and should, be conducted in coordination with disability stakeholders and people with disabilities in order to generate useful and implementable policy and practice information. This inclusive approach should take priority over rigorous academic research methods and standards for principled and practical -considerations.

A harmful untended consequence of the protective public health orders issued during the coronavirus disease 2019 pandemic was an increase in gender-based violence (GBV). This study examined the response of federal, provincial, and territorial governments in Canada to GBV during the peak of the pandemic (between February 2020 and October 2021) through a review of relevant media releases. These documents were then assessed for evidence of effective crisis leadership and compared to established international guidance for addressing GBV in disasters and other humanitarian emergencies. Five major themes emerged from the media review with respect to government communications and actions. First, governments announced funding to organizations working in the domestic violence sector to help support their ability to adapt their services during the pandemic. Second, media releases described efforts undertaken by governments to expand several different types of support services for victims of GBV. Third, governments promoted awareness of the ongoing problem of GBV, as well as its increase during the pandemic. Fourth, government communications acknowledged heightened risk for some populations, including Indigenous women, lesbian, gay, bisexual, transgender, queer, and intersex populations, and those at risk of human trafficking. Fifth, legislative and policy changes were announced by some governments during the pandemic. An analysis of the timing of communications suggests that only the federal government and one third of provinces and territories took early action to address the increase in GBV during the pandemic, which is consistent with international guidance that calls for the use of the precautionary principle. Most of the governments responded to the GBV crisis late or not at all. Although the analysis of media releases alone is insufficient to establish the scope of government actions taken to address GBV during the pandemic, public communication related to ongoing threats is an expected crisis communication competency. This study offers recommendations for practice, which might help address gender inequity in disasters.

Communities, scholars, and federal agencies have noted the increase in frequency and magnitude of hazardous events due to climate change. Emerging evidence suggests that marginalized communities are less likely to recover from a hazardous event when compared to their more advantaged peers, partly due to distrustful or nonexistent relationships with organizations meant to support recovery. These results suggest a need for research to inform governmental and nongovernmental organizations (NGOs) on how best to build trusting relationships for communitiesmost in need.