Maryland Preparedness Study

by P!N guest columnist Dr. Myrtle Evans-Holland
School of Community Health and Policy, Morgan State University, Baltimore, MD

Marginalized groups, the poor, and minorities suffer disproportionately by disasters where inequities are more evident during the response and recovery stages. Moreover, low-income minority populations may experience more inequities because of limited resources needed to lessen the impact of a disaster. Numerous antecedent studies have investigated the effects of disasters on its victims with emphasis on the response, recovery, and reconstruction stages, yet the scientific knowledge about disaster preparedness behavior is limited, particularly the preparedness behaviors of low-income African Americans. To address the limitation, a study was conducted among a sub-sample of low-income African Americans from urban, suburban and rural communities in Maryland by examining the association between perceived preparedness and preparedness behaviors (such as having a family emergency plan (FEP) and having more survival kit items (SKI)) in preparation for natural disasters and terrorism. The study objectives were: 1) to determine the extent to which perceived preparedness contributed to preparedness behavior among low-income African Americans; and 2) to determine if resources such as Internet access caused the association between perceived preparedness and preparedness behavior to vary among low-income African Americans.

Methods
Morgan State University School of Community Health and Policy – 2006 Special Population Public Health Emergency Preparedness Initiative (SPPHEPI) for Undeserved Populations collected data between July 31 and August 30, 2006. All participants who completed the surveys were adults aged >18 and met the criteria for low-income according to the 2006 Health and Human Services Poverty Guidelines. To examine the preparedness behaviors of the target population, data were analyzed from a sub-sample (n = 219) participants.

Results
An independent association between perceived preparedness and having an FEP was found. Likewise, an independent association between perceived preparedness and having more SKI emerged in the analyses. Distinctively, those who perceived preparedness were more likely to have more SKI if they had Internet access. Having Internet access did not cause the association between perceived preparedness and having an FEP to vary. The results of the study demonstrate that perceived preparedness among low-income African Americans with Internet access increases preparedness behavior, suggesting that those with more SKI were more prepared because of their access to the Internet.

Practical Implications
These results can be applied to existing programs and initiatives to re-frame and expand efforts toward personal preparedness. For instance, community-based public health emergency preparedness outreach strategies aimed at low-income African Americans can be augmented by providing use of the Internet to the target population to obtain preparedness information. These findings further support recommendations included in the report, Federal Response to Hurricane Katrina: Lessons Learned, which suggest use of the Internet to increase citizens and community preparedness (Townsend, 2006).

Finding an association of perceived preparedness and preparedness behavior by Internet access is important as reports on Internet access among Americans indicate low-income African Americans earning less than $15,000 are unlikely to have Internet access (USDC, 2000). Furthermore, results of the 2008 PEW Internet and American Life Project showed taking on Internet usage by means of broadband services was lower among those with incomes less than $20,000 per year and among African Americans.

In addition to Internet access, other indicators from this study that can be used to strengthen preparedness programs include the socio-demographic characteristics, and the preparedness behavior evidence of those who are prepared. Those who exemplify preparedness behaviors can be trained as peer educators and assist in educating those who are unprepared. Peer educators may also be useful in training those without Internet access on how to achieve preparedness.

Combined, these findings create opportunities that can be used to affect personal preparedness behaviors among the target population. The identification of Internet access as a significant factor in this association provides information on the type of resources that should be included in educational programs to facilitate preparedness among low-income African Americans who are unprepared. Disaster preparedness programs that provide use of the Internet as a preparedness resource will increase preparedness behaviors, which may ultimately, decrease the disparities often seen in the aftermath of disasters, among low-income African Americans.

About SPPHEPI: The 2006 Special Population Public Health emergency Preparedness Initiative is an initiative within the Why Culture Matters Project, directed by Dr. Randy Rowel, School of Community Health and Policy, Morgan State University. The Why Culture Project informs public health professionals, faith-based and community-based organizations about the needs of vulnerable populations during natural and technological disasters.

Myrtle Evans-Holland completed her doctorate of public health at Morgan State University. She is a research assistant to the Why Culture Matters Project.