An Evaluation of Select Seattle Emergency and Disaster Preparedness - - PowerPoint PPT Presentation

An Evaluation of Select Seattle Emergency and Disaster Preparedness Education Programs

By Rudy Owens, MA & MPHc UW School of Public Health (c/o 2012)

Background to Research Project with the Seattle Office of Emergency Management

• Capstone research project for UW School of Public

Health/Community Oriented Public Health Practice (COPHP) program requirements

• “Equity lens” (COPHP program focus)
• Goal: Partner with a local agency/organization
• Goal: “To contribute to solving a community

health problem in a meaningful, effective, and culturally competent fashion … .”

Primary Research Questions Addressed in Survey for OEM

1: Who attends SNAP and disaster supply kit classes (demographic data);

• 2. What do they know about emergency and

disaster preparedness (8 questions);

• 3. How prepared are attendees, how do they learn

about preparedness, and who do they trust for preparedness information.

Other Research Goals

1: Develop best practices for communicating emergency and disaster preparedness information (literature review, key informant interviews of emergency planners) 2: Compare survey results against results of key informants interviews (focus: how well are planners reaching vulnerable Seattle residents) 3: Share report with the OEM with recommendations to improve education/outreach to all residents, including vulnerable populations*

*16 groups as defined by VPAT/Public Health-Seattle & King County

Research Methods & Timeline

• July 2011: Agreement with OEM
• Aug. 2011: Approval UW Human Subjects Division (institutional review

board, or IRB)

• Sept.-Nov. 2011: Survey given at 7 SNAP/supply kit classes
• Sept.-Oct. 2011: Interviews with 8 key informants
• Oct.-Nov. 2011: Code & analyze data
• Nov. 2011-Jan. 2012: Prepare capstone and reports for OEM/UW

School of Public Health (SPH)

• Jan. 2012: 2 reports shared with OEM

So, What Do We Know?

International District, Seattle, immediately after Nisqually Delta Earthquake, March 2001.

• The United States has sustained 112 weather/climate

related disasters over the past three decades in which total damages/costs reached or exceeded $1 billion.

• The total losses for the 112 events exceed $750

billion (in 2011 dollars).

• This is not counting earthquakes or manmade

disasters/incidents

Source: NOAA, 2011

The Bad News – Disasters Happen Frequently, and They Are Very, Very Costly in Dollars and Lives:

Source: NOAA, 2010

1980 1983 1985 1986 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003

1980-2010 Billion Dollar U.S. Weather/Climate Disasters

(Damage Amounts in Billions of Dollars and Costs Normalized to 2007 Dollars Using GNP Inflation / Wealth Index)

< 5 5-20 20-30 30-40 > 40 Amounts in Billions of Dollars

2004

2005

e = estimated > = greater than/at least * = undetermined ~ = approximately/about

2006

2007

Source: NOAA’s National Climatic Data Center Asheville, NC 28801-5001 www.ncdc.noaa.gov/oa/reports/billionz.html

2008

2009

2010

The most deadly weather & climate disaster in the last 3 decades was the 1980 heat wave:

• $55 billion

damage (3rd costliest)

• Estimated 10,000

deaths (disputed by other sources)

Source: NOAA, 2011

Terrorism: Threat Real in PNW, Harder to Measure

• Difficult to quantify/describe "terrorist" attacks:
• Depends who is counting--FBI, advocacy groups, left/right-leaning foundations.
• How to count firearm-related violence?
• Southern Poverty Law Center estimate:
• 30 plots/attacks by “jihadists" on U.S. soil since 2002
• 100+ terrorist plots/attacks by right wing extremists since 1995.

Some High Profile Domestic Incidents (excluding flights attacked heading to USA) (sources vary, most major media accounts)

• 1995: Oklahoma City: 168 dead
• 1996: Olympic bombing, Atlanta: 1 dead, 100+ wounded
• 1999: Failed millennial bomb plot, Seattle (no casualties)
• 2001: 9/11 attacks, total dead and missing numbered 2,992 (all venues)
• 2001: Fort Dix shootings, 4 dead
• 2007: Virginia Tech shootings, 33 dead (may not be classified as terrorism)
• 2009: Fort Hood shootings, 13 dead

Earthquake Fatalities Since 1964 (Less Deadly Than Heat/Weather)

Earthquake date Name Fatalities 1964 03 28 Prince William Sound, Alaska* 128 1965 04 29 Seattle, Washington 7 1969 10 02 Santa Rosa, California 1 1971 02 09 San Fernando, California 65 1975 11 29 Hawaii Island, Hawaii 2 1983 10 28 Borah Peak, Idaho 2 1987 10 01 Los Angeles-Whittier, Cailfornia 8 1987 10 04 Los Angeles-Whittier, California 1 1989 08 08 Santa Cruz County, California 1 1989 10 18 Santa Cruz County, California 63 1991 06 28 Southern California 2 1992 06 28 Landers, California 3 1993 09 21 Klamath Falls, Oregon 2 1994 01 17 Northridge, California 60 1995 02 03 Wyoming 1 2003 12 22 Central California 2 *Tsunami: 98 Alaska, 11 California, 4 Oregon. Earthquake: 15 Alaska. Source: U.S. Geological Service, 2012

Disasters Tend to Impact Vulnerable Populations the Most

• One study after the 1980 heat wave noted,

“Public health preventive measures in future heat waves should be directed toward the urban poor, the elderly, and persons of other-than- white races.” (all “vulnerable populations”)*

• Has anything changed in 30 years?

*Jones et al., 1982

The Good News:

• The worst disasters occur mostly in the

“hottest” parts of the country.

• The PNW, though at risk of a major

earthquake, has escaped the most deadly natural incidents, most heat/climate related.

Source: NOAA, 2011

However, Disasters Occur Frequently in the PNW

YEAR DATE INCIDENT DESCRIPTION

• 2011 03/25

Severe Winter Storm, Flooding, Landslides, and Mudslides

• 2009 03/02

Severe Winter Storm and Record and Near Record Snow

• 2009 01/30

Severe Winter Storm, Landslides, Mudslides, and Flooding

• 2007 12/08

Severe Storms, Flooding, Landslides, and Mudslides

• 2007 02/14

Severe Winter Storm, Landslides, and Mudslides

• 2006 12/12

Severe Storms, Flooding, Landslides, and Mudslide*

• 2006 05/17

Severe Storms, Flooding, Tidal Surge, Landslides, and Mudslides

• 2003 11/07

Severe Storms and Flooding

• 2001 03/01

Earthquake

• 1998 10/16

Landslide In The City Of Kelso

• 1998 10/05

Flooding

• 1997 07/21

Snowmelt/Flooding

• 1997 04/02

Severe Storms/Flooding/Landslides/Mudslides

• 1997 01/17

Severe Winter Storms/Flooding

• 1997 01/07

Ice and Snow Storms

• 1996 02/09

Severe Storms/Flooding

Disaster declarations in WA state; severe storms were involved in 4 in 5 disaster declarations (most severe in red)

*December 2006 storm linked to 4 deaths (CO inhalation), 70 hospitalized CO poisoning.

Who Is Most At Risk?

• Disasters disproportionately

experienced by ethnic minorities and people with low socioeconomic

• status. (Rowell et al., 2011)
• Disaster-connected deaths occur in

disproportionately higher number among minorities. (Rowell et al., 2011)

• Minorities have worse health
• utcomes before and during

disasters compared to other groups, regardless of the disaster. (Lachlan and Spence, 2007)

African American residents of New Orleans following Hurricane Katrina (Photo, AP, 2005)

What Could Happen in Seattle?

• Major subduction zone earthquake could result in

1,000 casualties. Less severe risks: terrorism, major storms, flooding, other hazards.

• Many Seattle residents “could be extremely

vulnerable in the event of a serious disaster–the elderly, children, people with mental and physical disabilities, and those who are limited or non- English speakers.”

• By day 3 of a disaster, vulnerable groups would

experience “serious difficulties.”

Source: Seattle All-Hazards Mitigation Plan, 2009

Seattle’s Vulnerable Populations

• 120,000 persons can be classified as

vulnerable.*

• VPAT classifies 16 groups as vulnerable

(children, elderly, limited-English speakers, mentally ill, sight/hearing deficient, more).

• Examples: 46,000 students, 791 licensed day

care facilities, 35 nursing homes, 64,000+ residents living at or below the national poverty level.**

*Seattle Regional Development and Sustainability Committee, 2011 **Seattle Disaster Readiness and Response Plan, Vol. 1 , 2007

OEM Programs Preparing All Residents for Disasters/Emergencies

• Goal: Residents take care of themselves and their families for

at least 3 days.

• SNAP and earthquake supply kit and other general courses

target general population.

• Preparedness classes reach other groups like limited-English

proficient speakers.

• Materials in 19 languages.
• In 2011, 3 OEM instructors reached nearly 10,350 residents

(more than 3,500 “vulnerable”).*

*Source, Personal communication, OEM, December 2011

What Did the Survey of SNAP/ Disaster Supply Kit Classes Find?

• Valid surveys returned, n=94
• Typical attendee: middle-aged or older, white or Asian, college

educated, household income above $35,000 a year.

• Mean age: 52 years.
• Nearly two-thirds (61%) 45 years of age and older.
• Women outnumbered men at OEM courses by a more than

2-1 margin (69% vs. 31%).

• Young people (18-24 years of age) under-represented (1%)

Race/ Ethnicity Survey Respondents (%) City of Seattle (%) White 76.3 69.5 Asian American 19.4 13.8 African American 2.2 7.9 Hispanic/ Latino 1.1 6.6 Multiracial 1.1 5.1 Hawaiian- Pacific Islander 0.4 American Indian/AK Native 0.8

10 20 30 40 50 60 70 80

Survey Respondents (%) City of Seattle (%) Race/Ethnicity of Respondents and City

• f Seattle (2010 Census Estimate), N=94

Race/Ethnicity of Survey Respondents

• vs. City of Seattle (2010 Estimate)

Education and Income Levels of Respondents

Education Levels Percentage High school

• r less

9.6 Some college/ trade school 17.0 College degree 39.4 Advanced degree 34.0

5 10 15 20 25 30 35 40 45 50 High school

• r less

Some college/ trade school College degree Advanced degree

Education Level of Respondents (N=94)

Percentage

Household Income Levels Percentage $0 to $24,999 16.4 $25,000 to $49,999 22.3 $50,000 to $99,999 40.0 $100,000 or more 21.2

5 10 15 20 25 30 35 40 45 50 0 to $24,999 $25,000 to $49,999 $50,000 to $99,999 $100,000

• r more

Income Level of Respondents (N=94)

Percentage

Knowledge of emergency and disaster preparedness - high

Positives:

• Seen, read, or heard preparedness messages in last 30

days: 79%

• In last year, prepared or resupplied a disaster supply

kit at home: 52% Problems(?):

• In last year, made/updated family plan to reunite:

21%

• Practiced or drilled at home in last year: 12%

Respondents Are Ready at Home for an Emergency/Disaster:

10 20 30 40 50 60 70 80 90 100

Flashlight Hygiene items Extra clothes/shoes Extra batteries Food (3 days) Extra blankets First aid kit Fire extinguisher Fire alarm Battery/crank radio Water (3 days) Extra cash CO2 detector

• Emerg. contact info

To-go bag

Disaster and Emergency Supplies in Respondents’ Homes (%) Percentage

• Sample size too small to conclude higher-

income residents are more prepared.

• However, survey sample (n=85) shows

they likely are.

10 20 30 40 50 60 70 80 90 100

Not Well Prepared (0-5 Items) (N=13) Somewhat/Moderately Prepared (6-10 Items)(N=32) Well Prepared (11-15 Items)(N=49)

% Households by Number of Disaster Supplies at Home: 0-5 Items; 6-10 Items; 11-15 Items Not Well Prepared Somewhat / Moderately Prepared Well Prepared (0-5 items) (6-10 items) (11-15 items) N=5 N=10 N=7 22.70% 45.50% 31.80% N=2 N=11 N=18 6.50% 35.50% 58.10% N=5 N=9 N=18 15.60% 28.10% 56.30% Number of disaster and emergency supplies in respondents’ homes (N=85*) Low-Moderate Income, $0-$34,999 Middle Income, $35,000-$74,999 Upper Income, $75,000 and Higher

How Do They Learn About Preparedness?

20 40 60 80 SNAP Seattle OEM TV/radio Friends/relatives Flyer (utility/insurance co.) Other Internet source Workplace or employer Newspapers/news web sites Professional training Other gov't communication Schools/colleges/universities Other Magazines

How Respondents Learned About Preparedness (%)

Percentage

• Many respondents likely

are receiving information

• nline.
• OEM/SNAP program

successfully motivating attendees to come to 1 of the 2 courses.

• Confirms research that

TV/radio are effective means of communication.

Who Do Respondents Trust for Preparedness Messaging?

• Emergency

responders (police, firefighters, EMS) – very high trust

• American Red

Cross employees – high trust

Who Do Respondents Not Trust for Preparedness Messaging?

• Federal

government employees - medium/low trust

• Elected officials –

very low trust

Trust Levels in Emergency Preparedness Messengers; 1-10 Likert Scale: 1 Least trustworthy, 10 Most trustworthy

Messenger N* Mean Mode Emergency responders—police, firefighters, EMS 81 9 10 American Red Cross employees 77 8.1 8 Local government employees 78 6.6 7 Survivors of disasters or emergencies 75 6.5 8 State government employees 74 6.1 7 Social service agency employees 75 5.9 7 Community leaders 74 5.9 5 TV/radio reporters 77 5.5 5 Federal government employees 75 5.1 5 Elected officials 73 4 1 Respondents' trust levels in messengers for emergency and disaster preparedness information (N=94)

*All other cases missing

High to Medium Trust Messengers

Medium Trust Messengers

Low Trust Messengers

Key Informant Interview Results

1. Disaster preparedness planning model (kits, plan, be prepared) may not work for many vulnerable residents and many in the general population. “Most people would say that doesn’t apply to me. I barely have enough food day to day. … They’ll say, oh this is something for rich people.” “It’s relatively uncommon for individuals to have well- defined disaster plans and well defined kits together. … It’s unrealistic to assume the entire population will have a kit and have a plan. That doesn’t mean it’s impossible to get the community ready for disaster.”

• 2. Some populations will be more vulnerable in an

emergency and disaster (concern expressed over persons with mental health issues). “What I hear frequently from people … is they can’t get a reserve of medications.” “Someone who is really struggling in the day to day … in the triage of the to-do list for the day, preparing for the future sometimes is a little challenging to do.”

• 3. Television, radio, the Internet, and visual

materials are effective communications tools. City of Seattle gets mostly high marks (not always though) translating materials to different languages and educating vulnerable groups. “I don’t know how well it’s working. I see a lot

• f efforts especially to provide information to

people who aren’t English speaking. I don’t know if people are responding to them.”

• 4. Planners favor working with community-based
• rganizations (CBOs) to reach vulnerable

groups; community resiliency considered an

• asset. Trust issues can be overcome by training

the trainer.

“The people from the community have the trust in the community. They have the language and

• culture. Those barriers are

eliminated.” “Peer-led meetings are more effective than any of the ones I’ve ever done. They define what they want to do and how they want to do it.”

• 5. Disaster Preparedness is a difficult topic for

individuals and the public to embrace. More research is needed to know what does and does not work. “Whether those messages are connecting with people, and they’re taking action, that’s our golden question we are striving to get.” “The key to this right now is, how can we communicate this in a way that’s more

• effective. … That’s something I have not been

able to figure out. … There’s a lot more we can be doing.”

Planning With Community

• Vision from the ‘Top’: FEMA Chief Craig

Fugate: “Plan for who we serve, not who fits our plans” & focus on community planning/ engagement.*

*Source, “The Hill,” 2011. **Klaiman et al., 2010: “Locating and Communicating With At-Risk Populations About Emergency Preparedness: The Vulnerable Populations Outreach Model”

• Vision from the

‘Bottom’: Grassroots/CBO

• utreach model**

A Few Barriers/Problems

• OEM has limited resources—staff of 12, $1.2 million annual budget

(much federal grants)—to prepare a city of 608,000 persons for multiple disasters.

• 3 OEM staff handle public education/programming for the city.
• How well does "inclusive planning” work – now underway with

public meetings in to solicit public’s ideas on Seattle’s Disaster Readiness and Response Plan.

• Disconnect between local/federal priorities (funding tied to

bioterrorism planning).

• High levels of mistrust for government, particularly among

vulnerable populations, hard for any one agency to overcome.

What’s Working Well/Opportunities

• OEM has strong focus on educating vulnerable populations and inclusive

planning.

• OEM collaborates well with partners (VPAT, Vulnerable Populations System

Coordination Steering Committee).

• OEM communicates visually/in many languages and uses CBO-outreach

model to engage vulnerable groups.

• More research needed to determine what messaging works well with all

populations (opportunity to duplicate 2004 survey by Hebert Research).

• Continuous evaluation can improve outreach (surveys, focus groups for

populations not attending SNAP meetings).

• Education/communications strategies should implement methods and

channels identified by VPAT’s 2010 research on H1N1 vaccine outreach

Parting Words:

"Adequate planning will go far to minimize the extent to which [vulnerable] groups suffer disproportionately and experience devastating outcomes. Responsible emergency preparedness and response efforts are critical to preventing disasters from ending or ravaging the lives of society’s disadvantaged members.”

Sharona Hoffman Senior Associate Dean for Academic Affairs Co-Director of Law-Medicine Center Professor of Law, and Professor of Bioethics Case Western Reserve University School of Law in Cleveland, Ohio

Thank You. Questions?

Rudy Owens rsdowens@uw.edu www.rudyfoto.com