Evaluation of a community-based emergency preparedness program for medical special needs individuals

The field of public health changed in many ways after the fall of 2001 with the anthrax attacks and the ensuing heightened awareness of vulnerability by the general public. Although the widespread use of biological weapons did not materialize, local health departments found themselves preparing for and responding to many other outbreaks and disasters. As the efforts in preparation and response developed, departments took on new roles and responsibilities in the community. In the State of Texas, responsibility for the non-institutionalized vulnerable populations was assigned to the local health departments. New data gathering and data management systems were developed and refined. New challenges such as West Nile Virus, H1N1 and various hurricanes, among others, tested the systems and found their strong and weak points. ^ In this study, one local health department\u27s data system for registering and planning for the medical special needs population in the community was evaluated by analyzing data collected by the local health department. Two data collection methods were used by the health department. The first was a series of in-person interviews in the home of registered individuals to contrast data points with the existing registry information, which was collected by phone or on a paper or electronic form. Analysis was conducted using descriptive statistics, and an estimate of the statistical significance of differences in regards to emergency planning using McNemar\u27s test. The second data collection was conducting in-depth interviews with members of the vulnerable population to describe their experiences during and after the landfall of Hurricane Ike in 2008. The stories were reviewed and analyzed for common findings that could inform the planning and response activities of the local health department for this vulnerable population. ^ The analysis showed that while the existing registry information collected much detail about each registrant, it is most accurate on objective data that is not open to interpretation. Basic demographic data, including age and weight, are accurately reflected, as is specific medical diagnoses, such as diabetic. Data varied significantly based on methods of collection. The information collected via phone and self-report showed underreporting of needs, especially whether an individual has a plan for emergencies, is dependent on electricity for medical needs, and whether the individual is confined to bed or is sight or hearing impaired. ^ The data gathered from in person interviews can more accurately inform emergency planners about the needs of medical special needs individuals in the community, probably because the interviewer in the home is able to see the patient and their equipment and medication and ask questions based on them, and is able to clarify the meaning of questions,. Planners should incorporate personal interviewing in the home, when possible, to improve planning and response for special needs individuals in the community.