Running head: DIASTER PREPAREDNESS
Disaster Preparedness
Sandra Adrianne Pena
Concordia University
Health Behavior Theory
MPH 515
Dr. K. Brodie
October 23, 2013
1
DIASTER PREPAREDNESS
2
Disaster Preparedness
“Thou shalt be visited by the Lord of hosts with thunder, and with earthquakes and
great noise, with storm and tempest, and the flame of devouring fire” -Isaiah 26:9 (The King
James Bible, Cambridge Edition).
Countless individuals consider Isaiah to be the first documented disaster epidemiologist.
Looking deeper into the word “disaster” it is of Latin origin, like so many other words that are
used in present day literature. “Disaster” is derived from the word astrum, which means star.
“The ancients believed that earthquakes, volcanoes, and the like were mandated by the heavens”
(Zibulewsky, 2001). Disasters can be triggered by the devastating hand-of-man or by natural
causes that no one man can control. Natural disasters are defined as, “an event such as a flood,
earthquake, or hurricane that causes great damage or loss of life” (The Oxford Dictionary, 2013).
Even today, “we do not have much control over these natural disasters, but we do have control
over their effects” (Zibulewsky, 2001). We have control over how prepared we are to deal with
the after effect of disaster, this can be hours or days, but we as individuals can be prepared.
Depending on the part of the United States in which an individual lives the threats of
disaster can, and do vary considerably. Below a map of the United States is shown and the most
common natural disasters that occur in certain areas are highlighted (figure 1.1) these are the
constant threats to the people of the area. As indicated by the map, some areas of the United
States face the threat of more than one natural disaster depending on the weather season or the
time of year. Being as the United States is a vast amount of land it is further broken up into
regions, the five regions are:
DIASTER PREPAREDNESS
3
Figure 1.1
West, Southwest, Midwest, Southeast, and Northeast. The ‘West’ region (Figure 1.2) of The
United States is made up of 11 states including: California, Nevada, Utah, Colorado, Oregon,
Alaska, Hawaii, Washington, Idaho, Montana, and Wyoming.
Figure 1.2
This Region of the country is constantly under threat of disaster and it faces many problems that
include tsunami and volcanos now those occurrences are rare, but the biggest reoccurring
problems facing the west region of the United States are wildfires, flash floods, and devastating
earthquakes.
As many have learned throughout time, natural disasters can occur with little or no
announcement and the consequences of unpreparedness can lead to loss of life, loss of property,
DIASTER PREPAREDNESS
4
financial instability, and in extreme cases even civil duress as there is a potential for breakdown
in access to public services such as water, electricity, and transportation. Focusing on one of the
major disasters facing the west region we look at earthquakes which are defined as, “shaking or
trembling of the earth that is volcanic or tectonic in origin” ("Merriam-Webster," 2013).
Earthquakes are one of the biggest threats because they strike with no warning, All 50 states and
all U.S. territories are vulnerable, but California experiences the most frequent and damaging
earthquakes in the United States. Daily, there are multiple small earthquakes that mostly go
unnoticed and unreported by any news agency, but California has had its share of major
earthquakes that have been incredibly devastating including, ‘The Great 1906 San Francisco
Earthquake’ which resulted in a massive fire and consequently the loss of more than 700 people
and the Sylmar earthquake in 1971.
Since 1971, there has been another memorable earthquake in California. That earthquake
occurred in 1994 and registered a magnitude 6.7, killing 60, injuring more than 7,000 and
damaging more than 40,000 buildings in the Los Angeles area (“Earthquake hazards program,
2012). The Northridge earthquake (figure 1.3, below) is a present day reminder that disasters
happen and they cripple day-to-day life. It is estimated that, “a major earthquake in a highly
populated area of the United States could cause as much as $200 billion in losses” ("Disaster
survival resources," 2103). It is critical to reduce the loss of life and property associated with
natural disasters such as earthquakes. Over the last decade, “China, the United States, the
Philippines, India, and Indonesia constitute the top five countries that are most frequently hit by
natural disasters” (Jasper, 2012). If that information alone is not reason enough to change a
behavior and to promote preparedness there is not much that will.
DIASTER PREPAREDNESS
5
Figure 1.3
A disaster is defined as a, “sudden overwhelming and unforeseen event” while
preparedness is defined as, “activities necessary to build, sustain, and improve readiness
capabilities to prevent, protect against, respond to, and recover from natural or manmade incidents” (The Johns Hopkins and the International Federation of Red Cross and Red
Crescent Societies, 2012). Disaster preparedness is essential at all levels which includes federal,
state, city, and of course individual (family) levels. Preparedness at the individual or family level
is something that has often gone unacknowledged or prepared for as many believe that disaster
will not happen to them or their families or that if something happens they will be able to quickly
and easily recover from it. Many do not consider the potential ramifications of a major disaster
as it may cause shut-downs in key systems that affect everyone’s daily lives such as access to
monetary funds, food, water, and medical supplies, and other key resources such as electricity. It
is essential to change the mindset that has been a way of the past to ensure that there is
sustainability for the future as the incidence of natural and man-made disasters continue to occur
with a frighteningly increasing frequency.
As discussed preparedness is essential for all people to ensure the survival of humanity
should a worst-case scenario mass-disaster occur. Therefore, a particular age, race, or
socioeconomic status (SES) cannot be targeted as a population to specifically increase
preparedness know how or knowledge in, because doing so is essential asking who you would
rather survive, and who deserves to parish if a disaster were to occur. The greatest necessity is
DIASTER PREPAREDNESS
6
changing a behavior in a population that believes disaster cannot happen to them or that they will
be able to supersede the problems that occur secondary to major. In 2011, “332 natural disasters
were registered” (Guha-Sapir, Vos, Below, & Ponserre, 2012). The human and economic
impacts of the disasters in 2011 were massive, “natural disasters killed a total of 30,773 people
worldwide. The economic damages from natural disasters were the highest ever registered, with
an estimated cost of $ 366.1 billion US dollars” (Guha-Sapir et al., 2012).
To determine how far a population needs to go with preparedness education one needs
to first identify the, “circumstances under which people have prepared, and assesses the extent to
which respondents' overall perceptions of preparedness match their reports of preparedness
activities” (Russell, Goltz, & Bourque, 1995). It is also important to determine, a population’s
access to information regarding potential and current disasters/pandemics. “Data revealed that
public health emergency information was present on nearly all (96%) of the sites examined”
(Tanner, Friedman, Barr, & Koskan, 2008). This information can then be applied to the use of
the Health Belief Model (HBM) for increasing disaster preparedness at the family (individual)
level.
Through the use of The The HBM is very versatile and can be beneficial when discussing
disaster preparedness because it can be applied to encourage individuals to change a potentially
detrimental behavior. The HBM is predicated on the basis that, “behavior change will occur only
when sufficient benefits remain after subtracting the costs incurred by preforming the behavior”
(DiClemente, Salazar, & Crosby, 2013). In this particular situation, that behavior is an
intentional or unintentional lack of knowledge and preparedness for imminent occurrence of
natural disaster. The ultimate goal of the use of the HBM is to educated individuals to prepare
themselves for disaster for relatively little monetary cost directing individuals to the numerous
DIASTER PREPAREDNESS
7
resources that are available oftentimes for free through governmental sites such as ready.gov.
Below (figure 1.3) is an example of the HBM specifically applied to disaster preparedness:
C. Modifying factors:
Knowledge
E. Benefits of being
prepared
A. Perceived severity
of disaster
D. Level of perceived
threat imposed when
thinking about disaster
F. Likelihood of changing
previous behaviors and
becoming prepared for
potential disaster.
B. Perceived
susceptibility of
experiencing a disaster
G. Cues to action for
preparedness for disaster
Figure 1.4
To further understand the HBM it is essential to understand the individual constructs that make
this model one that has been trusted and relied upon for the last 50 years to explain and
understand behavior. Letters ‘D’ and ‘E’ highlighted in figure 1.4 (above) are the two main
constructs of this model are letter ‘D’: perceived threat and letter ‘E’ expected benefit are the
independent influences on health behavior. Ultimately individuals want to maximize benefits
while minimizing cost. ‘A’ and ‘B’ are perceived threats, consequences of unpreparedness while
‘A’ is perceived severity, ‘B’ perceived susceptibility, and ‘C’ is modifying factor(s).
(DiClemente et al., 2013).
A & B - are oftentimes thought to be repetitive, when they are actually quite different.
B - one should ask themselves how likely am I to experience a natural disaster such as an
earthquake.
C - likely influence on the expected net gain (from preparedness)
DIASTER PREPAREDNESS
8
“The HBM suggests that this combined construct of perceived threat directly influences the
likelihood of engaging in protective behaviors, however the HBM also suggest that perceived
threat may be moderated by a host of factors such as age, race, and SES” (DiClemente et al.,
2013).
To put it briefly, preparedness is essential and use of the HBM can encourage individuals
and families to promote positive habit such as being prepared in a worst-case scenario and that
preparedness can be as simple as creating a ‘go-bag’ that has a minimum of three-days’ worth of
clothes, food, and water per family member. Special items that should be included in go-bags are
prescription medications and important documents such as photo identification and birth
certificates. These kits are recommended incase help is unable to immediately reach you or your
family during an emergency. It must be considered that realistically in a mass disaster situation
where there could be hundreds of individuals hurt help may not be available for days or longer.
With adequate preparation additional stress of a mass-disaster can be avoid allowing time to
focus on other issues as they arise.
DIASTER PREPAREDNESS
9
References
DiClemente, R. J., Salazar, L. F., & Crosby, R. A. (2013). Health Behavior Theory for Public
Health . Burlington, MA: .
Earthquake. (2103). Retrieved from http://www.disaster-survival-resources.com/earthquake.html
Earthquake definition. (2013). Retrieved from http://www.merriam-webster.com/dictionary
/earthquake
Guha-Sapir, D., Vos, F., Below, R., & Ponserre, S. (2012). Annual disaster statistical review
2011 The numbers and trends . Retrieved from
http://reliefweb.int/sites/reliefweb.int/files/resources/2012.07.05.ADSR_2011.pdf
Historic Earthquakes. (2012). Retrieved from
http://earthquake.usgs.gov/earthquakes/states/events/1994_01_17.php
Jasper, T. (2012). EM defined: Preparedness vs. readiness. Retrieved from
http://toddjasper.com/2012/02/19/em-defined-preparedness-vs-resdiness/
Russell, L. A., Goltz, J. D., & Bourque, L. B. (1995). Preparedness and hazard mitigation actions
before and after two earthquakes . Environment & Behavior, 27(6).
http://dx.doi.org/10.1177/0013916595276002
Tanner, A., Friedman, D. B., Barr, D., & Koskan, A. (2008, October). Preparing for disaster: An
examination of public health emergency information on local TV web sites. Sage
Publications, 2(4). http://dx.doi.org/10.1080/19312430802453953
The Johns Hopkins and the International Federation of Red Cross and Red Crescent Societies.
(2012). Public health guide for emergencies . Retrieved from http://www.jhsph.edu
/research/centers-and-institutes/center-for-refugee-and-disaster-response/publications
DIASTER PREPAREDNESS
10
_tools/publications/_CRDR_ICRC_Public_Health_Guide_Book/Chapter_1_Disaster_Def
initions.pdf
The Oxford Dictionary. (2013). Natural Disaster. In The Oxford Dictionary. Retrieved from
http://www.oxforddictionaries.com/us/definition/american_english/natural-disaster
Travel & geography: The regions of the United States . (2013). Retrieved from
http://usinfo.org/enus/life/geotravel/usa.usembassy.de/travel-regions.html
Zibulewsky, J. (2001). Defining disaster: The emergency department perspective. Retrieved from
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1291330/