Date Presented 4/7/2016
People with physical and mental disabilities are significantly less prepared for emergencies than persons without disabilities. Occupational therapy practitioners have an important role in reducing this disparity through training and advocacy for participation at the community level.
Primary Author and Speaker: Diane Smith
RESEARCH QUESTIONS: Is there a significant difference in the emergency preparedness of people with and without disabilities? Has emergency preparedness of people with disabilities changed across time (2006–2012)? What variables increase the likelihood of not being prepared for an emergency for persons with and without disabilities?
RATIONALE: Adequate household emergency preparedness could significantly reduce the negative consequences from disasters and ensure that people can care for themselves and their families (Chou et al., 2004; Diekman, Kearney, O’Neil, & Mack, 2007; World Health Organization, 2013). Assessment of emergency preparedness of people with disabilities is important for occupational therapy practice to determine what approaches may be needed to improve preparedness among these populations.
DESIGN: This study was quantitative, using data from the 2006–2012 Behavioral Risk Factor Surveillance System (BRFSS), a publicly available dataset from the Centers for Disease Control and Prevention (CDC).
PARTICIPANTS: Participants included those who responded to the General Preparedness module of the BRFSS (N = 23,172).Participants were further analyzed by those who identified themselves as having an activity limitation and mental health limitation and/or needed the use of specialized equipment.
METHOD: The BRFSS is a publicly available dataset with data collected on an annual basis through random telephone surveys. Data were imported into an SPSS file for analysis.
ANALYSIS: To determine whether there is a significant difference in the general preparedness of persons with disabilities compared with persons without disabilities, a chi-square analysis was performed for all preparedness variables. To determine what variables increase the likelihood of not being prepared for an emergency, logistic regression was used with general preparedness as the dependent variable. Confounding factors were gender, age, relationship status, race/ethnicity, employment, education, metropolitan area, and poverty level.
RESULTS: People with disabilities are significantly (p < .001) less prepared for emergencies than persons without disabilities. Results of the logistic regression show that those with an activity limitation are 1.24 times as likely to not be prepared for an emergency and those with a severe mental health condition are 1.81 times as likely not to be prepared for an emergency. Increasing age and education are protective against not being prepared for an emergency.
DISCUSSION: Effective occupational therapy intervention includes empowerment of persons with disabilities, including involvement in emergency preparedness planning at the community level and development of an emergency plan at the individual/family level. Additional intervention for persons with mental health disabilities includes resilience training. At the policy level, occupational therapy practitioners can advocate for clients with disabilities to participate in formation of emergency preparedness legislation and training.
IMPACT STATEMENT: This research addresses disparities faced by persons with disabilities with regard to emergency preparedness. As occupational therapy practitioners, this significant environmental concern can influence participation at the very basic level of survival as well as in the community.
References
Chou, Y.-J., Huang, N., Lee, C.-H., Tsai, S.-L., Chen, L.-S., Chang, H.-J. (2004). Who is at risk of death in an earthquake? American Journal of Epidemiology, 160, 688–695. http://dx.doi.org/10.1093/aje/kwh270
Diekman, S. T., Kearney, S. P., O’Neil, M. E., & Mack, K. A. (2007). Qualitative study on homeowners’ emergency preparedness: Experiences, perceptions and practices. Prehospital and Disaster Medicine, 22, 494–501.
World Health Organization. (2013). Guidance note on disability and emergency risk management for health. Geneva: Author.
