Enablers of Emergency Preparedness for People With Disabilities and Chronic Health Conditions: A Scoping Review

PURPOSE: People with disabilities and chronic health conditions experience inequities in preparing for emergency situations caused by natural hazards, and have support needs that challenge their ability to shelter in place or evaluate to a safe place when an emergency occurs. Current emergency preparedness activities do not address the unique capabilities and support needs of people with disabilities. To support people with disabilities to participate in emergency preparedness activities and be prepared when disaster strikes, it is important to understand what enables people with disabilities and chronic health conditions to be prepared for emergencies caused by natural hazards. The purpose of this study was to compile and synthesize the available literature on what enables people with disabilities and chronic health conditions to prepare for emergency situations caused by natural hazards.

DESIGN: This scoping review sought to gather the available literature on emergency preparedness for people with disabilities across five databases (Scopus, Web of Science, PsycINFO, MEDLINE, CINAHL) using search terms for emergency preparedness and people with disabilities or people with chronic conditions. Inclusion criteria included that the article must be a peer-reviewed publication focused on barriers or enablers to emergency preparedness for community dwelling people with disabilities or chronic health conditions. The authors did not consider quality of reporting due to the scoping nature of the search.

METHOD: The search yielded 3237 studies which were review based on title and abstract. The full text of 171 studies were read, with 73 articles included in the final analysis. Data reduction began with data extraction of ideas related to barriers and enablers to emergency preparedness in each article. Analysis continued with reviewers using tables to group and synthesize similar concepts, and finally reviewers organizing the prominent findings across articles into four themes of knowledge, networks, actions, and advocacy.

RESULTS: To enable emergency preparedness, people with disabilities require knowledge of 1) how to prepare, 2) the natural hazards in their community, and 3) community resources; networks of others to support them in emergency situations; actions they can do to prepare; and advocacy to address unmet support needs. Individuals, organizations (such as home health providers), and communities have differing roles and opportunities to address emergency preparedness. The literature includes few studies contributing the voice and perspective of people with disabilities, and is largely deficit rather than capability focused.

CONCLUSION: The literature predominately focuses on how others can prepare for people with disabilities, rather than what enables people with disabilities to have the capability to prepare for themselves. Occupational therapists can support people with disabilities’ emergency preparedness capabilities through collaborating with the person with disabilities, their families, and carers to: develop an emergency preparedness plan that addresses the person’s capabilities and support needs, consider ways to expand their network in everyday life to increase potential network support in an emergency, and advocate for unmet support needs at the community, organizational, and policy levels. Emergency preparedness is an emerging area of practice for occupational therapists, and will be of increasing importance as the frequency and severity of emergencies caused by natural hazards increases with climate change. To effectively support clients, occupational therapists require tools that support addressing knowledge, networks, actions, and advocacy for emergency preparedness.

References

Wyte-Lake, T., Claver, M., Dalton, S., & Dobalian, A. (2015). Disaster Planning for Home Health Patients and Providers: A Literature Review of Best Practices. Los Angeles, CA: SAGE Publications. https://doi.org/10.1177/1084822314567536

Subramaniam, P., & Villeneuve, M. (2019). Advancing emergency preparedness for people with disabilities and chronic health conditions in the community: A scoping review. Disability and Rehabilitation, DOI: 10.1080/09638288.2019.1583781

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Scaffa, M. E., Gerardi, S., Herzberg, G., & McColl, M. A. (2006). The role of occupational therapy disaster preparedness, response, and recovery. American Journal of Occupational Therapy, 60(6), 642–649. DOI:10.5014/ajot.60.6.642