Stories after disaster survival: Preparing, heeding warnings, and self-reliance.

OBJECTIVE: The purpose of the study was to examine the content of stories told by people personally impacted by disasters. DESIGN: Semistructured, qualitative interviews. SETTING: Northwest part of a mid-south state. PARTICIPANTS: Fourteen disaster survivors who were recruited through their attendance at an emergency preparedness-related fair. MAIN OUTCOME MEASURES: Interview schedule based on previous research using the family resilience framework. RESULTS: Three themes emerged: prior emergency preparation, heeding warnings of impending disaster, and rural self-reliance. CONCLUSIONS: Participants had made prior emergency preparedness plans, but their personal experiences led to them adjusting their plans, or making more relevant plans for future disasters. Participants expressed the importance of sharing their experiences with family and community members, expressing hope that others would learn, vicariously rather than first-hand, from their experiences.

Emergency Preparedness of Persons Over 50 Years Old: Further Results From the Health and Retirement Study.

OBJECTIVE: This article conceptualized emergency preparedness as a complex, multidimensional construct and empirically examined an array of sociodemographic, motivation, and barrier variables as predictors of levels of emergency preparedness. METHODS: The authors used the 2010 wave of the Health and Retirement Study's emergency preparedness module to focus on persons 50 years old and older in the United States by use of logistic regression models and reconsidered a previous analysis. RESULTS: The models demonstrated 3 key findings: (1) a lack of preparedness is widespread across virtually all sociodemographic variables and regions of the country; (2) an authoritative voice, in the role of health care personnel, was a strong predictor of preparedness; and (3) previous experience in helping others in a disaster predisposes individuals to be better prepared. Analyses also suggest the need for caution in creating simple summative indexes and the need for further research into appropriate measures of preparedness. CONCLUSION: This population of older persons was generally not well prepared for emergencies, and this lack of preparedness was widespread across social, demographic, and economic groups in the United States. Findings with implications for policy and outreach include the importance of health care providers discussing preparedness and the use of experienced peers for outreach. (Disaster Med Public Health Preparedness. 2017;11:80-89).

Attenuation of racial differences in health service utilization patterns for previously uninsured children in the Delta.

CONTEXT: A school-based health insurance program for children of the working poor was conducted in 2 isolated, rural communities in the Lower Mississippi Delta region. The larger of the 2 communities had an array of locally available health care providers, whereas the smaller community did not. In response to this lack of available care, the project designed and delivered outreach programs, including transportation to providers. PURPOSE: The purpose of this paper is to examine the role of race, age, and gender in the relationships between the utilization of care and the impact of outreach programs. METHOD: General estimating equation models are used to examine the response of utilization variables to race, age, gender, and community. Four years of insurance claims data are analyzed. FINDINGS: Race is seen to be an important component of utilization. The majority of participants were African American; however, children receiving prescription services, emergency room care, routine physician visits, and hospital outpatient services were more likely to be white. Outreach programs in vision and dental services were found to eliminate racial differences and increase utilization. A relatively strong gender effect was found in prescription, wellness, vision, and dental services. CONCLUSIONS: Previous research has shown differences by race in utilization of care. Our findings show that targeted outreach programs can significantly diminish these differences. Findings also suggest that barriers to health care for poor rural children are closely linked to transportation and availability of providers, not merely to cost of care or insurance.