To evaluate key attributes, strengths, and limitations of the American Red Cross (ARC) disaster-related mortality surveillance system implemented during Hurricane Ike in Texas 2008, and to provide recommendations for system improvement.

We evaluated key attributes of the ARC mortality surveillance system. Evaluation included interviews with stakeholders and linking ARC data with the Texas Department of State Health Services’ (DSHS) system for comparison.

During September 11 through October 6, 2008, the ARC identified 38 deaths, whereas DSHS identified 74 deaths related to Hurricane Ike (sensitivity = 47%; positive predictive value = 92%). The ARC had complete data on 61% to 92% of deaths, and an 83% to 97% concordance was observed between the 2 systems for key variables.

The ARC surveillance system is simple, flexible, and stable. We recommend establishing written guidelines to improve data quality and representativeness. As an important supporting agency in disaster situations and the sole source of data regarding disaster-related mortality in multiple states, improvement of the ARC system will benefit stakeholders and promote dissemination of useful information for preventing future deaths. (Disaster Med Public Health Preparedness. 2013;7:13-19)

To aid emergency response, Centers for Disease Control and Prevention (CDC) researchers monitor unplanned school closures (USCs) by conducting online systematic searches (OSS) to identify relevant publicly available reports. We examined the added utility of analyzing Twitter data to improve USC monitoring.

Georgia public school data were obtained from the National Center for Education Statistics. We identified school and district Twitter accounts with 1 or more tweets ever posted (“active”), and their USC-related tweets in the 2015-16 and 2016-17 school years. CDC researchers provided OSS-identified USC reports. Descriptive statistics, univariate, and multivariable logistic regression were computed.

A majority (1,864/2,299) of Georgia public schools had, or were in a district with, active Twitter accounts in 2017. Among these schools, 638 were identified with USCs in 2015-16 (Twitter only, 222; OSS only, 2015; both, 201) and 981 in 2016-17 (Twitter only, 178; OSS only, 107; both, 696). The marginal benefit of adding Twitter as a data source was an increase in the number of schools identified with USCs by 53% (222/416) in 2015-16 and 22% (178/803) in 2016-17.

Policy-makers may wish to consider the potential value of incorporating Twitter into existing USC monitoring systems.

The effectiveness of local public health systems in emergency management depends on trust from the entire community. However, the failure of some government agencies to respond effectively to several major disasters has had a disproportionate impact on certain groups-racial/ethnic minorities, in particular-that are well-represented in the veteran population. Many veterans belong to multiple vulnerable populations at greater risk of harm during disasters. This study examines confidence that local public health systems will respond fairly to disasters in a diverse sample of US veterans.

This study is an analysis of cross-sectional data on 5955 veterans in the 2009 California Health Interview Survey. Respondents were asked about their confidence that public health systems would respond fairly to their needs in the event of a disaster, regardless of their race/ethnicity or other personal characteristics. Multivariable regression analysis was used to identify variables on respondent characteristics that were independently associated with confidence. The hypothesis was that there would be less confidence in county public health systems among respondents who were racial/ethnic minorities, had less than a college degree, and were of low-income backgrounds.

Approximately 79% of veterans were confident that public health systems would respond fairly. The hypothesis was unsupported, with no differences in confidence by race/ethnicity, education, or income. Also, no differences were noted between men and women or between veterans with and without disabilities. However, confidence was associated with continent of birth, age, homeownership, and marital status.

If confidence affects veterans’ willingness to accept disaster preparedness communications or to give proper consideration to recommended emergency countermeasures, then local health departments that issue such information to veterans are not likely to encounter barriers by race/ethnicity, income, education, disability status, or gender.(Disaster Med Public Health Preparedness. 2013;7:75-81)

Closure of several New York City (NYC) hospitals after Hurricane Sandy caused an unanticipated, extended surge in patient demand at open hospitals. This study identified hospitals with a significant increase in mental-health-related emergency department, inpatient, and outpatient visits from Medicaid patients displaced by Hurricane Sandy.

NYC Medicaid patients were classified into non-mutually-exclusive geographic categories corresponding to residence in areas served by Bellevue Hospital Center and Coney Island Hospital, the hurricane impact area, and all of NYC. For each geographic region, we compared the observed to the expected number of service visits in the 6 months after the storm. The expected number of visits was calculated from 2-year trends in mental health claims.

Twenty-four facilities in all 5 NYC boroughs experienced patient redistribution from storm-affected areas. Eighteen facilities had a concurrent surge in total Medicaid patients, which suggested that redistribution had a greater impact on resource use at these locations.

The redistribution of Medicaid patients after Hurricane Sandy increased mental health service utilization at facilities not near flooded areas. Our findings can aid in surge capacity planning and thereby improve the continuity of mental health care after a natural disaster. (Disaster Med Public Health Preparedness. 2016;10:420–427)

This descriptive study aimed to determine the disaster preparedness of a senior class of undergraduate nursing students.

The study sample was composed of 73 undergraduate nursing school students from Ankara, Turkey. Data were collected by using a questionnaire developed by the researchers and were evaluated with descriptive statistics.

More than half (56.1%) of the students stated that the disaster competencies of nurses should include leadership, manager, and coordinator skills; 42.4% of them indicated the competencies of decision-maker, critical thinking, autonomy, and planning skills. Regarding education, 56.4% of the students considered their education on disaster nursing as “efficient”; however, 35.9% of them considered their education as “partly efficient” or “inefficient.”

Many correct concepts related to the definition, features, competencies, and roles of disaster nurses were stated by students. However, low percentages and insufficient statements showed low preparedness for disasters. Curriculum development or redesign is necessary to include content and clinical experiences related to disasters. (Disaster Med Public Health Preparedness. 2016;10:557–561)

Compliance with college emergency notifications can minimize injury; however, time is often wasted in alert verification. Building on prior research, this study assesses using health-behavior theory to predict rapid compliance to emergency notifications across a range of scenarios and within a diverse college population.

Cross-sectional, student data were collected in 2017-2018 (n = 1529). The Theory of Planned Behavior and Protection Motivation Theory were used to explain intention to comply with emergency notifications in scenarios: robbery, shooter, fire, chemical spill, protest, health emergency, and air quality. Regression models assessed associations between constructs and intention to rapidly comply with each notification.

The most consistent predictors of rapid compliance were attitudes and subjective norms (adjusted odds ratio [AOR]: 1.057-1.118; 95% CI: 1.009-1.168). Scenarios prone to rapid developments such as robbery, shooter, and fire were associated with increased perceived threat and response efficacy (AOR: 1.024-1.082; 95% CI: 1.003-1.132) Slower developing situations such as air quality and health hazards were associated with increased perceived control (AOR: 1.027-1.073; 95% CI: 1.031-1.117).

This study identified attitude and subjective norms as consistent predictors of rapid compliance and improves understanding of additional constructs across scenarios. Campuses may benefit from leveraging concepts from health-behavior theory to provide targeted intervention focusing on factors associated with rapid compliance.

This study aimed at investigating HCWs’ perceptions of PPE compliance and barriers, as well as influencing factors, in order to develop methods to combat the rise in their infection rates.

During the ‘second wave’ surge, a cross-sectional correlational analysis was conducted over a 1-month period. It consists of HCWs from various hospital sectors that admit COVID-19 patients using an online self-administered predesigned tool.

Out of the 285 recruited participants, 36.1% had previously been diagnosed with COVID-19. Around 71% received training on PPE use. The perceived compliance was good for (PPE) usage (mean 2.60 ± 1.10). A significant higher compliance level was correlated with previous diagnosis with COVID-19, working with patients diagnosed with COVID-19, and having a direct contact with a family member older than 45 years old (P < 0.01). The main perceived barriers to the use of PPEs were unavailability of full PPEs (35%), interference with their ability to provide patient care (29%), not enough time to comply with the rigors of PPEs (23.2%) and working in emergency situations (22.5%). With regards to perceived barriers, those working with patients diagnosed with COVID-19 and those who reported having a direct contact with a family member older than 45 years old showed significantly higher level of barriers.

A series of measures, including prioritization of PPE acquisition, training, and monitoring to guarantee appropriate resources for IPC, are necessary to reduce transmission.

The legal environment may improve response willingness among local health department (LHD) workers. We examined whether 3 hypothetical legal protections influence LHD workers’ self-reported response willingness for 4 emergency scenarios and whether specific demographic factors are associated with LHD workers’ response willingness given these legal protections.

Our 2011–2012 survey included questions on demographics and about attitudes and beliefs regarding LHD workers’ willingness to respond to 4 emergency scenarios given specific legal protections (i.e., ensuring priority health care for workers’ families, granting workers access to mental health services, and guaranteeing access to personal protective equipment). Data were collected from 1238 LHD workers in 3 states.

Across scenarios, between 60% and 83% of LHD workers agreed that they would be more willing to respond given the presence of 1 of the 3 hypothetical legal protections. Among the 3 legal protections, a guarantee of personal protective equipment elicited the greatest agreement with improved response willingness.

Specific legal protections augment a majority of LHD workers’ response willingness. Policymakers must, however, balance improved response willingness with other considerations, such as the ethical implications of prioritizing responders over the general public. (Disaster Med Public Health Preparedness. 2015;9:98–102)

Road traffic collisions (RTC) result in a significant number of preventable deaths worldwide. In 2010, the United Nations General Assembly launched, “The Decade of Action for Road Safety (2011–2020)” with the stated goal to “reduce road traffic deaths and injuries by 50% by 2020.” This study aims to analyze trends in RTC numbers and subsequent deaths with respect to road safety laws in Nigeria and to suggest suitable interventions.

Annual reports for the period 2007–2017 were obtained from the Federal Road Safety Corps of Nigeria. These reports were analyzed for trends in RTC, including reported causes, fatalities, injuries, and casualties.

Overall total injuries, casualties, and fatalities increased by 74.7%, 61.2%, and 9.6%, respectively. Analysis showed that the 3 main causes of RTC were speed violation, loss of control, and dangerous driving.

Although current trends do not suggest that Nigeria will accomplish its initial goal of decreasing fatalities by 50% by 2020, there has been a reduction in the number of crashes resulting from dangerous driving. Further interventions such as implementing automated speed monitoring, collaboration, and data sharing between federal and regional agencies, and improving the state of road networks should be implemented to decrease fatalities further.