Monday, April 27, 2020

Factors associated with disaster preparedness among US households


Association of US Households’ Disaster Preparedness With Socioeconomic Characteristics, Composition, and Region

JAMA Netw Open. 2020;3(4):e206881. doi:10.1001/jamanetworkopen.2020.6881
Key Points Español  中文 (Chinese)
Question  What characteristics are associated with resource- and action-based disaster preparedness among US households?
Findings  In this cross-sectional study using nationally representative survey data from 16 725 US households, 68.9% of households fulfilled at least half of recommended preparedness items, but households were more likely to fulfill resource- than action-based items. Fulfillment of specific resource- or action-based items differed substantially by household characteristics.
Meaning  These findings suggest that because households may treat preparedness items differently, targeted strategies are needed to promote preparedness across communities, and risk communication should emphasize the importance of both resource- and action-based preparedness.

Abstract
Importance  Since the terrorist attacks on September 11, 2001, the US government has promoted household disaster preparedness, but preparedness remains low.
Objective  To identify disparities in disaster preparedness among US households.
Design, Setting, and Participants  This cross-sectional study used data from a nationally representative sample of US households from the 2017 American Housing Survey’s topical section on preparedness to assess associations of disaster preparedness with households’ socioeconomic characteristics, composition, and region. Logistic regressions were used to assess associations of household characteristics with overall preparedness, resource- and action-based preparedness, and specific preparedness items. Data analyses were completed on March 27, 2020.
Exposures  Combined household income, head of household’s education level, race/ethnicity, marital status of head of household, head of household aged 65 years or older, presence of children or a household member with a disability, and region.
Main Outcomes and Measures  Nine actionable preparedness items, such as having an emergency carry-on kit (resource), food and water stockpiles (resource), and alternative communication plans and meeting locations (action). Items were summed for the measures of overall, resource-based, and action-based preparedness, with preparedness defined as meeting at least half of the criteria.
Results  Among 16 725 included households, 9103 household heads were men (54.4%), 11 687 were married (69.9%), and 10 749 (66.1%) had some college education or higher. In all, 1969 household heads (11.8%) were black, while 2696 were Hispanic/Latino (16.1%); 3579 household heads (21.4%) were 65 years or older. A total of 7163 households (42.8%) included children, and 3533 households (21.2%) included a person with a disability. Households were more likely to fulfill at least half of the criteria for resource-based preparedness (10 950 households [65.5%]) than for action-based preparedness (6876 households [41.1%]). Wealthy households and those with household heads aged 65 years or older were more likely to fulfill at least half of resource-based items (wealthy households: adjusted odds ratio [aOR] by logged income, 1.18 [95% CI, 1.13-1.22]; household heads age ≥65 years: aOR, 1.42 [95% CI, 1.29-1.55) but less likely to fulfill action-based items (wealthy households: aOR: 0.96 [95% CI, 0.93-0.99]; household heads age ≥65 years: aOR, 0.92 [95% CI, 0.84-0.99]). Households with black household heads were more likely to fulfill items directly related to emergencies (carry-on emergency kit: aOR, 1.26 [95% CI, 1.14-1.39]; alternative communication plan: aOR, 1.55 [95% CI, 1.39-1.72]; alternative meeting location: aOR, 1.18 [95% CI, 1.07-1.31]) but less likely to fulfill resource-based items (at least half of resource items: aOR, 0.89 [95% CI, 0.80-0.99]).
Conclusions and Relevance  These findings suggest that types of preparedness vary by household characteristics. Targeted strategies are needed to promote preparedness across communities.
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