Giving a voice to medically vulnerable populations: A mixed‐methods investigation of their unique perceptions and needs in emergency situations

Abstract

Older adults in poor health represent a growing sector of the population worldwide. These medically vulnerable individuals often tend to be ill‐prepared for emergencies. In times of crisis they are at higher risk of experiencing adverse health outcomes and are liable to place an additional burden on health and social care services. The aim of this study was to explore the unique perceptions and diverse needs of community‐dwelling medically vulnerable individuals in Israel in order to gain insights that could be used to promote future preparedness. A mixed methods design was employed that included 16 in‐depth interviews, followed by a quantitative survey of 179 participants. Data were collected between 2016 and 2017. The analysis process included thematic analysis for qualitative data. Quantitative data analysis focused on estimating associations between preparedness levels and participants’ characteristics and perceptions. The results indicated low levels of preparedness—only 13.5% of participants reported having prepared a full emergency kit with supplies. Family members played a key role in almost every dimension related to emergency preparedness; alongside certain authorities perceived by the participants as responsible for initiating the preparedness process. Additional issues that emerged were related to information and communication and to the logistics of medication handling and special nutrition. The findings suggest that it is vital to adopt a proactive approach to the problem of preparedness in this population. This conclusion should be of value to health and social care practitioners in the community as well as to family members and caregivers. Practical and simple recommendations for enhancing preparedness based on these findings are provided. Viewing preparedness as a process that is the joint responsibility of the individual, the family, caregivers, and community health and social welfare services could contribute to maintaining continuity of care among vulnerable populations and mitigate adverse health outcomes in future events.

Chronically unprepared: emergency preparedness status among US medically vulnerable populations

“…Research demonstrates that in the context of disasters, m e d i c a l l y v u l n e r a b l e p o p u l a t i o n s a r e a f f e c t e d incommensurately to other populations (Bethel et al 2011;Shapira et al 2020). These individuals may be "at risk" and require more resources in disaster situations, with chronic health conditions playing a role.…”

“…As the frequency and severity of both natural and David Barbato, Lindsey Bryie, Carolina Maria Carlisle, Padydeh Doroodchi, Patricia Dowbiggin, and Larissa Brunner Huber contributed equally to this work. biological disasters continue to increase annually, adequate emergency preparedness can minimize the impact of these disasters, especially for individuals highly susceptible to harm (Smith and Notaro 2015;O'Sullivan and Phillips 2019;Shapira et al 2020).…”

“…Diminished health status in individuals has been associated with poor outcomes in the event of an emergency, including difficulty accessing emergency services (Shapira et al 2020;O'Sullivan and Phillips 2019;Nick et al 2009). People with chronic health diseases, such as hypertension, diabetes, or asthma, are at an increased risk of adverse health outcomes in the face of natural and biological disasters, and this risk increases exponentially with the severity of the event (Smith and Notaro 2015;Shapira et al 2020). In 2012, it was estimated that nearly half of all adults in the U.S. (117 million people) suffered from at least one chronic disease, and one in four U.S. adults had multiple chronic conditions (Ward et al 2014).…”

“…In 2012, it was estimated that nearly half of all adults in the U.S. (117 million people) suffered from at least one chronic disease, and one in four U.S. adults had multiple chronic conditions (Ward et al 2014). Despite known increased risks of morbidity associated with those chronic conditions, research has not found that individuals with chronic conditions have increased levels of preparedness (Ko et al 2014;Shapira et al 2020). Ko et al (2014) investigated the relationship between chronic diseases and general emergency preparedness in the U.S.…”

“…Emergency preparedness is a common concern among countries with studies comparing responses and programs in order to update and improve their reactions during a crisis (Kruk 2008;Moore et al 2007;Shapira et al 2020). However, despite international interest, the current literature is limited because it does not address the most vulnerable population of individuals who have both chronic disease and disability-i.e., the medically vulnerable.…”