Emergency Preparedness and Response: Health and Social Policy Implications for Older Adults

Abstract

Additional efforts are necessary. The Gulf Coast hurricanes of 2005 left more than 1,500 dead and 780,000 displaced persons (Louisiana Recovery Authority, 2006). While these disasters affected individuals across the lifespan, older adults were disproportionately affected by Hurricane Katrina, as other articles in this issue have noted. Most striking, perhaps, is the estimation that 74 percent of hurricane-related deaths were among those 60 years of age and older (Simerman, Ott, and Mellnik, 2005). Older adults were among the most vulnerable post-disaster subgroups because of their lack of connection to resources and supports (Rudowitz, Rowland, and Shartzer, 2006). And, as has also been noted, many survivors have experienced a lasting legacy of ongoing social, economic, and mental health consequences in the wake of the storm. According to Bytheway (2007), the failure to effectively protect older adults during Katrina makes this an unprecedented disaster. In assessing the impact of disasters on older adults, other authors in this issue have stressed that older age alone does not automatically and exclusively make an individual vulnerable or resilient (see also, Fernandez et al., 2002), but that instead, a variety of interconnected disaster-related factors and personal variables increase the vulnerability or resilience of some older adults to disasters. Among the moderating variables thought to be of potential importance to the post-disaster health and well-being of older adults are trauma severity; social, economic, and cultural factors; health and functional status; psychosocial resources and social support; gender; and caregiving status. These variables are important, as they may help us to identify those within the older adult population who may be more vulnerable to the effects of disasters, as well as those who may be able to provide assistance to others in need. Further, these areas warrant additional examination because they have the potential to inform efforts to modify existing disaster preparedness, response, and recovery programs, highlight where additional resources need to be allocated, and indicate how existing policies should be refined. While many policies are in place to help safeguard the health and well-being of the general public, additional policy efforts are necessary to meet the needs of older adults. This article provides a starting point for such a discussion. We draw our implications for improving public policies related to emergency preparedness and recovery for older adults from the empirical literature, practical knowledge obtained from experienced emergency responders, federal and state commissioned reports, and lessons learned from previous disasters. FEDERAL POLICIES Federal policies to address issues of disaster preparedness and response have existed for decades. Among the most important federal policies for the general population as well as for older adults during times of emergency are the Robert T. Stafford Disaster Relief and Emergency Assistance Act (the Stafford Act) and the Older Americans Act. The Robert T. Stafford Disaster Relief and Emergency Assistance Act. The Stafford Act was signed into law in 1974 to allow for federal resources to be released when a disaster overwhelms the capabilities of the state (Beacute;a et al., 2006). When the president declares a federal disaster, the Stafford Act authorizes special federal resources. Among the services funded under the Stafford Act are temporary housing, emergency communications and public transportation, restoration of damaged or destroyed infrastructure, clearing of debris, aid to individuals and families with uninsured needs, and crisis counseling services (Bea et al., 2006; Bea, 2007). One of the programs authorized under the Stafford Act that is particularly important to the mental health of survivors is the Crisis Counseling Assistance and Training Program (CCP). The program is intended to provide crisis counseling services for a period ranging from sixty days to nine months following the disaster (Sundararaman, Lister, and Williams, 2006). …