Transcript of Get Ready Report Podcast, episode 42: Working with minority communities to prepare for disasters

This is the Get Ready Report, coming to you from Washington, D.C. In this episode, we interview Nicole Lurie, assistant secretary for preparedness and response at the U.S. Department of Health and Human Services. Lurie spoke with Get Ready team member Daniel Greenberg.

Dr. Lurie, thanks so much for joining us.

It’s a pleasure.

You know, it’s National Minority Health Month, almost National Public Health Week, we got a lot of stuff to talk about. First off, I wanted to ask you, your responsibility is to help the U.S. prepare for and respond to and recover from public health threats, usually large ones. What threats are top of mind right now in your office?

Well, you know, every disaster has the potential to impact health. And in many ways, disaster preparedness is one of the ultimate forms of prevention. It’s ways to keep people healthy and it has a direct payoff in making sure that people can stay healthy in the face of a disaster. So there are all kinds of things at the top of my list. First of all, our office was formed to deal with threats caused by bioterrorism. So it could be anthrax, or smallpox, or a nerve agent, or an improvised nuclear device, or a newly emerging disease that has nothing to do with bioterrorism but only has to do with mother nature. And we’ve certainly seen a lot of those, whether it was H1N1 influenza, or whether it was Ebola. It’s also the case that Mother Nature deals us all kinds of weather events. We’re coming into tornado season, after that it will be hurricane season, and bad ones of any of those also cause a lot of illness, and often death and destruction.

You mention H1N1…and with Hurricane Katrina 10 years ago, it’s a good time to ask. Because it’s also timely that April is National Minority Health Month and you’ve said that it’s the perfect time to take action through preparedness and response. And emergencies like H1N1 and Hurricane Katrina made the case. So why is preparedness and response particularly important for minority communities?

Well, I think our focus on minority health has taught us a lot about how to improve community resilience. The first thing I would say is that populations that are poorer, populations that are less educated, or underserved in some way, or just live in crummier infrastructure are often the hardest hit during disasters. And those populations are, more often than not, likely to be racial and ethnic minority populations. Dealing with these emergency situations there’s often a lot of mistrust in the community, there are populations, there are populations that are overlooked, sometimes the mainstream responder community doesn’t speak the language of the community, or understand their cultural or linguistic needs. By the same token, minority populations are often more resilient than other populations. There are often very close social connections and ties in a community and those social connections are one of the most important things to promote community resilience and personal resilience. We saw that during Hurricane Katrina, where it was really a Vietnamese population that was the first back up on its feet and recovered quickly and did very well in the long run. It’s also the case in minority communities that their youth, their children, are a particular asset in part because many times their children, their youth, are the only English speakers in their community and they are able to intergenerationally connect to families and extended families in some really important ways. And so, in those communities, youth and people who are on social media and can use those connections are also really, really important.

In my office, we’ve made a huge effort over the past couple of years to get to the point where we, as I like to say, can circle an area on a map and know who lives there. And so, that means we know whether we have a lot of children or older people. It also means knowing whether we have people who speak languages other than English so that we can get to them quickly. And that if we have to send responders we can send responders that speak their language and understand the cultural issues and cultural needs of those communities. So this juxtaposition of Preparedness Month and your Get Ready campaign with Minority Health Month is very fortuitous.

You talk about innovations and social media and another one I wanted to mention, which you brought up in a CDC Public Health Grand Rounds, was a device that your office was creating called Raspberry Pi. So I was interested in what this is and how it relates to preparedness?

Great question. Well, first of all, let me correct you a little bit. The Raspberry Pi is like a card-sized micro-computer that people can program. Okay, it’s tiny, it’s easily programmable, it connects to a keyboard, and people all over the country, whether it’s in schools, or in their living rooms, or in their garages, are playing around with these things, for all kinds of needs. So that’s what Raspberry Pi is. One of the things that we realized is that during disasters, there are a lot of people who live at home perfectly fine, but have electrical devices that they need to either deliver medicine, or keep them alive in one way or another. And when the power goes out for long periods of time, like it did in Katrina or did in Hurricane Sandy or others, people who are electricity dependent have lots of trouble. So one of the things that we’ve done is build a prototype device using this Raspberry Pi technology that will read the battery life of somebody’s equipment and ultimately signal when it gets into trouble. So that’s what that innovation was.

The other things that we’ve done has been to use claims information from Medicare to try to understand who actually has that kind of equipment at home. And we’re able to make a map with nobody’s names on it, or nobody’s exact addresses but let’s say at a ZIP code level, so that emergency planners, or health departments for the community, can have an idea of how many people who are electricity dependent, or how many people who are dependent on dialysis, live in their community and they make plans for them. If there’s a disaster, the health department can actually agree to privacy protect personally identified information and get access to the names and addresses of people who might be electricity dependent and can go knock on their doors and prioritize getting them out of harm’s way. Ultimately, we hope that the Raspberry Pi-derived battery signaling device will do the job much more efficiently.

Wow, it’s just amazing to hear about how preparedness has evolved.

Well, it’s actually pretty exciting and it’s a reminder that it’s everybody’s business. Right, whether it’s families, or friends, or responders, or people who just like to write computer code, or go to hack-a-thons or volunteer in some other way. Everybody’s got a role to play.

At APHA, we have a belief that health really should exist in all policies. And hearing innovations like that is 2015, just hearing what’s been done in the 21st century, in the first 15 years. And within the next 15 years APHA has a goal to create the healthiest nation by 2030. So my final question for you is how will being prepared and responding quickly to health disasters help us get there?

Well, I think you said it in the beginning of your question. One of the most important things that we can do is build health into all policies. So we have a huge focus on what we call building resilience. And people in communities that are resilient do better in disasters and they bounce back faster. Part of building resilience on an individual level is having healthier people. And having building resilience on a community level is creating those conditions under which people can be healthy, be able to make choices about how to protect themselves, get and have the information they need to be able to take care of themselves and their families and communities. So that part is really important. In the face of a disaster, being prepared is going to reduce injury, reduce disability, reduce illness, reduce death, and one of the major things we focus on now, in addition in both response and recovery, is psychological resilience and emotional well-being. And so addressing both kinds of stressors are also things that help people be healthier in the long run. And those health benefits extend across the entire health spectrum. They’re not just limited to the specific injury you might incur when there’s a disaster.

We’ve also spent a lot of time talking about what we call the mitigation and the recovery phases of disaster. So after a disaster happens and really destroys a big part of your community like it did during the Joplin tornado or like it did during Hurricane Sandy there’s often a rebuilding phase. And in this rebuilding phase it is especially important to think about health in all policies. Not only how do we build resilient buildings that aren’t going to fall down, but how do we build buildings and communities so people can exercise, so they can have access to fresh foods, so in the course of their day-to-day lives people encounter one another and develop social ties and social capital because those things are good for people’s health? How do we make those communities more walkable so that people will be healthier one way or another? So all of this ties together with those underlying determinants of health and the health in all policies approach.

Wow. Dr. Lurie, thank you so much for taking the time to speak with us about really many layers of preparedness. Hearing you talk about health in all policies was particularly inspiring. And I know that we have a partnership with you that’s going to last a long time. And hopefully, in 2030, with some of this new technology, that you have, and some of the new technology that’s sure to come over the next 15 years will get there. So I wanted to thank you once again for joining us at APHA.

It was a pleasure.

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Posted: April 27, 2015