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Community Assessment for Public Health Emergency Response (CASPER): State and County Perspectives on Evaluating Emergency Preparedness in Lake County,

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Presentation on theme: "Community Assessment for Public Health Emergency Response (CASPER): State and County Perspectives on Evaluating Emergency Preparedness in Lake County,"— Presentation transcript:

1 Community Assessment for Public Health Emergency Response (CASPER): State and County Perspectives on Evaluating Emergency Preparedness in Lake County, California Rebecca Cohen, MPH CSTE/CDC Applied Epidemiology Fellow California Department of Public Health Environmental Health Investigations Branch

2 Acknowledgements 2 CDPH o Rachel Roisman o Svetlana Smorodinsky o Lori Copan o Tracy Barreau o Rebecca Cohen o Jason Wilken o Rebecca Lakew o Olga Martinez o Alberto Aparicio o Rick Kreutzer o Eric Moyer o Russ Bartlett o Danny Kwon o Matt Conens o Alyce Ujihara o Rosemary Kim o Natalie Sacramento LCPHD o Karen Tait o Ray Ruminski o Linda Fraser Lake County Air Quality Management District o Doug Gearhart CDC o Tesfaye Bayleyegn o Sara Vagi o Bryan Christensen o Amy Wolkin o Fuyuen Yip o Lauren Lewis Interview Teams o CDPH o Cal STAPH o UC Berkeley Other logistic support staff

3 Background 3

4 Background 4

5 Background Previous collaboration with Lake County Community Assessment for Public Health Emergency Response (CASPER) ◦ National Center for Environmental Health ◦ “Quick” and reliable ◦ Household-based ◦ Disaster or non-disaster settings 5

6 Aims 1. Assess the degree of emergency or disaster preparedness of the community. 2. Assess community perceptions and experiences associated with geothermal venting. 3. Determine outdoor air levels of hydrogen sulfide and methane to identity new vents and potential areas of vapor intrusion in the community. 4. Assess private well vulnerabilities, including well characteristics and well water testing practices. 6

7 (Inside Scoop) Aims 1. Assess ability to survive five months of weekly 2 hour conference calls. 2. Navigate winding, rural roads in pouring rain. 3. Perform door-to-door surveys in marijuana- growing region without getting attacked by dogs or their owners. 4. Execute uniform interview with diverse individuals in difficult situations (without entering their homes) after 3 hours of training. 7

8 Methods Community Assessment Two-staged probability sampling 30 Census Blocks x 7 households 14 interview teams November 26 th – 28 th Weighted to account for sampling design 8

9 Methods 9 Questionnaire ◦ Geothermal gas venting ◦ Emergency and disaster preparedness ◦ Well water 24 Questions? 12 Versions? 101 28

10 Methods 10

11 Methods 11 Arrive Count households Divide number of households by 7 (n) Pick a starting point Approach every n th house Track progress

12 Methods Sampled Housing Units1234567891011121314151617 1) ACCESS House is Accessible□□□□□□□□□□□□□□□□□ House is Inaccessible□□□□□□□□□□□□□□□□□ 2) TYPE OF DWELLING No housing structure□□□□□□□□□□□□□□□□□ Mobile Home□□□□□□□□□□□□□□□□□ Single Family Home□□□□□□□□□□□□□□□□□ Apartment or Condo□□□□□□□□□□□□□□□□□ Other□□□□□□□□□□□□□□□□□ 3) ANSWER Door was answered□□□□□□□□□□□□□□□□□ Appears as though someone is home but no answer□□□□□□□□□□□□□□□□□ Appears vacant□□□□□□□□□□□□□□□□□ Nobody home after… 1 st visit □□□□□□□□□□□□□□□□□ 2 nd visit □□□□□□□□□□□□□□□□□ 3 rd visit□□□□□□□□□□□□□□□□□ 4) INTERVIEW Language Barrier□□□□□□□□□□□□□□□□□ Refused to Participate□□□□□□□□□□□□□□□□□ Non-resident□□□□□□□□□□□□□□□□□ No adult over 18 yrs old□□□□□□□□□□□□□□□□□ Unsafe environment□□□□□□□□□□□□□□□□□ Interview begun, not finished□□□□□□□□□□□□□□□□□ Interview Completed□□□□□□□□□□□□□□□□□ Survey # (i.e., 1-7) from Completed Questionnaire: 12 12

13 I wonder if there are any gases here?

14 Results 26,730 Sampling Frame Target 210 interviews 514 Houses approached 261 Doors Answered 161 Interviews Complete 86 refusals, 8 non-residents, 2 language barriers 14

15 Results 15 Frequency (n=161) % of HHProjected HH Weighted % 95% CI Household size 1 4226.16,57024.616.0 – 33.1 2 to 4 10364.017,71266.357.2 – 75.3 5 or more 159.32,3218.73.3 – 14.0 Households with vulnerable age groups <2 yrs old 138.12,2448.43.1 – 13.7 ≥65 yrs old 5735.49,16934.324.6 – 44.0 Main language English 15395.025,39695.091.3 – 98.7 Spanish 85.01,3345.01.3 – 8.7 Household Demographics

16 Results 16 Frequency (n=161) % of HHProjected HH Weighted % 95% CI Wild fires 10364.017,54065.655.0 – 76.3 Earthquakes 10162.717,10164.053.2 – 74.8 Floods 6741.611,28842.229.6 – 54.8 Winters storms 6540.410,31938.628.3 – 48.9 Volcanic eruptions 4024.86,19923.215.5 – 30.9 Chemical releases 2515.54,56117.18.9 – 25.2 Heat waves 2414.94,24915.910.1 – 21.7 Other 1811.22,82210.64.1 – 17.0 Terrorist attacks 106.21,4475.41.9 – 9.0 Tornadoes 53.18063.00.2 – 5.8 Of the following, which do you view as the three greatest emergency or disaster threats to your household?

17 Results 61% of households had experienced earthquakes or tremors while living in their neighborhood 17% of respondents said earthquakes had affected their peace of mind. 17

18 Results 18 Freq (n=161) % of HH Projected HH Weighted % (95% CI) CHIS Lake County Weighted % (95% CI) CHIS California State Weighted % (95% CI) 1 - 3 days 2314.34,05615.2% (8.7 – 21.7) 15.7% (11.0 – 20.3) 21.2% (20.2 – 22.1) 4 - 6 days 2213.73,00411.2% (5.7 – 16.8) 17.5% (13.3 – 21.6) 26.5% (25.6 – 27.4) 7 - 9 days 3421.15,66821.2% (13.3 – 29.1) 21.6% (16.5 – 26.7) 21.6% (20.8 – 22.5) 10+ days8049.713,70451.3% (41.9 – 60.7) 44.7% (39.9 – 49.5) 30.2% (29.3 – 31.1) For how many days would you be able to stay in your home without anyone shopping for additional supplies?

19 Results 19 Frequency (n=161) % of HHProjected HH Weighted % 95% CI Television 5534.28,80032.924.9 – 40.9 AM/FM Radio 2817.45,06619.09.4 – 28.5 Text message 95.61,8546.91.2 – 12.7 Cell phone 2314.33,48613.06.6 – 19.5 Landline telephone 116.81,9817.42.3 – 12.5 Internet 1710.63,04211.45.9 – 16.8 Printed newspaper 10.61270.50.0 – 1.5 Word of mouth 74.39633.61.2 – 12.7 Church/community center 00000 Bulletin board 00000 Child’s school 10.61270.50.0 – 1.5 Ham radio 42.55091.90.1 – 3.7 Work 00000 What is your household’s preferred method for receiving information during an emergency?

20

21 Discussion Strengths ◦ Tracking of interview teams ◦ Greater understanding of emergency preparedness in Lake County ◦ Successful collaboration ◦ Trained DEODC for future CASPERs  First CASPER in California  First CASPER nationwide with air monitoring 21

22 Discussion Limitations ◦ Vacant houses ◦ Information Bias ◦ Didn’t capture socioeconomic status ◦ Spring Valley 22

23 Survey Design Issues 23

24 Survey Design Issues 24

25 Additional Lessons Learned Integrate epidemiology into disaster response Track interview teams Time and place Offer participants an incentive 25

26 Conclusions CASPER was timely and relevant Lake County households are affected by natural disasters Households have taken steps to prepare for future disasters or emergencies Recommendations to the County ◦ Provide information on low-cost preparations ◦ Use multiple communication media for messages ◦ Prepare for pet-friendly shelters in the event of an evacuation 26

27 Questions? 27

28 Video http://youtu.be/6AlZvoBBBwo


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