+ No One Left Behind: Disaster Planning for People Experiencing Homelessness Health Care & Housing Are Human Rights Sabrina Edgington, MSSW | June 3, 2010

+ Most Gulf Coast state, county, and parish evacuation plans lacked adequate procedures for communicating emergencies to special needs and hard to reach populations (Federal Highway Administration, 2006). Only 10% of state and 12% of local government plans adequately addressed the evacuation needs of transportation disadvantaged individuals (GAO, 2006). Only 30% of health centers had a role in their community’s emergency plan and even less participated in exercises (Weinman et al., 2007). Health Care & Housing Are Human Rights Holy smoke!

Nashville flood Kenny Chesney Health Care & Housing Are Human Rights

+ Social vulnerability Set of characteristics of a group or individual in terms of their capacity to anticipate, cope with, resist and recover from the impact of a natural hazard It involves a combination of factors that determine the degree to which someone's life and livelihood is at risk by a discrete and identifiable event in nature or society Source: Blaikie, P., T. Cannon, I. Davis & B. Wisner. (1994). At Risk: Natural hazards, People's vulnerability, and disasters. London, Routledge. Health Care & Housing Are Human Rights

+ Source: Blaikie, P., T. Cannon, I. Davis & B. Wisner. (1994). At Risk: Natural hazards, People's vulnerability, and disasters. London, Routledge. Health Care & Housing Are Human Rights

+ Why is it important that we understand social vulnerability? We can minimize the impact of disasters for people who are homeless by identifying and addressing factors that make people vulnerable to environmental hazards. Health Care & Housing Are Human Rights

+ Major factors that influence social vulnerability Access to resources (including information, knowledge, and technology) Access to political power and representation Social capital, including social networks and connections Beliefs and customs Age, gender, race Health and physical ability Source: Cutter, S., Boruff, B., & Shirley, W. (June 2003). Social vulnerability to environmental hazards. Social Science Quarterly, 84(2), Health Care & Housing Are Human Rights

+ Lack of access to resources Limited capacity to take risk reduction measures Sheltering in place Avoiding congregate settings (during pandemic flu) Stockpiling food, water, and supplies Health Care & Housing Are Human Rights

+ Lack of access to resources Poor disaster communication Limited access to technology Instructions are targeted to people who are housed and have resources to take risk reduction measures Most communication is not “trauma-informed” Transportation disadvantaged No transportation to evacuate Health Care & Housing Are Human Rights

+ Limited access to political power and representation People who are homeless are often unintentionally excluded from government emergency plans Most preparedness campaigns are not applicable to people who are homeless People who are homeless are not eligible for most FEMA housing assistance Health Care & Housing Are Human Rights

+ Limited social capital, including social networks and connections Many people who are homeless are isolated and have limited family/friend supports Most people who are homeless will depend on homeless service providers for support and assistance. Health Care & Housing Are Human Rights

+ Beliefs and customs Consider the beliefs held by people who have been largely marginalized by society. Consider how culture influences help-seeking behaviors, healing, trauma, and loss. Consider how people from family-centered cultures will respond to a disaster. How will language barriers be addressed? Health Care & Housing Are Human Rights

+ Age, gender, race Children and older adults are more vulnerable than young and middle aged-adults Women are more vulnerable than men Minorities are more vulnerable than non-minorities Health Care & Housing Are Human Rights

+ Frail and physically limited individuals High rates of physical disability People who are homeless are sicker than people who are housed (unmanaged chronic disease, exposure to the elements) 27% - 33% of adults who are homeless have a serious mental illness (U.S. Conference of Mayors, 2009; NAMI, 2007) 47% - 66% of homeless individuals have a substance use disorder (U.S. Conference of Mayors, 2007; Burt, 1999) 75% of those who have a substance use disorder have a co-morbid non-substance related mental illness (Kertesz, 2006) Health Care & Housing Are Human Rights

+ Action steps Understand social vulnerabilities so that you might address factors that increase disaster risk Learn how to better coordinate with other service providers and your local government. Make sure your organization’s emergency management plan aligns with your local government’s emergency management plan. Know your role. Health Care & Housing Are Human Rights

+ Contact information Sabrina Edgington, MSSW, Policy Analyst National Health Care for the Homeless Council 615/ Health Care & Housing Are Human Rights