Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-25T19:41:53.418Z Has data issue: false hasContentIssue false

Confidence in the Fairness of Local Public Health Systems’ Response to Disasters: The US Veterans’ Perspective

Published online by Cambridge University Press:  25 April 2013

Abstract

Objective

The effectiveness of local public health systems in emergency management depends on trust from the entire community. However, the failure of some government agencies to respond effectively to several major disasters has had a disproportionate impact on certain groups-racial/ethnic minorities, in particular-that are well-represented in the veteran population. Many veterans belong to multiple vulnerable populations at greater risk of harm during disasters. This study examines confidence that local public health systems will respond fairly to disasters in a diverse sample of US veterans.

Methods

This study is an analysis of cross-sectional data on 5955 veterans in the 2009 California Health Interview Survey. Respondents were asked about their confidence that public health systems would respond fairly to their needs in the event of a disaster, regardless of their race/ethnicity or other personal characteristics. Multivariable regression analysis was used to identify variables on respondent characteristics that were independently associated with confidence. The hypothesis was that there would be less confidence in county public health systems among respondents who were racial/ethnic minorities, had less than a college degree, and were of low-income backgrounds.

Results

Approximately 79% of veterans were confident that public health systems would respond fairly. The hypothesis was unsupported, with no differences in confidence by race/ethnicity, education, or income. Also, no differences were noted between men and women or between veterans with and without disabilities. However, confidence was associated with continent of birth, age, homeownership, and marital status.

Conclusion

If confidence affects veterans’ willingness to accept disaster preparedness communications or to give proper consideration to recommended emergency countermeasures, then local health departments that issue such information to veterans are not likely to encounter barriers by race/ethnicity, income, education, disability status, or gender.(Disaster Med Public Health Preparedness. 2013;7:75-81)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2013

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Bascetta, CA. HomelandSecurity: Need to Consider VA's Role in Strengthening Federal Preparedness. Washington, DC: General Accounting Office; 2001.Google Scholar
2.Steeves, A. VA and Military Assistance and Technical Support to Civilian Healthcare Preparedness. Comprehensive Emergency Management Program Evaluation and Research Conference. Alexandria, VA; 2011.Google Scholar
3.Nesbit, R, Reingold, DA. Soldiers to citizens: the link between military service and volunteering. Public Adm Rev. 2011;71(1):67-76.Google Scholar
4.US Department of Veterans Affairs. National Center for Veterans Analysis and Statistics. Population Tables: Race/Ethnicity. http://www.va.gov/vetdata/veteran_population.asp. Accessed September 21, 2011.Google Scholar
5.Washington, H. Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present. New York: Random House; 2006.Google Scholar
6.Adams, G, O'Brien, LT, Nelson, JC. Perceptions of racism in Hurricane Katrina: a liberation psychology analysis. Anal Soc Issues Public Policy 2006;6(1):215-235.Google Scholar
7.Hughes, A. Cures for the Privileged? Newspoints/Washington Report. Black Enterprise. January 2002: 19.Google Scholar
8.Thompson, MW. Survivor, Brentwood; Leroy Richmond Was Hit with a Biological Weapon in the Line of Duty. His Experience Just Might Be Instructive. Washington Post Magazine. March 30, 2003: W18.Google Scholar
9.Vedantam, S, Flaherty, MP. CDC Rushed Paperwork for Anthrax Vaccinations; 48 Congressional Aides Received Inoculations. Washington Post. December 22, 2001:10.Google Scholar
10.Blendon, RJ, Buhr, T, Cassidy, EF, etal. Disparities in health: perspectives of a multi-ethnic, multi-racial America. Health Aff (Millwood). 2007;26(5):1437-1447.Google Scholar
11.Plough, A, Bristow, B, Fielding, J, Caldwell, S, Khan, S. Pandemics and health equity: lessons learned from the H1N1 response in Los Angeles County. J Public Health Manag Pract. 2011;17(1):20-27.Google Scholar
12.Eisenman, DP, Wold, C, Setodji, C, etal. Will public health's response to terrorism be fair? Racial/ethnic variations in perceived fairness during a bioterrorist event. Biosecur Bioterror. 2004;2(3):146-156.Google Scholar
13.UCLA Center for Health Policy Research CHIS. California Health Interview Survey. Release 1 [computer file] ed. Los Angeles, CA; 2009.Google Scholar
14.California Health Interview Survey. CHIS 2009 Adult Survey. UCLA Center for Health Policy Research. Los Angeles, CA: March 2011.Google Scholar
15.Richardson, C, Waldrop, J. Veterans: 2000; Census 2000 Brief. #C2KBR-22. US Census Bureau; May 2003.Google Scholar
16.American FactFinder. 2005-2009 American Community Survey 5-Year Estimates. Veteran Status. Washington, DC: US Census Bureau.Google Scholar
17.Meredith, LS, Eisenman, DP, Rhodes, H, Ryan, G, Long, A. Trust influences response to public health messages during a bioterrorist event. J Health Commun 2007;12(3):217-232.Google Scholar
18.Mays, VM, Ponce, NA, Washington, DL, Cochran, SD. Classification of race and ethnicity: implications for public health. Annu Rev Public Health. 2003;24(1):83-110.Google Scholar
19.Perrin, AJ, Smolek, SJ. Who trusts? Race, gender, and the September 11 rally effect among young adults. Soc Sci Res 2009;38(1):134-145.CrossRefGoogle ScholarPubMed
20.StataCorp L. Stata Survey Data Reference Manual: Release 11. StataCorp LP; 2009.Google Scholar
21.Wenger, MR. No More Katrinas: How Reducing Disparities Can Promote Disaster Preparedness. Washington, DC: Joint Center for Political and Economic Studies; 2008.Google Scholar
22.MacGregor, MJ. Integration of the Armed Forces, 1940-1965. Defense Studies Series. Washington, DC: Center of Military History, United States Army; 1985.Google Scholar
23.King, ML Jr. Beyond Vietnam: A time to break silence. Speech. Riverside Church, New York, NY; April 4, 1967. http://www.hartford-hwp.com/archives/45a/058.html.Google Scholar
24.Teigen, JM. Enduring effects of the uniform: previous military experience and voting turnout. Polit Res Q. 2006; 59(4):601.CrossRefGoogle Scholar
25.Pollack, JC. When soldiers return: combat and political alienation among white Vietnam veterans. New Directions Political Social. 1975;317-333.Google Scholar
26.Sampson, RJ, Raudenbush, SW, Earls, F. Neighborhoods and violent crime: a multilevel study of collective efficacy. Science. 1997;277(5328):918-924.Google Scholar
27.Edelstein, M. Contaminated Communities: The Social and Psychological Impacts of Residential Toxic Exposure. Boulder, CO: Westview Press; 1988.Google Scholar
28.Gibson-Davis, CM. Money, marriage, and children: testing the financial expectations and family formation theory. J Marriage Fam 2009;71:146-160.CrossRefGoogle Scholar
29.Gibson-Davis, CM. Mothers but not wives: the increasing lag between non-marital births and marriage. J Marriage Fam. 2011;73:264-278.Google Scholar
30.Gibson-Davis, CM, Edin, K, McLanahan, S. High hopes but even higher expectations: the retreat from marriage among low-income couples. J Marriage Fam. 2005;67:1301-1312.Google Scholar
31.Stevenson, B, Wolfers, J. Marriage and Divorce: Changes and their Driving Forces. Populations Study Center Working Paper Series PSC 07-04. Philadelphia, PA: University of Pennsylvania; 2007.CrossRefGoogle Scholar
32.Favell, A. A politics that is shared, bounded, and rooted? rediscovering civic political culture in Western Europe. Theory Soc. 1998;27(2):209-236.Google Scholar
33.California Health Interview Survey. CHIS 2007 Area Probability Sample to Assess Nonresponse Bias. CHIS Working Paper Series (presentation version). Los Angeles, CA: UCLA Center for Health Policy Research; 2008.Google Scholar
34. Integrated Public Use Microdata Series. USA. American Community Survey, 2009. http://usa.ipums.org/usa/. Accessed October 10, 2011.Google Scholar
35. US Department of Veterans Affairs. Center for Women Veterans: Statistics. Women Veterans Population. http://www.va.gov/womenvet/statistics.asp. Accessed February 6, 2012.Google Scholar