How Colorado Develops Preparedness with Diverse Populations
Lesson learned: Relationships spawned during the planning stages are vital.
Lack of access to resources makes people disproportionately vulnerable to disasters. It can lead to more severe consequences, less resilience and longer recovery. For the purposes of emergency preparedness, response and recovery, the definition of vulnerable populations for the Colorado Department of Public Health and Environment is anyone who cannot reliably access resources, who may have difficulty evacuating or sheltering in place, or whose health may be more severely affected by a disaster.
Demographics indicated that Colorado's populations include 20 percent Hispanic and 2.7 percent Asian. Although that may not seem like much, those numbers have grown, and many are recent immigrants or refugees who are most comfortable with their native languages. The population of immigrants from areas like Sudan, Eritrea, Burma and Iraq are all increasing. Those small percentages add up to a large number of people who may have difficulty understanding or accessing the system for crucial information, such as point of dispensing for medication or shelter information.
Other demographics include 9.4 percent disabled. Different disabilities and different levels of disability cannot be addressed the same way. As with adjusting messages to be easily understood by people using different languages or literacy levels, there must be consideration for different disabilities, such as recognizing that a cognitively disabled person may have difficulty in a busy, noisy shelter, whereas a deaf person is fine in a general population shelter, but cannot hear a reverse 911 call.
To provide access to preparedness, response and recovery in Colorado to all Coloradans, a project was begun to build capacity in diverse communities in the topic areas they indicated needed the most assistance.
- Differing needs, such as language, or physical needs and limited resources.
- Different communities are accessed in different ways. For example, in the Denver Native American community, approval and interest are needed from elders. And informal leaders (not on paper) are needed for trust as well as formally recognized leaders.
- Mutual distrust between emergency management in terms of trusting community volunteers and fear of other languages, needs and cultures, and local communities who may have had negative experiences with government either in home countries or even here in the United States.
- Different language in terms of community functioning versus agency language and structure.
- Lack of understanding between the top-down agency view of community needs versus view of needs within the community.
Colorado Preparedness Communities
In the first year, we held a couple of community discussions to identify interested organizations. Once we had interest, we focused on getting a baseline of information from the communities on what they wanted, felt they needed and where they were starting as far as information on emergency preparedness. In collaboration with the organizations, we held focus groups and with the organizations' assistance, created and collected surveys.
In the next few years, each community organization developed and taught its own emergency preparedness trainings, after getting training from the Colorado Department of Public Health and Environment on basic points to cover in the trainings. These points were determined by the surveys and focus groups and what people in the communities wanted training on. Most of the trainings were based on templates of trainings provided by the state or local government on the topic requested, and adapted for language and cultural considerations, and simplified.
The agency language in many government trainings was more complicated than that needed by community members. In addition, their scopes of work included other things that the community organizations needed support on, such as funding for an emergency contact database capable of querying for special needs. In addition, materials for different audiences were created, such as pictorial flyers on emergency preparedness and pandemic influenza for the migrant worker populations, tested and critiqued by members of the migrant community.
One thing that often helped was working on streamlining emergency preparedness agendas to address other community needs as well. For example, in the Denver Indian Center there was a need for funding to re-establish the seniors group so that elders without many resources could meet for lunch to keep in touch. The lunch meetings were then organized around topics of emergency preparedness with special speakers engaged to address water safety and other issues of concern. These elders finally created groups of stories that might help governments understand their perspectives.
Another example of a unique training was created by Inner City Parish. It incorporated an emergency preparedness module into the parochial school science class. At the end of the module, participants learned about epidemics by eating different ice cream flavors and toppings, one of which was “contaminated.” They then did a drill in which they compiled food histories, developed a case definition and calculated an odds ratio.
The Colorado Cross-Disability Coalition is a disability advocacy organization. The coalition created training for assisted and independent-living communities. In addition, the coalition created resource lists and specific solution lists for emergency managers to incorporate disabled needs into plans. The coalition also enlisted community volunteers with expertise in multiple areas for volunteer databases. Other organizations were involved in partnership, with the initial organizations, such as Queen of Vietnamese Martyrs Catholic Church, Wat Buddhararam Thai Buddhist Temple, Korean Lions Club and Aurora First Church of Seventh Day Adventists.
The conclusion of the exercise was that the relationships formed in the planning phase were critical to the success of the exercise, in addition to their emergency operations planning. The relationships that were begun during that time were an integral part of the response, because both sides, community and government, felt that it was a positive experience and had the trust necessary for each organization to perform their tasks. They all anticipate and look forward to collaborative future exercises in the next year.
In working with different communities, some of the comments I heard repeatedly that guided our methods of engaging people were:
- "We want to be at the table from the beginning." Too many times in the past, agencies have created projects for communities without having input from the communities from the very beginning. Often collaboration comes at a later time in the planning process rather than from the ground up.
- "We want to be asked what we need rather than told." Our view from a state or local department is radically different from a community organization, so we tried whenever possible to let them write their own scopes of work with their priorities.
- "Meet us during our hours, at our meetings. If you have all the meetings during the regular work hours, no one can go." We tried to go to events they were already having or whenever they were available, not limited from nine to five, because most of them are volunteers, working on preparedness outside their normal job hours. We found in many situations that combining trainings and exercises with existing events provided people with one-stop shopping.
- "We can teach you something too." Whenever possible, we tried to give stipends or some kind of indication of our appreciation, especially because of the sheer amount of time they donated in working with us, and teaching local agencies about their ideas on emergency preparedness. There was a tremendous amount of talent in these communities, which was an asset to emergency preparedness, not just for them, but for us.
- Food is a social lubricant and often integral to developing trust between groups. So whenever possible, we provided funding for food at the meetings and trainings, and especially the exercises.
- Adapting exercises and trainings to the different needs of the communities really helped to allay fears and apprehension on the community side for trying experiences they had never had exposure to previously.
- There is no substitute for community outreach and involvement by preparedness agencies, and getting to know the communities in partnership. Familiarity bred tremendous respect for each side of this effort, and strong friendships between each side in the Colorado community preparedness projects.
Rachel Coles is community preparedness coordinator with the Emergency Response Division of the Colorado Department of Public Health and Environment.