The American Preparedness Project: Where the US Public Stands in 2015

The American Preparedness Project was launched by the National Center for Disaster Preparedness (NCDP) in 2002, in the aftermath of the 9/11 attacks in order to survey public perceptions and opinions on disaster preparedness and to acknowledge that a comprehensive understanding of the concerns of individuals and families is critical to emergency planning efforts on …

Children in Disasters: Do Americans Feel Prepared? A National Survey

This study was led by the National Center for Disaster Preparedness (NCDP) at Columbia University’s Earth Institute on behalf of the Resilient Children/Resilient Communities (RCRC) Initiative, in partnership with Save the Children with funding from GSK.The purpose of the study was to learn more about people’s opinions and attitudes toward disaster preparedness with a focus …

Schools and Terrorism: Global Trends, Impacts, and Lessons for Resilience

This study characterizes trends in the frequency and characteristics of terrorist attacks in child-serving educational institutions around the world, examining the specific vulnerabilies of children and schools with regard to terrorist violence, as well as the various impacts that violence has on children, communities, and societies. Following the analysis of available data on terrorist attacks …

Acts of terrorism and mass violence targeting schools : Analysis and implications for preparedness in the USA

To enhance the preparedness of US schools to acts of terrorism and mass violence, the landscape of threats against schools must first be understood. This includes exploring the global trends of acts of terrorism against schools, as well as looking specifically at the history of terrorism and acts of mass violence against schools domestically. This …

Care of the Child With Ebola Virus Disease

Objectives: To provide clinicians with practical considerations for care of children with Ebola virus disease in resource-rich settings. Data Sources: Review of the published medical literature, World Health Organization and government documents, and expert opinion. Data Synthesis: There are limited data regarding Ebola virus disease in children; however, reported case-fatality proportions in children are high. …

Development of Functional Symptoms in Children Exposed to Traumatic Events

This chapter will review the typical symptoms occurring in children after stressful traumatic exposures. Unlike other chapters in this book, no specific organ system is the most likely focus of functional symptoms in this setting. Psychological distress may exacerbate symptoms of physical illness and injury associated with the traumatic events, may be expressed as almost …

School Interventions After the Joplin Tornado

Background/Objective To qualitatively describe interventions by schools to meet children’s needs after the May 2011 Joplin, Missouri tornado. METHODS: Qualitative exploratory study conducted six months after the tornado. Key informant interviews with school staff (teachers, psychologists, guidance counselor, nurse, principal), public health official, and physicians. Report After the tornado, school staff immediately worked to contact …

Children’s Health after the Oil Spill: A Four-State Study Findings from the Gulf Coast Population Impact (GCPI) Project

In 2012, with funding from the Baton Rouge Area Foundation, the National Center for Disaster Preparedness (NCDP) at Columbia University, in partnership with the Children’s Health Fund, launched a four-state study in order (1) to identify communities of children in the coastal areas of Louisiana, Mississippi, Alabama and Florida who were adversely impacted by the …

Measuring the Impact of Hurricane Katrina on Access to a Personal Healthcare Provider: The Use of the National Survey of Children's Health for an External Comparison Group

This paper examined the effect of Hurricane Katrina on children’s access to personal healthcare providers and evaluated the use of propensity score methods to compare a nationally representative sample of children, as a proxy for an unexposed group, with a smaller exposed sample. 2007 data from the Gulf Coast Child and Family Health (G-CAFH) Study, …

The 2011 Tuscaloosa Tornado: Integration of Pediatric Disaster Services into Regional Systems of Care

Objective: To empirically describe the integration of pediatric disaster services into regional systems of care after the April 27, 2011, tornado in Tuscaloosa, Alabama, a community with no pediatric emergency department or pediatric intensive care unit and few pediatric subspecialists. Study design: Data were obtained in interviews with key informants including professional staff and managers …

Regional Variation in Critical Care Evacuation Needs for Children After a Mass Casualty Incident

To determine the ability of five New York statewide regions to accommodate 30 children needing critical care after a hypothetical mass casualty incident (MCI) and the duration to complete an evacuation to facilities in other regions if the surge exceeded local capacity. A quantitative model evaluated pediatric intensive care unit (PICU) vacancies for MCI patients, …

Children as Bellwethers of Recovery: Dysfunctional Systems and the Effects of Parents, Households, and Neighborhoods on Serious Emotional Disturbance in Children After Hurricane Katrina

Background: Over 160 000 children were displaced from their homes after Hurricane Katrina. Tens of thousands of these children experienced the ongoing chaos and uncertainty of displacement and transiency, as well as significant social disruptions in their lives. The objectives of this study were to estimate the long-term mental health effects of such exposure among …

Impact on Children and Families of the Deepwater Horizon Oil Spill: Preliminary Findings of the Coastal Population Impact Study

Although the ruptured Deepwater Horizon oil well was capped on July 15, 2010, an estimated 3 to 5 million barrels of oil spilled in to the Gulf of Mexico over a three-month period. Several surveys prior to the capping of the well documented the concerns and immediate effects of the oil spill on coastal residents. …

Second Wind: The Impact of Hurricane Gustav on Children and Families Who Survived Katrina

The category 2 Hurricane Gustav made landfall on the Louisiana Coast on Sept. 1, 2008, nearly three years to the day after Hurricane Katrina, resulting in an evacuation of approximately 2 million people and considerable property damage. Although it did not match the intensity or consequence of Hurricane Katrina, the experience of anticipating and responding …

Building Integrated Mental Health and Medical Programs for Vulnerable Populations Post-Disaster: Connecting Children and Families to a Medical Home

Introduction: Hurricane Katrina, a Category 3 hurricane, made landfall in August 2005. Approximately 1,500 deaths have been directly attributed to the hurricane, primarily in Louisiana and Mississippi. In New Orleans, Louisiana, most of the healthcare infrastructure was destroyed by flooding, and >200,000 residents became homeless. Many of these internally displaced persons received transitional housing in …

Biological Terrorism

In the aftermath of the September 11, 2001 attacks and the subsequent mail-borne anthrax attack of October 2001, it has become dear that health care providers may be called upon to respond to victims of terrorism. Biological terrorism (BT), in particular, involves the use of virulent agents with the intent to cause mass casualties and/or …

Mental Health Services in Louisiana School-Based Health Centers Post-Hurricanes Katrina and Rita

Following Hurricanes Katrina and Rita, Louisiana school-based health centers (SBHCs) were called on to respond to a sharp increase in mental health needs, especially for displaced students coping with grief, loss, trauma, and uncertainty. To assess the impact of the hurricanes on the students and the needs of SBHC mental health providers (MHPs), we surveyed …

The Recovery Divide: Poverty and the Widening Gap Among Mississippi Children and Families Affected by Hurricane Katrina

Six months after Hurricane Katrina hit the Gulf Coast, a Columbia-led research team conducted a random household survey of people who had been displaced by the disaster in Louisiana. Mental health disability and psychological strain were rampant, people’s lives were chaotic, and their futures were uncertain. The children who had been displaced were often socially …

The Legacy of Katrina's Children: Estimating the Numbers of Hurricane-Related At-Risk Children in the Gulf Coast States of Louisiana and Mississippi

The 2005 hurricane season, which included hurricanes Katrina, Rita and Wilma, exacted a monumental toll on the people and infrastructure of the Gulf Coast region in the southern United States. Disaster-related losses were estimated to have exceeded $110 billion. Much has been written about the short-term effects on the local housing stock, economy, and populations. …

Mississippi Child and Family Health Study — Toplines

During the period of August 6 through August 26, 2006, the Columbia-led Mississippi Child & Family Health Study conducted an assessment among Mississippi residents displaced or heavily impacted by Hurricane Katrina. The purpose of the study was to gather information that could inform local, state, and federal policymakers about the health and social service needs …

Children and Megadisasters: Lessons Learned in the New Millennium

Hurricane Katrina is America’s most recent encounter with a megadisaster. But what made it a megadisaster instead of just another category 3 hurricane of the type that seasonally exists in the Gulf of Mexico? Katrina was not the largest or strongest hurricane to strike the United States mainland in the recent past, but its effects …

The Pediatrician and Disaster Preparedness

Recent natural disasters and events of terrorism and war have heightened society’s recognition of the need for emergency preparedness. In addition to the unique pediatric issues involved in general emergency preparedness, several additional issues related to terrorism preparedness must be considered, including the unique vulnerabilities of children to various agents as well as the limited …

Chronicles From Out-of-State Professionals: Providing Primary Care to Underserved Children After a Disaster: A National Organization Response

Hundreds of thousands of lives in the Gulf Coast region were affected by Hurricane Katrina. The Children’s Health Fund (CHF) responded rapidly to the needs of children and their families after the hurricane. CHF is a national organization that supports direct health services, education, and advocacy for medically underserved children. Although CHF’s principle mission is …

Critical Concepts for Children in Disasters Identified by Hands-on Professionals: Summary of Issues Demanding Solutions Before the Next One

This supplement contains many hands-on experiences of pediatricians and others who cared for children during the Hurricane Katrina disaster. They have all offered significant insightful suggestions to help planners better prepare for care of children during the next disaster. Pediatricians and other providers need to educate families on many aspects of disaster planning. Families should …

On the Edge: Children and Families Displaced by Hurricanes Katrina and Rita Face a Looming Medical and Mental Health Crisis

The individuals and families who were displaced by Hurricanes Katrina and Rita and who have ended up in FEMA-subsidized community housing in Louisiana are facing a second crisis, one in which untreated and undertreated chronic medical problems and incipient mental health issues will overwhelm patients and providers. Among the displaced, children may be particularly vulnerable. …

Challenges in Meeting Immediate Emotional Needs: Short-term Impact of a Major Disaster on Children's Mental Health: Building Resiliency in the Aftermath of Huricanne Katrina

Disasters, whether resulting from terrorism or natural events, have a dramatic impact on the health and well-being of children. Studies after the terror attacks of September 11, 2001, in New York City and the 1995 Oklahoma City bombing and countless reports on the impact of natural disasters on children show that a child’s mental health …

Psychopathology Among New York City Public School Children 6 Months After September 11

It has been proposed that the terror itself that results from a terrorist attack elicits what is perhaps one of the attack’s more profound consequences: a direct assault on the population’s mental health. Prior research suggests that in the context of a mass disaster, children may be an especially vulnerable group. Previous research has shown …

Psychosocial Implications of Disaster or Terrorism on Children: A Guide for the Pediatrician

During and after disasters, pediatricians can assist parents and community leaders not only by accommodating the unique needs of children but also by being cognizant of the psychological responses of children to reduce the possibility of long-term psychological morbidity. The effects of disaster on children are mediated by many factors including personal experience, parental reaction, …

Pediatric Terrorism Preparedness National Guidelines and Recommendations: Findings of an Evidenced-based Consensus Process

A cadre of experts and stakeholders from government agencies, professional organizations, emergency medicine and response, pediatrics, mental health, and disaster preparedness were gathered to review and summarize the existing data on the needs of children in the planning, preparation, and response to disasters or terrorism. This review was followed by development of evidence-based consensus guidelines …

Uncommon Sense, Uncommon Courage: How the New York City School System, Its Teachers, Leadership and Students Responded to the Terror of September 11

Eight public schools are situated within a quarter mile of Ground Zero with 9,000 students ranging in ages from three to eighteen years – grammar, middle and high schools. On Tuesday, September 11, 2001 in the midst of chaos and a relentless unfolding of tragedy, professionals of the Board of Education safely evacuated all 9,000 …

Atropine Use in Children After Nerve Gas Exposure

Following the FDA’s approval of a pediatric dosage Atropen®, the Pediatric Expert Advisory Panel was asked to review the existing guidelines and recommendations regarding the treatment of children exposed to nerve agents and the Mark-1 Kit; review the new literature on pediatric nerve agent exposure; and to develop recommendations and guidelines for this new device …

Pediatric Preparedness for Disasters and Terrorism: A National Consensus Conference: Executive Summary

In a time of crisis, it is essential to ensure the needs of children are being met in planning and preparing for disasters and terrorist events. The current adult models and guidelines cannot be applied to the care of children. We convened experts from the multiple areas of expertise and disciplines involved in the planning …

Disaster and Terrorism Preparedness: What Pediatricians Need To Know

This chapter is designed to provide an overview of key issues for the pediatrician with respect to terrorism and disaster preparedness. It is not intended to be a complete compendium of didactic content, but it does represent an approach to understanding what needs to be learned by the pediatrician on this difficult topic and how …

The 9/11 terror attacks: Emotional consequences persist for children and their families

The terror attacks of Sept. 11, 2001, on the World Trade Center in New York City and the Pentagon in Washington, D.C., are unique in American history. The magnitude of the attack in New York, in terms of loss of life and property, was enormous. The destroyed twin towers of the World Trade Center had …