Exploring Community Needs for Disaster Shelters Using Cultural Probes During disasters, emergency shelters play a central role in emergency management, providing both a secure environment and centralized sites for the distribution of information, material relief supplies, and access to health and human services. Despite their importance, challenges such as physical access, public awareness, and peoples’ willingness to relocate limit the impact of both shelters … Continue reading “Exploring Community Needs for Disaster Shelters Using Cultural Probes” Learn More
Evidence-Based Pediatric Outcome Predictors to Guide the Allocation of Critical Care Resources in a Mass Casualty Event Objective: ICU resources may be overwhelmed by a mass casualty event, triggering a conversion to Crisis Standards of Care in which critical care support is diverted away from patients least likely to benefit, with the goal of improving population survival. We aimed to devise a Crisis Standards of Care triage allocation scheme specifically for children. … Continue reading “Evidence-Based Pediatric Outcome Predictors to Guide the Allocation of Critical Care Resources in a Mass Casualty Event” Learn More
Would Triage Predictors Perform Better than First-Come-First-Served in Pandemic Ventilator Allocation? In a pandemic, needs for ventilators might overwhelm the limited supply. Outcome predictors have been proposed to guide ventilator triage allocation decisions. However, pandemic triage predictors have not been validated. This quantitative simulation study evaluated outcomes resulting from allocation strategies varying in their performance for selecting short stay survivors as favorable candidates for ventilators. A … Continue reading “Would Triage Predictors Perform Better than First-Come-First-Served in Pandemic Ventilator Allocation?” Learn More
Disaster Planning for Vulnerable Populations: Leveraging Community Human Service Organizations Direct Service Delivery Personnel Given the variability, complexities, and available resources for local vulnerable populations, it is clear that preparing effectively for catastrophic events cannot be accomplished with a single, simple template. Inclusion of Community Human Service Organizations’ (CHSO’s) direct service delivery personnel ensures that emergency disaster planning efforts for vulnerable populations are effective and responsive to unique needs … Continue reading “Disaster Planning for Vulnerable Populations: Leveraging Community Human Service Organizations Direct Service Delivery Personnel” Learn More
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 … Continue reading “Children’s Health after the Oil Spill: A Four-State Study Findings from the Gulf Coast Population Impact (GCPI) Project” Learn More
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, … Continue reading “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” Learn More
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 … Continue reading “The 2011 Tuscaloosa Tornado: Integration of Pediatric Disaster Services into Regional Systems of Care” Learn More
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. … Continue reading “Impact on Children and Families of the Deepwater Horizon Oil Spill: Preliminary Findings of the Coastal Population Impact Study” Learn More
Legacy of Katrina: The Impact of a Flawed Recovery on Vulnerable Children of the Gulf Coast It is estimated that in the aftermath of Hurricane Katrina, which made landfall on August 29th, 2005 and was followed a month later by Hurricane Rita, approximately 1.5 million people, including some 163,000 children were displaced in Louisiana and Mississippi alone. Since children and families who had the means fled the city, those who were … Continue reading “Legacy of Katrina: The Impact of a Flawed Recovery on Vulnerable Children of the Gulf Coast” Learn More
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 … Continue reading “Children as Bellwethers of Recovery: Dysfunctional Systems and the Effects of Parents, Households, and Neighborhoods on Serious Emotional Disturbance in Children After Hurricane Katrina” Learn More
The Future of Pediatric Preparedness This article is part of a collaborative effort by experts in the field of emergency preparedness to complete an overview begun by the late Michael Shannon, MD, MPH, on the current challenges and future directions in pediatric disaster readiness. This particular article, “The Future of Pediatric Preparedness,” will offer a perspective on future directions in … Continue reading “The Future of Pediatric Preparedness” Learn More
Broadcasting Flu Messages – Citywide Transmission and Community Reception: An Evaluation of Ready New York’s pandemic influenza outreach campaign Public health risk communication is a central feature of New York City’s pandemic flu preparedness plan. Particularly in the early stages of a pandemic, before effective therapeutic measures are available, non-pharmaceutical interventions such as social distancing, personal protective hygiene, and voluntary isolation are critical strategies for suppressing the spread of a novel viral strain. New … Continue reading “Broadcasting Flu Messages – Citywide Transmission and Community Reception: An Evaluation of Ready New York’s pandemic influenza outreach campaign” Learn More
Pediatric Emergency Preparedness for Natural Disasters, Terrorism, and Public Health Emergencies: A National Consensus Conference: 2009 Update This is the third consensus document in an ongoing process to convene experts from the multiple disciplines that are involved in the planning for children affected by disasters. Learn More
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 … Continue reading “Second Wind: The Impact of Hurricane Gustav on Children and Families Who Survived Katrina” Learn More
Lessons from Katrina – What Went Wrong, What Was Learned, Who’s Most Vulnerable If humans did not occupy the planet, disasters would never occur. Massive climatic events, earthquakes, volcanic eruptions, and tsunamis would be regular occurrences, of course, and the earth would look like a dynamic cauldron of natural activity, changing the look and the balance of nature and natural events continuously and randomly. What morphs these natural … Continue reading “Lessons from Katrina – What Went Wrong, What Was Learned, Who’s Most Vulnerable” Learn More
Prevalence and Predictors of Mental Health Distress Post-Katrina: Findings From the Gulf Coast Child and Family Health Study Background: Catastrophic disasters often are associated with massive structural, economic, and population devastation; less understood are the long-term mental health consequences. This study measures the prevalence and predictors of mental health distress and disability of hurricane survivors over an extended period of recovery in a postdisaster setting. Methods: A representative sample of 1077 displaced or … Continue reading “Prevalence and Predictors of Mental Health Distress Post-Katrina: Findings From the Gulf Coast Child and Family Health Study” Learn More
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 … Continue reading “Mental Health Services in Louisiana School-Based Health Centers Post-Hurricanes Katrina and Rita” Learn More
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 … Continue reading “Building Integrated Mental Health and Medical Programs for Vulnerable Populations Post-Disaster: Connecting Children and Families to a Medical Home” Learn More
Population Vulnerabilities, Preconditions, and the Consequences of Disasters In a perfect illustration of our nation’s proclivity for postevent crisis response and our resistance to longer term planning and system investment, the nation put a rush order on developing a massive bureaucracy designed to fast track new systems for preventing and responding to terrorism and large scale natural disasters. FEMA and many other agencies … Continue reading “Population Vulnerabilities, Preconditions, and the Consequences of Disasters” Learn More
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 … Continue reading “Mississippi Child and Family Health Study — Toplines” Learn More
Pediatric Preparedness for Disasters, Terrorism and Public Health Emergencies: A National Consensus Conference: Executive Summary and Final Report In 2003, we convened experts from the multiple areas of expertise and disciplines involved in the planning for and care of children during times of disaster and terrorist events. The goals of this unprecedented meeting were to: 1) Build collaboration among individuals with expertise in emergency management, including disaster medicine, disaster planning, pediatric emergency medicine, … Continue reading “Pediatric Preparedness for Disasters, Terrorism and Public Health Emergencies: A National Consensus Conference: Executive Summary and Final Report” Learn More
Unanticipated Consequences of a Pandemic Flu in New York City: A Neighborhood Focus Group Study There is fairly consistent evidence that ethnic and minority communities have historically been more vulnerable to disasters, less trusting of public authority, and often so socially marginalized that it placed them in harm’s way. In an effort to explore some of these issues we conducted a series of community-based focus groups among selected ethnic communities … Continue reading “Unanticipated Consequences of a Pandemic Flu in New York City: A Neighborhood Focus Group Study” Learn More
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. … Continue reading “The Legacy of Katrina’s Children: Estimating the Numbers of Hurricane-Related At-Risk Children in the Gulf Coast States of Louisiana and Mississippi” Learn More
The Recovery Divide: Poverty and the Widening Gap Among Mississippi Children and Families Affected by Hurricane Katrina: Executive Summary 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 … Continue reading “The Recovery Divide: Poverty and the Widening Gap Among Mississippi Children and Families Affected by Hurricane Katrina: Executive Summary” Learn More
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 … Continue reading “The Recovery Divide: Poverty and the Widening Gap Among Mississippi Children and Families Affected by Hurricane Katrina” Learn More
Establishing Permanent Mental Health Programs Post-Hurricane Katrina: Lessons Learned and Recommendations for Practice in Underserved Communities Impacted by Mass Trauma Operation Assist, a joint initiative of Columbia University’s National Center for Disaster Preparedness and the Children’s Health. Fund was formed after Hurricane Katrina hit the Gulf Coast of the United States in August 2005. Mental health, medical, and public health professionals have spent one year addressing the needs of victims through direct work and research … Continue reading “Establishing Permanent Mental Health Programs Post-Hurricane Katrina: Lessons Learned and Recommendations for Practice in Underserved Communities Impacted by Mass Trauma” Learn More
Emergency Preparedness: Addressing the Needs of Persons with Disabilities In July 2004, President Bush signed an Executive Order explicitly stating the policy of the United States in the area of emergency preparedness for people with disabilities. The Executive Order built on The Americans with Disabilities Act (ADA), passed in 1990 “to provide a clear and comprehensive national mandate for the elimination of discrimination against … Continue reading “Emergency Preparedness: Addressing the Needs of Persons with Disabilities” Learn More
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 … Continue reading “Chronicles From Out-of-State Professionals: Providing Primary Care to Underserved Children After a Disaster: A National Organization Response” Learn More
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 … Continue reading “The Pediatrician and Disaster Preparedness” Learn More
On the Edge: Children and Families Displaced by Hurricanes Katrina andRita Face a Looming Medical and Mental Health Crisis: Executive Summary 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. … Continue reading “On the Edge: Children and Families Displaced by Hurricanes Katrina andRita Face a Looming Medical and Mental Health Crisis: Executive Summary” Learn More
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. … Continue reading “On the Edge: Children and Families Displaced by Hurricanes Katrina and Rita Face a Looming Medical and Mental Health Crisis” Learn More
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 … Continue reading “Critical Concepts for Children in Disasters Identified by Hands-on Professionals: Summary of Issues Demanding Solutions Before the Next One” Learn More
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 … Continue reading “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” Learn More
Homelessness and its Consequences Understanding the implications and meaningful details of homelessness helps to clarify the health care challenges that homeless people and the service providers who care for them face on a daily basis. This is not just a matter of very disadvantaged children who need medical care and a food pantry; it is also about families who … Continue reading “Homelessness and its Consequences” Learn More
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, … Continue reading “Psychosocial Implications of Disaster or Terrorism on Children: A Guide for the Pediatrician” Learn More
Children in a Post-9/11 World There is a special set of concerns with respect to children in a post·9/ll world. With the enormous national effort being made to prevent terrorism and particularly to enhance response capacity to unconventional weapons of terror, the special needs of children must be accounted for in preparedness planning at all levels. The important principle is … Continue reading “Children in a Post-9/11 World” Learn More
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 … Continue reading “Uncommon Sense, Uncommon Courage: How the New York City School System, Its Teachers, Leadership and Students Responded to the Terror of September 11” Learn More
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 … Continue reading “Atropine Use in Children After Nerve Gas Exposure” Learn More
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 … Continue reading “Pediatric Preparedness for Disasters and Terrorism: A National Consensus Conference: Executive Summary” Learn More
Homeless Women and Their Children in the 21st Century In spite of an unprecedented growth in the economy and subsequent record low unemployment levels throughout most of the 1990s, the number of people who were homeless in the United States steadily increased. A slowdown in the economy that began in 2000 and continued through 2001 magnified the problem. Safety-net programs remain inadequate and a … Continue reading “Homeless Women and Their Children in the 21st Century” Learn More
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 … Continue reading “Disaster and Terrorism Preparedness: What Pediatricians Need To Know” Learn More
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 … Continue reading “The 9/11 terror attacks: Emotional consequences persist for children and their families” Learn More
Access Denied: Taking Action for Medically Underserved Children Advocacy centered on access to health care for children is a straightforward business. The goal is clear: children need readily available, comprehensive, continuity-based, family-friendly, and child-friendly health services to meet a range of well-accepted objectives, including preventing, screening, acute care as needed, management of chronic conditions, and anticipatory guidance. Pediatricians refer to such a health … Continue reading “Access Denied: Taking Action for Medically Underserved Children” Learn More
The Homeless Child Health Care Inventory: Assessing the Efficacy of Linkages to Primary Care Each year, the New York City homeless family shelter system provides transitional housing for nearly 20,000 homeless children. While health care needs of these children are substantial, there is currently no system-wide mechanism for ensuring that they have access to appropriate medical care. This report analyzes information from the Homeless Child Health Care Inventory, a … Continue reading “The Homeless Child Health Care Inventory: Assessing the Efficacy of Linkages to Primary Care” Learn More
System-based Mobile Primary Pediatric Care for Homeless Children: The Anatomy of a Working Program The New York Children’s Health Project (NYCHP) of the Montefiore Medical Center-Albert Einstein College of Medicine has been providing comprehensive health services to homeless and medically under served children since 1987. Fully equipped mobile child health offices have been the major mechanism for bringing pediatrician-led teams to places that are convenient for and accessible to … Continue reading “System-based Mobile Primary Pediatric Care for Homeless Children: The Anatomy of a Working Program” Learn More
Constructive Conflict Management and Coping in Homeless Children Adolescents In this largely exploratory study of the conflict management and coping behavior of homeless adolescents, the authors interviewed 176 families (mother-adolescent dyads) living in New York City welfare hotels. Results indicated that peer conflict was the “worst” problem of the previous month as reported by approximately 50% of these youth. Homeless adolescents demonstrated conflict management … Continue reading “Constructive Conflict Management and Coping in Homeless Children Adolescents” Learn More
Overcoming barriers to health care access for medically underserved children Many children in the United States face serious challenges in seeking appropriate medical care, including lack of insurance coverage, linguistic and social barriers, geographic isolation, and localized shortages of health personnel. This article reviews the New York Children’s Health Project (NYCHP), outlining the planning and implementation of a mobile service delivery model for pediatric care … Continue reading “Overcoming barriers to health care access for medically underserved children” Learn More
