Ability and willingness to report to work during a disaster: Results of a survey of home health care employees

Background: Disaster preparedness relies on the willingness of the healthcare workforce to report to work during emergencies. The Emergency Response Program of a large home care agency in New York sought to understand the factors associated with ability and willingness to work under different disaster scenarios.

Methods: A modified Columbia University's Center for Public Health Preparedness “Health Care Staff: Disaster Survey” was made available to all employees through a secure website in Spring 2006, including demographic, employment, geographic and caregiving questions as well as employee's ability and willingness to report to work during different epidemics, fire, explosion or snowstorm.

Results: Over 1500 employees responded, a 32 percent rate for the agency. Respondents generally reflected the agency demographic and employment profile. Respondents were overwhelmingly female (80%) with median age of 45, almost 40% reported dependent children, 18% had eldercare responsibilities and 8 percent had both. Kappa analyses found that ability and willingness were strongly correlated (p-value < 0.0001). Logistic regression revealed that caregiving responsibilities and whether an employee lives in the same region in which the disaster occurred were the best predictors of willingness to report to work, regardless of whether the disaster is perceived as “terrorist” or “natural”. Discussion: Employers may increase willingness to work during disasters if employees are encouraged to develop emergency care plans for dependents, and assisting employees to devise alternative commuting routes should a disaster occur in their region. Findings also suggest that disaster preparedness policymakers might be constructing artificial distinctions between natural and terrorist disasters.