Using epidemiological methods to identify underserved and high risk populations and effectively provide all-hazards preparedness education

To accurately assess disparities in the educational efforts and subsequent status of the local population, the City of Fort Worth Public Health Department conducted a comprehensive Community Needs Assessments (CNA) in part to evaluate emergency preparedness throughout the population. Factors examined included knowledge of emergency contingencies, preparation for emergencies, access to emergency information and level of self-perceived preparedness. Extent of preparedness was further stratified by socio-economic status, educational level, race/ethnicity, geopolitical boundaries, income and other variables that provided supplementary evaluation of the efficacy of educational interventions. These data provided insight into preparedness disparities within the community and among specific cross-sections of the population. Respondents often did not demonstrate a level of preparedness commensurate with their self-perceived level of knowledge and security. CNA data indicated a population-wide contrast between perceived and actual preparedness. The first two years of a multidisciplinary, multi-medium bioterrorism preparedness educational program indicate that over 65% of the city's households have been exposed to emergency preparedness education. The CNA indicates, however, that less than a third of households have engaged in behavior indicative of a minimal level of preparedness. Remarkably, non-English speaking Hispanics in select parts of the city were identified as having been virtually unaware of these educational efforts and consequently felt unprepared. An epidemiologically based CNA initiative that allows for reliable analysis and insight into the status of the community is critical in identifying un-served, underserved and high risk populations to assure public health emergency preparedness and access to other health and social services.