Death Care Sector: Preparedness for Mass Fatalties

Background: Information regarding the disaster preparedness of critical infrastructures in the United States and elsewhere is limited. In particular, the capacity and response capabilities of the death care sector, which is a key element in the mass fatality management infrastructure in the U.S. is largely unknown. The purpose of our study was fourfold: 1) to increase our knowledge on this issue, 2) to characterize mass fatality preparedness of the death care sector (i.e., funeral industry organizations, representing funeral homes, funeral suppliers, cemeteries, and crematories), 3) to determine the workforce's ability and willingness to report to duty, and 4) to identify factors that served as barriers or facilitators to ability and willingness to report during a hypothetical high fatality pandemic event. Methods: An anonymous, web-based, cross-sectional survey of a national funeral industry sample was conducted. Preparedness was characterized using descriptive statistics. Factors significantly associated with ability and willingness were identified using chi-squared bivariate analysis. Results: Respondents (N=492) generally rated their organizational preparedness planning as suboptimal; only six of 13 preparedness checklist items were typically in place. In contrast, response intentions were uniformly high; more than 80% of respondents were willing to report to work, although high prevalence of secondary obligations might hinder this. Conclusions: Preparedness strategies that address inter-organizational, surge capacity, and personal emergency planning are likely to be most efficacious.