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Part 2: Emergency Preparedness from an Intersectional Approach

Thursday, November 15th, 2018

Written by: Jose Juan Lara, Jr., Project Manager, Casa de Esperanza: National Latin@ Network

Click here to read Part 1 of this blog

Click here to download the PDF of parts 1 and 2 of Emergency Preparedness from an Intersectional Approach

Barriers to Full Inclusion of Latin@ Communities in Emergency Planning[1]

As previously mentioned, Latinos are the nation’s largest and fastest-growing racial/ethnic group and an important population in many cities and states. For example, at the time of Katrina, the 117 hardest-hit parishes and counties along the Louisiana and Mississippi Gulf Coasts had about 1.8 million Hispanic residents, many of them immigrants.

In response to this tragedy, the National Council of La Raza (NCLR) — now UnidosUS — the largest national Hispanic civil rights and advocacy organization in the United States, in conjunction with the Office of Minority Health, U.S. Department of Health and Human Services (OMH/HHS), Mosaica: The Center for Nonprofit Development and Pluralism, and the National Immigration Law Center (NILC) developed the Emergency Managers Tool Kit: Meeting the Needs of Latino Communities.  The toolkit was created to increase emergency responder information about and understanding of the Latin@ community, community and media relationships established before an emergency occurs, and effective systems and procedures for reaching and assisting Latin@s. The toolkit identified the following barriers preventing full inclusion of Latin@ communities in emergency planning:

Barriers related to lack of appropriate systems and procedures

  • Emergency plans without information about where Latin@s live
  • Lack of pre-existing relationships with Latino community-based organizations – so these natural allies are not trained and ready to assist during an emergency
  • Lack of pre-existing relationships with Spanish language media
  • No plan for transmitting critical information and warnings to the Latino community via Spanish-language media and other mechanisms during the critical hours and days before a disaster or during a public health emergency
  • Few Spanish-language and/or bilingual materials in use for either preparedness or response
  • Lack of procedures and/or low priority given to recruiting and training Latin@s as emergency responders

Barriers related to emergency responders’ knowledge and experience gaps

  • Lack of awareness of the importance of planning and community relationships that include Latin@s
  • Latino community needs not built into pre-planning desktop exercises or simulations
  • Inappropriate actions by some responders (elected officials, staff, and volunteers) that create distrust, so Latin@s do not come forward and request assistance – even when their lives are at risk
  • Incorrect assumptions about the need to obtain documentation or determine eligibility during an emergency, rather than focusing on protecting lives and public safety
  • Incorrect assumptions that Latin@ legal residents and citizens, especially those with limited English skills, are undocumented – so they are denied or discouraged from seeking assistance they are entitled to

Barriers related to Latin@s’ language, past experiences, and immigration status

  • Limited English skills among Latin@ immigrants, especially recent immigrants
  • Use of Spanish language media rather than mainstream media
  • Fear and distrust of government based on experiences in the home country
  • Fear of deportation by Latin@s who are undocumented or who have an immigrant family member – so they are afraid to request help in an evacuation, entry to a shelter, or assistance during an emergency
  • Fear by legal residents who are not yet citizens that accepting assistance will lead them to be adversely affected under federal “public charge” provisions
  • Complicated laws like the welfare reform legislation passed in 1996, which bars many legal residents from federal financial assistance for the first five years and limits total years of service eligibility for refugees

Cultural and Linguistic Competency in Disaster Preparedness and Response[2]

The National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (CLAS Standards), issued by the Office of Minority Health, U.S. Department of Health and Human Services (OMH/HHS), offer individuals working in the areas of emergency management, public health, and other health-related organizations a framework for developing and implementing culturally and linguistically competent policies, programs, and services. Developing cultural and linguistic competency allows public health officials and emergency managers to better meet the needs of diverse populations and to improve the quality of services and health outcomes during and after a disaster.  To be effective, however, cultural and linguistic competency must be included in all phases of a disaster or public health emergency – preparedness, response, and recovery.

Five Elements of Cultural Competency within Disaster Preparedness

  1. Awareness and Acceptance of Difference: Responders and survivors are often different in their racial, ethnic and/or language characteristics. By improving communication skills as well as becoming self-aware of potential biases and stereotypes, however, public health officials and emergency managers can provide quality care to diverse populations in a culturally competent manner.

Example: Not all cultures react to pain in the same way.  While the experience of pain is universal, the way of perceiving, expressing, and controlling pain is one of these learned behaviors, that when manifested, is culture-specific.  An example of cultural competency is a public health official’s and an emergency manager’s self-awareness of expectations associated with how an individual expresses pain or stress.

  1. Awareness of One’s Own Cultural Values: Examining personal prejudices and cultural stereotypes by performing an individual self-assessment can help public health officials and emergency managers become aware of their own cultural values and biases. Example: The Valuing Diversity and Self-Assessment questionnaire is a widely used self-assessment that allows individuals to identify their own strengths and weaknesses when working with or treating populations with backgrounds different than their own.  For example, immigrant and refugee populations may speak a language other than English, have different cultural norms, come from a different socioeconomic background, and have a different style of dress.  Recognizing and respecting cultural differences and understanding your own biases and beliefs are critical to effectively serving or assisting culturally diverse populations during or after an emergency.
  2. Understanding and Managing the “Dynamics of Difference”: This refers to the various way’s cultures express and interpret information. Taking an individual’s medical history is a systematic way to collect both medical and cultural information. This information promotes cultural understanding and improves the quality of services provided to the individual. Example: The RESPOND tool succinctly defines the key components of taking the medical history of culturally and linguistically diverse populations.

R – Build rapport
– Explain your purpose
– Identify services & elaborate
– Encourage individuals to be proactive
O – Offer assistance for individuals to identify their needs
– Negotiate what is normal to help identify needs
D – Determine next steps

  1. Development of Cultural Knowledge: Cultivating a working knowledge of different health and illness related beliefs, customs, and treatments of cultural groups in your local area can better equip public health officials and emergency managers with the information necessary to provide timely and appropriate services.

Example: Research illustrates that racial and ethnic minorities are disproportionately vulnerable to, and impacted by, disasters.  Minority communities also recover more slowly after disasters because they are more likely to experience cultural barriers and receive inaccurate or incomplete information because of cultural differences or language barriers.

  1. Ability to Adapt Activities to Fit Different Cultural Contexts: This concept refers to the ability to adapt and as appropriate, to modify, the services offered to fit the cultural context of the patients and communities you are serving.

Click here to download the PDF of parts 1 and 2 of Emergency Preparedness from an Intersectional Approach

Additional Resources on Cultural Competency in Disaster Preparedness and Response

Andrulis, D. P., Siddiqui, N. J., Cooper, M. R., & Dotson, E. (2012, September). Status and Progress of Emergency Planning for Racially and Ethnically Diverse Communities in Greater Houston Findings from Co-Educational Forums with Community and Response Organizations. Retrieved September 22, 2018, from https://www.texashealthinstitute.org/uploads/1/3/5/3/13535548/thi_houston_case_on_diversity__preparedness_2012_updated.pdf

Cultural and Linguistic Competency in Disaster Preparedness and Response Fact Sheet. (2015, September 10). Retrieved September 19, 2018, from https://www.phe.gov/Preparedness/planning/abc/Pages/linguistic-facts.aspx

Cusicanqui, E., & Gantz McKay, E. (2011, May 02). Emergency Managers Tool Kit: Meeting the Needs of Latino Communities. Retrieved September 22, 2018, from http://publications.unidosus.org/handle/123456789/382

Federal Coordination and Compliance Section, Civil Rights Division, U.S. Department of Justice. (2016). Tips and Tools for Reaching Limited English Proficient Communities in Emergency Preparedness, Response, and Recovery. Retrieved September 22, 2018, from https://www.justice.gov/crt/file/885391/download

MDC. (n.d.). When Disaster Strikes: PROMISING PRACTICES Immigrants, Ethnic Minorities and Non-English Speakers. Retrieved September 22, 2018, from https://www.mdcinc.org/when-disaster-strikes/

[1] Adapted from Cusicanqui, E., & Gantz McKay, E. (2011, May 02). Emergency Managers Tool Kit: Meeting the Needs of Latino Communities. Retrieved September 22, 2018, from http://publications.unidosus.org/handle/123456789/382

[2] Adapted from Cultural and Linguistic Competency in Disaster Preparedness and Response Fact Sheet. (2015, September 10). Retrieved September 19, 2018, from https://www.phe.gov/Preparedness/planning/abc/Pages/linguistic-facts.aspx

 

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