Prioritizing Within and Among High-Risk Groups

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Prioritizing Within and Among High-Risk Groups


Most community pediatricians and pediatric care providers are left out of formal planning for disaster response. Ideally, this should be rectified before a pandemic or public health emergency. Pediatricians can ensure that federal, state, and local disaster plans include protocols for management of children by advocating for the special needs of children during planning efforts at every level. Public health leaders can connect with relevant AAP chapters to identify pediatric experts who can collaborate on preparedness efforts.

The unique medical attention that will be required for infants, children, and young adults with special health care needs must be considered. Taking the steps to include pediatric care providers in state-level decision-making and promote strategic communications and systematic messaging are key components of achieving prioritization within and among high-risk groups of children.

Pediatricians Can Improve Preparedness Planning for At-Risk Children
Pediatricians and others who advocate for children can help improve preparedness by encouraging others to be strategic in the way they communicate with others about children at risk. Within the general population, high-risk groups can include:
  • Pregnant woman
  • Lactating mothers and their infants
  • Health care personnel
  • Children and Youth with Special Health Care Needs (CYSHCN)
  • Hard-to-reach populations such as minorities, undocumented immigrants, the homeless, or families without access to computers or cellular telephones
Use of a generic catch-all terminology (at-risk, special needs, special populations) for diverse populations with very different needs interferes with the need to examine each of these groups and their needs individually. Use of these generic terms has resulted in combining children, pregnant woman, the elderly, and even pets into one group, and this practice sends an unhelpful message regarding the unique needs of each of these populations.

A better message to send is that children have important physical, physiological, developmental, and mental differences from adults that can and must be anticipated in the disaster planning process. In addition, there are certain groups of children that will require specialized planning and extra consideration up front. By carefully considering which groups of children may be at increased or even highest risk in a specific disaster or emergency, planning will benefit all children and the population at large. 

Pediatricians can improve pediatric preparedness planning for at-risk children by:
  • Clarifying that children have important needs and that certain groups of children are at increased risk
  • Identifying and planning for at-risk groups
  • Putting a plan in place to keep children together with their parents/caregivers during evacuation, transport, sheltering, or the delivery of other services
  • Strategically addressing influenza prevention and control for children with chronic medical conditions (such as asthma, diabetes mellitus, immunosupression, or neurological disorders)
Questions to Consider
  • Has a strategic plan been developed to identify and address the needs of high-risk populations before, during, and after a disaster?
  • What strategies can be implemented at the state, regional, and local level to enhance the care of children at high risk, including CYSHCN?
  • Does the state preparedness plan consider the unique needs of all children, especially CYSHCN?
  • What are the opportunities at the local level to advocate for hard-to-reach populations?
  • Are there questions that public health leaders have about children in high-risk categories that AAP member experts can help answer in advance of an emergency or disaster?
  • Is there a mechanism in place for AAP chapter and public health decision-makers to determine how to allocate resources and address the needs of children, especially those at increased risk after a disaster?  See one example from Kansas here.
  • Can a current public health emergency or local disaster situation be used to reinforce influenza preparedness or other health messages (eg, need for annual influenza immunization, early treatment, connection to the child’s medical home)?
The information on this page was adapted from a section of the Pediatric Preparedness Resource kit.


Children and Youth With Special Needs (AAP)

Additional Information about Vaccination of Specific Populations (CDC)

Caring for Children in a Disaster (CDC)

Neurologic Disorders Among Pediatric Deaths Associated With the 2009 Pandemic Influenza (AAP)

Infant Nutrition During a Disaster: Breastfeeding and Other Options

Prevention and Control of Influenza: Special Considerations for Newborns and Very Young Infants (AAP)
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