The Lack of Equity in Pediatric Disasters
Disasters impact all children, but disasters do not impact all children equitably. Some children experience worse outcomes after disasters. As we have seen in recent years, factors such as race, ethnicity, medical complexity, income, and geographic location can negatively impact how a family experiences a disaster and leads to a lack of equity for children.
Promoting Equity in Pediatric Disaster Preparedness
Being aware of biases and differential practices are the first steps in addressing inequality in pediatric disaster preparedness. Knowing the challenges is not enough, however. The system of care that families rely on during disasters should be built with the input of families who represent the community regarding various aspects of diversity including race, ethnicity and languages spoken to prevent or mitigate systemic inequality. The partners in any system – from the smallest rural town to a larger urban environment – must work together to get accurate information from trusted sources to families. Communication between those partners – such as health care personnel, social services, educational institutions – will help support the transfer of critical information regarding a child’s health and wellbeing and result in improved outcomes for children after a disaster or emergency.
Resources For Implementing Equity in Pediatric Disaster Preparedness
Many trusted institutions have developed resources to support communities and organizations to address equity in their pediatric disaster preparedness efforts. Some of these resources are listed below.
The AAP team at the Bright Futures National Center has developed a compendium of resources to support pediatric health care professionals and their partners to address the impact of racism, bias, and discrimination on the health and well-being of their patients and families. The purpose of these resources, which include tips and tools, is to prepare pediatric health care professionals to engage in meaningful conversations that positively affect infants, children, adolescents, young adults, and their families within the context of the health supervision visit.
Pediatricians and others can use this resource from the AAP to learn how the language we use can have a positive or negative influence on helping families feel included in pediatric disaster preparedness and response efforts. Tips are included for terminology that can replace language that we have used in the past that may not reflect the level of respect and inclusivity that we want to have in pediatric disaster management.
This landmark policy statement acknowledges the bias and race-based approach used in health care in the past and lays a course for a more equitable approach to pediatric health care going forward.
The team at Child Welfare Information Gateway has developed a tip sheet to help those specifically in child welfare agencies to ensure that pediatric disaster preparedness activities include perspectives that support equity, diversity, and inclusion and reduce disparities.
To be more effective in its efforts to promote equity, diversity, and inclusion, FEMA conducted an initial equity analysis of multiple programs across the agency, each of which has different capacity to conduct a thorough equity assessment and implement actions to address identified barriers. This action plan summarizes the barriers discovered so far for each program and potential actions that could be taken to address them.
The Federal Emergency Management Agency (FEMA) has developed web content addressing equity in disaster preparedness, response, and recovery. This provides background on the agency’s priorities related to improving equity, diversity, and inclusion in their activities.
The current climate crisis has resulted in numerous natural disasters that affect communities of color, those living in poverty, and other groups unequally. The OCCHE addresses climate change and health policy, programming, and analysis, in pursuit of environmental justice and equitable health outcomes. The Office also facilitates the use of regulatory and statutory powers of the Department of Health and Human Services to address matters affecting disadvantaged communities and people on the frontlines of the climate crisis. The Office works alongside community-based organizations, non-governmental organizations, academia, business, industry, along with, state, tribal, local, and territorial governments, to define and implement strategies, conduct strategic outreach and communications, and train and empower community residents.
HHS provides a helpful description of health equity and how it intersects with climate crisis-related disasters. While all of us are impacted by climate disasters, there are communities that are at a significant disadvantage and children in these communities are at higher risk for poor outcomes during and after disasters.
American Academy of Pediatrics