The hurricanes of 2005 highlighted the many distinct populations with unique needs during an emergency that cannot be addressed with a one-size-fits-all approach and certainly cannot be confronted during an event without careful and appropriate pre-event planning. The events of 2005, along with the passage of the Pandemic and All-Hazards Preparedness Act (PAHPA) of 2006, have catalyzed public health emergency planning for special needs populations. Incorporating special needs populations into emergency preparedness planning is important because, during an emergency, valuable resources are often stretched beyond capacity, and without proper planning, the most vulnerable populations are least likely to receive what...

Five core strategies must be included in any planning for special needs populations during a public health emergency. Although each population has specific needs requiring unique strategies (described in Section II), these four cross-cutting approaches are essential to ensuring successful emergency planning.

Identifying, enumerating, and locating special populations living in the community require a set of critical initial steps in emergency preparedness planning and response. A variety of resources and tools is available to help public health agencies take these steps. For example, ASTHO and CDC developed planning guidance for at-risk populations during a pandemic (available at:http://www.astho.org/Programs/Infectious-Disease/At-Risk-Populations/). The guidance...

There are various definitions ofdisabled populations. However most encompass multiple, diverse groups of people with different conditions that affect sensory, cognitive, or physical, capabilities [6, 19]. According to the Americans with Disabilities Act,disabilityis defined as, “a mental or physical impairment that substantially limits one or more major life activities” [20].

In the context of emergency preparedness and response, the termdisabilityis misleading and should be considered more broadly [21]. Many individuals who could be characterized as disabled are highly independent, and they do not consider themselves disabled [6]. In an emergency situation, they may require little...

Racial and ethnic minorities and LEP populations are vulnerable to harm during a public health emergency for several reasons: They are more likely to be among those with less income and less education and those who lack the material resources needed to navigate a disaster [17, 18]. Minorities often have higher rates of disability and poor health [4, 31]; and they are more likely to be culturally or linguistically isolated [17, 18]. Low trust in traditional sources of public health information may also serve as a barrier to successful navigation of public health emergencies by some of these groups [9...

Although rural populations vary considerably according to the regions where they live, they share some individual- and community-level characteristics that make them particularly vulnerable in a public health emergency.

Rural populations have high rates of other characteristics that contribute to vulnerability, such as advanced age, poverty, and lack of insurance. In addition, some individuals living in rural areas, particularly those that are the most isolated, may have a very independent nature and tend to view government with some skepticism, making them less likely to cooperate in an emergency by heeding public health warnings or complying with public health orders or...

Children are often overlooked in public health emergency planning, but they can have special needs that should be considered before, during, and after an event. These needs are biophysical and emotional, and they also can vary considerably by developmental age. In addition, since children can be separated from their family during an event, schools and child care facilities are integral in any preparedness plans addressing pediatric needs.

First, children are uniquely susceptible to many man-made disasters (e.g., chemical or biological attack) because of their physical characteristics. For instance, children have rapid respiratory rates compared with adults, thus increasing their absorption...

Choosing a program or practice to implement in a specific community can be daunting. However, it can be made easier by breaking the process down into basic steps. Through our review of the literature on vulnerability and the interviews we conducted with staff involved in designing and implementing programs for special needs populations, we have identified several steps that local public health agencies can take to inform their decisions regarding which programs and/or practices are a good match for their community:

1. Specify the population group(s).

2. Determine the size of the group(s) and its geographic distribution within the community....

Given limited resources and many competing priorities, understanding whether a program is working as intended is critical to informing difficult allocation decisions. Health departments and other organizations need to be able to conduct evaluations to identify which practices work and make better resource-allocation decisions.

The prospect of conducting a formal evaluation can be daunting. There are, however, a number of things that a health department can do to make it easier.

First, as a practice is being developed, it is important to think about how it will be evaluated, which will help ensure that the data needed to assess performance...