Assessment of Pandemic Preparedness in a Socially Vulnerable Community in South Texas
Kiltz, Linda, Fonseca, Diana, Rodriguez, Christina, Munoz, Paola, Journal of Health and Human Services Administration
Pandemics and epidemics of influenza viruses represent one of the greatest threats to our nation, particularly among vulnerable populations (Hutchins, Truman, Merlin, and Redd, 2009; Debruin, Liaschenko, Marshall, 2012). The latest outbreaks of avian influenza (H5N1) and the novel H1N1 influenza have heightened concerns about the impact of such events on communities and nation-states (Cinti, 2005; Hutchins, Fiscella, et al., 2009). The management of previous outbreaks demonstrated problems with our capacity and governance structures in responding to public health emergencies. These concerns are clearly highlighted in the national pandemic influenza and implementation plans that are designed to stop or slow down pandemic virus transmission and mitigate the impact on the U.S. population (Homeland Security Council, 2006; White House, 2005).
In November, 2005, the U.S. Department of Health and Human (HHS) services released their pandemic influenza preparedness and response plan. This plan articulated steps to be taken by HHS agencies and offices, and by state and local public health authoritiesrin preparing for and responding to a pandemic (U.S. Department of Health and Human Services, 2005). Specific activities discussed included surveillance, vaccine development and use, antiviral drug use, and communications. Additionally, President Bush released the "National Strategy for Pandemic Influenza," in 2005 to coordinate pandemic preparedness and response activities across federal agencies. This strategy explained how domestic response activities would be carried out under the broad, all-hazards blueprint for a coordinated federal, state and local response laid out in the National Response Plan, released by the Department of Homeland Security (DHS) in 2004.
The strategy emphasizes a collaborative intergovernmental approach to pandemic planning and response. It not only highlights how the nation intends to prepare, detect, and respond to a pandemic, but also outlines the roles to be played by the federal government, state and local governments, private industry, individuals and families. States in partnership with local communities play a leading role in preparing for and responding to public health threats, and are responsible under the national strategy for establishing comprehensive and credible preparedness and response plans; integrating non-health entities (utilities, law enforcement, city services) in the planning for pandemic; providing public education campaigns; identifying key spokespersons for the community and ensuring they are educated in risk communication; and ensuring reasonable measures are taken to limit the spread of the outbreak (White House, 2005). Furthermore, this strategy emphasizes the critical role of individuals and families in helping to contain a pandemic and consequently the importance of public education programs (White House, 2005). Planning is further complicated by the fact that the timing and severity of pandemics are inherently unpredictable.
Researchers have found that racial and ethnic minority populations to be at greater risk during pandemics because they often have less capacity to implement preparedness strategies or tolerate its impact given disparities in underlying health status and social factors, such as socio-economic disadvantages, cultural, educational and linguistic barriers, and lack of access to and use of health care (Hutchinson, Fiscella, et. al, 2009; Blumenshine, Reingold, et al., 2008).
A more severe influenza pandemic could have a disproportionate effect on the health of more than 120 million members of racial/ethnic minorities in the U.S. (U.S. Census Bureau, 2011). This is particularly true in Texas, where people who identified themselves as Hispanic accounted for 65 percent of the state's growth in the last decade and now make up 38 percent of the population (Spruill, 2011; McKinley, 2011). The Texas Association of Counties (2011) noted that the major ethnic group in San Patricio County in 2010 was Hispanics (54. …