Water Safety & Emergency Preparedness

woman carrying jugs

August is National Water Quality Month

The United States has one of the safest and most reliable drinking water systems in the world. However, emergencies, such as natural (e.g., hurricanes, floods, and droughts) and man-made disasters (e.g., chemical spills), can damage water infrastructure and/or contaminate water supplies.

Safe drinking water is essential to the health and wellbeing of communities. Every year, about 7.2 million people get sick in the U.S. from diseases spread through water. Knowing how to ensure your access to safe water during & after emergencies can protect you from getting sick.callout

Ensuring Access to Safe Water

Depending on the emergency, your water may be safe to use for personal hygiene and handwashing, but unsafe for drinking and cooking. Or it could be unsafe to use for any reason.

Authorities use drinking water advisories to inform communities about public health threats related to drinking water. Advisories are designed to inform consumers about the situation and provide recommendations on what to do. Advisories usually include one of these warnings: Boil Water Advisory, Do Not Drink Advisory, and Do Not Use Advisory.

If tap water is unavailable or unsafe to drink or use after an emergency, it’s important to know how to make your water safe and where to find alternative water sources inside your home.

Unopened commercially bottled water is the safest and most reliable source of water in an emergency. If bottled water is unavailable, you can make your water safe through boiling, disinfection, filtration, or ultraviolet light.

You may also consider exploring alternative sources of safe water. Water sources can be inside your home (e.g., liquid from canned fruits and vegetables)— or outside your home. Learn about places where you might find sources of water that are safe to use.

Creating an Emergency Water Supply

It’s important to develop a plan to ensure access to clean drinking water at home, the office, the school, or other places where a water-related emergency may occur.

Storing unopened commercially bottled water is one of the most reliable and least expensive sources of water in an emergency. Store at least one gallon of water per person per day for three days for drinking and sanitation. Try to store a two-week supply if possible.

CDC recommends that you keep in mind the following:

Set a reminder to replace store-bought water according to their expiration date and bottles of water appropriately bottled at home every 6 months.

Keep a bottle of unscented liquid household chlorine bleach to disinfect your water, if necessary. The label should say it contains between 5% and 9% of sodium hypochlorite.

Considerations for At-Risk Populations

Consider people’s specific health needs and the conditions in the places where they live when communicating about water preparedness.

Access to and use of safe treated water is often influenced by geographical location and/or socioeconomic status. People living near contaminated sources of water (e.g., aging infrastructure, rural, tribal, immigrant, or refugee communities) may face increased exposure to unsafe drinking water.

Certain populations, including infants and children, people with certain medical conditions, pregnant people, and older adults are at a higher risk of suffering from health issues because of the lack of access to safe water.

  • Infants and young children have unique feeding and hygiene needs during an emergency:
    • Infant formula feeding requires safe water to prepare the formula and cleaning supplies to clean bottles, nipples, and other parts. Find more information and resources for emergency preparedness and response personnel, families, and the public to ensure that children are fed safely during an emergency: Infant and Young Child Feeding in Emergencies (IYCF-E) Toolkit | Nutrition | CDC.
    • It’s always important to change diapers in a safe, germ-free way, but an emergency can make this difficult. CDC offers guidelines and checklists to help parents, childcare providers, emergency responders, and others learn how to prevent the spread of germs while changing diapers during emergencies.
  • Schools, day-care centers, and camps for children can be at risk for outbreaks during an emergency. CDC has available information to help state and local health departments respond to suspected waterborne outbreaks.
  • People who are immunocompromised or have a weakened immune system because of a medical condition or medical treatment may be more susceptible to getting sick.
  • Adults aged 65 and older are at increased risk of infection and disease from harmful germs because of many factors, including reduced immunity, existing chronic illness, and institutional exposure (e.g., exposures at hospitals and nursing homes). Visit CDC’s Promoting Health for Older Adults to learn about this topic.

Similarly, people with limited access to safe water in their homes, grocery stores, or the means to travel to and haul water may find it difficult or even impossible to prepare a home water supply.

Emergency preparedness authorities should account for their communities’ specific needs when developing response plans. CDC offers customizable and printable tools and templates, which include checklists, fact sheets, and press releases that can be adapted to the needs of each community.

Resources

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

#PrepYourHealth with Vaccines

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August is National Immunization Month.

Over the years, vaccines have prevented countless cases of disease and saved millions of lives. Vaccines are important to helping people stay healthy and protected from serious and sometimes deadly diseases.

Staying up to date on recommended immunizations can help keep you healthy in response to emergencies, including disease outbreaks and natural disasters.

Immunization Recommendations for Responders

Vaccination is an important step every first responder should take to prepare for a response. Some vaccine-preventable diseases are more common after a disaster.

Being up to date on tetanus and hepatitis B vaccines is important for everyone, including emergency responders.

Tetanus is a potential health threat if you sustain wound injuries. Being up to date on tetanus vaccination is the best tool to prevent infection, along with immediate and good wound care.(1)

Everyone aged less than 60 years are recommended to be up to date on Hepatitis B vaccination. Hepatitis B vaccination is also recommended if you are expected to have exposure to blood or blood-contaminated bodily fluids.(2)

People in certain response jobs and travel situations may be exposed to dangerous or deadly diseases that are uncommon in the U.S. Emergency responders should check Traveler’s Health for current vaccine recommendations before they deploy outside of the country. They may include anthrax, cholera, typhoid, rabies, and yellow fever.

Immunization Recommendations for All Individuals

People need different vaccinations depending on their age, location, job, lifestyle, travel schedule, health conditions, or previous vaccinations.

Everyone needs immunizations to help them prevent getting and spreading serious diseases to their loved ones or others in their community.

  • Everyone 6 months and older needs the seasonal flu (influenza) vaccine every year. The flu vaccine is especially important for people with chronic health conditions, pregnant women, and older adults.
  • Every adult should get a Tdap vaccine once if they did not receive it as an adolescent to protect against pertussis (whooping cough). They should get a Td (tetanus, diphtheria) or Tdap booster shot every 10 years. Women should get the Tdap vaccine each time they are pregnant, preferably at 27 through 36 weeks.(3)

CDC recommends COVID-19 primary series vaccines for everyone ages 6 months and older, and COVID-19 boosters for everyone ages 5 years and older, if eligible.(4)

Vaccines help protect you from getting sick or severely ill. Vaccines like those for seasonal flu and COVID-19 are especially important if your emergency action plan is to go to a shelter in an evacuation.

Evacuations for hurricanes and wildfires can force people into emergency shelters, where close quarters, shared spaces, and high-touch surfaces can make it easy for illnesses, including COVID-19 and flu, to spread.

Stay Informed About Staying Up to Date

Immunizations are not just for children. Protection from some childhood vaccines can wear off over time. Adults may also be at risk for vaccine-preventable disease due to age, job, lifestyle, travel, or health conditions.

It’s important that everyone stay up to date on their immunizations so that they are protected when a disaster strikes. You are up to date with when you have received all doses in the primary series of a vaccine and all boosters recommended for you.

Here are three ways you can stay informed of how well you’re staying up to date on recommended vaccines.

  • Take this quiz to find out what other vaccines may be recommended for you. Talk with your healthcare provider to make sure you get the vaccines that are right for you.
  • Download or print copies of age-appropriate vaccination schedules to help you stay informed of when you or a loved one is due for a vaccine or booster. Take with you to your next doctor’s appointment.
  • Ask your doctor, pharmacist, or vaccination provider for a vaccination record form or download one. Keep it with your other important paperwork. Take the form with you to health visits. Ask your vaccination provider to sign and date the form for each vaccine you receive.(5)

Staying up to date can help keep you, your loved ones, and your community safe. Learn more ways to prepare your health for emergencies.

References

  1. https://www.cdc.gov/tetanus/about/prevention.html
  2. https://www.cdc.gov/mmwr/volumes/71/wr/mm7113a1.htm?s_cid=mm7113a1_w
  3. https://www.cdc.gov/vaccines/adults/rec-vac/index.html
  4. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html
  5. https://www.cdc.gov/vaccines/adults/vaccination-records.html#record-vacc

Resources

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Be Prepared to be Away During an Emergency

Kids hugging their mom before heading off to their first day of school.

July 24 is National Parents Day

Emergencies can happen anywhere, at any time, including when you’re not with your children and pets. It’s a scary thought. But you can take steps to protect them when you’re not around to do it yourself.

Camp & Childcare Parents

On any given weekday during the school year, an estimated 69 million children are in school and childcare.(1) During summer, some of those same children are in camps and childcare.

Parents, guardians, and other caregivers want to know their children are safe when they’re away from home. Camp and childcare providers play an important role in giving parents and guardians peace of mind. They should have family reunification plans and hold regular drills to help children and staff practice staying safe in the event of an emergency.

In addition, here are some ways you can prepare for an emergency that happens when you are not with your child.

Knowing camp or childcare providers have an emergency plan and the supplies they need to care for your child can help you feel better about leaving them in the care of others.

Pet Parents

Pets are family, too. It’s natural for pet parents to feel anxious about leaving their pet in the care of someone else, such as a pet sitter or kennel, or if you have someone nearby who can check in on them. Having someone who can check up on your pet if they are not somewhere safe can give you peace of mind.

Here are suggested steps you can take to help keep your pets healthy and safe if an emergency happens while you’re away.(2)

  • Make sure your pet has plenty of food. Write out feeding instructions, including portion size and other special considerations, such as the feeding order of multiple pets.
  • Check that your pet has enough medicine. Write out instructions for giving prescription medicines and where they’re kept. Keep medicines up and away from children and pets.
  • Write out your itinerary and contact information, including your cell phone number and the name and phone number of where you’re going.
  • Leave contact information for your veterinarian and one or two people you trust to make decisions in case you can’t be reached. Be sure to ask those people before you do this. Contact your veterinarian’s office to let them know you have a pet sitter.
  • Leave the pet sitter with copies of important paperwork, including a list of vaccinations and dates received.
  • Microchip your pet.
  • Make sure your pet wears collars and tags with up-to-date contact information and other identification.
  • Keep your pet’s carrier or crate near the exit. Tell the sitter where your pet might hide when it feels stressed or scared.
  • Prepare a pet emergency kit, including first-aid supplies and detailed instructions on how to use it.
  • Leave instructions about your home, such as garage door codes, utility shutoff instructions, and your neighbor’s names and phone numbers.

Prepping your pet sitter or a person you trust to check in on your pet can help ensure that your pet gets the best possible care when you’re away.

Reuniting After an Emergency

Separation from one’s family during or after an emergency can have mental and physical effects on everyone involved, including parents and guardians, children, and pets.

Reunification is the process of returning children and pets to their families as quickly as possible after an emergency. The faster reunification happens after an emergency, the better.

Learn more about reuniting with loved ones after an emergency.

References

  1. https://www.cdc.gov/childrenindisasters/reunification.html
  2. https://www.cdc.gov/healthypets/keeping-pets-and-people-healthy/emergencies.html

Resources

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

3 Uses for ZIP Codes to Stay Informed

A person takes mail from mailbox.

July 1 is U.S. ZIP Code Day.

The U.S. Postal Service (USPS)—then called the U.S. Post Office Department—introduced the Zone Improvement Plan (ZIP) code in 1963. USPS’ purpose was to facilitate the automatic sorting of mail and reduce the number of steps a piece of mail would go through to reach a recipient.(1)

Since then, USPS has created and deleted ZIP codes as needed. It expanded ZIP codes from 5 digits to 9 and then to 11.(1)

The meanings and utility of ZIP codes have changed too. Today, they have impact implications and uses beyond moving mail.

Your ZIP code can help you stay informed before and during emergencies, including disease outbreaks and natural disasters. Here are three examples of the kinds of information you can find using your ZIP code.

Your Hazards Riskmap

You can’t prepare for something if you don’t know it’s a threat. Part of staying informed is knowing about the hazards that can cause you harm and how to mitigate (or reduce) your risk. Your ZIP code can help you learn about hazards in your area.

The National Risk Index is an online mapping application from FEMA that is searchable by ZIP code. It was developed with local emergency planners in mind, but you too can use it to identify the hazards most likely to threaten your health and safety.

The Index uses data for natural hazards and community risk factors to develop a “baseline relative risk measurement” for each county and census area. It analyzes expected annual loss, social vulnerability, and community resilience to determine a community’s potential for negative impacts resulting from 18 natural hazards.(2) Hazards include earthquakes, heat waves, hurricanes, and wildfires.

Learn more about how the Index calculates risk.

The Nearest Vaccine Provider

As with other diseases, you are protected best from COVID-19 when you stay up to date with the recommended vaccine doses and boosters.(3)

Staying up to date means getting all doses in the primary series and all boosters recommended for you. CDC recommends COVID-19 vaccines for everyone ages 6 months and older, and COVID-19 boosters for everyone ages 5 years and older, when eligible.(3)

COVID-19 vaccines are available at no cost.(4) Use your ZIP code to find COVID-19 vaccines and boosters near you. You can also text your ZIP code to 438829 for location information.

You can also use your ZIP code to find the nearest Test to Treat sites.  There are hundreds of locations nationwide where you can

  • get tested or bring your test results,
  • get a prescription from an on-site healthcare provider if you are at high risk of getting very sick, and
  • fill your prescription for an oral COVID-19 treatment.(5)

Learn more about the Test to Treat initiative, including what to bring with you when you go.

Your Local Forecast

The right message at the right time from the right person can save lives in times of crisis. Having multiple ways to receive those messages, including emergency alerts, can help you stay healthy and safe during an emergency.

Some of the most important kinds of emergency alerts are hazardous weather advisories, watches, and warnings. They are issued by the National Weather Service (NWS) when hazardous weather is happening, about to happen, or likely to happen.

There are two ways you can use your ZIP code to stay informed of weather advisories, watches, and warnings where you live:

  1. Enter your ZIP code on the NWS website to see a localized weather forecast.
  2. Search for your local NWS Weather Forecast Office on social media.

Take both actions to improve your odds of receiving the right message from the right source in enough time to take action.

Visit the Prepare Your Health website for more tips on how to stay informed before and during an emergency.

Resources

References

  1. https://www.uspsoig.gov/sites/default/files/document-library-files/2015/rarc-wp-13-006_0.pdf
  2. https://www.fema.gov/flood-maps/products-tools/national-risk-index
  3. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html
  4. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/no-cost.html
  5. https://aspr.hhs.gov/TestToTreat/Pages/process.aspx

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Making Emergency Plans Inclusive

A decorative image that says "LGTBQ+" above a box. Inside the box it says "PRIDE".

June is Lesbian, Gay, Bisexual, Transgender, Queer, and Intersex (LGBTQI+) Pride Month. This post was written in collaboration with the National LGBTQIA+ Health Education Center.

LGBTQIA+ communities must prepare for—and are affected by—emergencies, including natural disasters and disease outbreaks. Unlike some, LGBTQIA+ communities often face barriers, such as discrimination and harassment, that can make it difficult to meet their preparedness and response needs.

All people, regardless of their sexual orientation or gender identity, should feel safe and have access to opportunities and services during an emergency. Here are some steps that emergency planners can take to ensure the public health and safety needs of LGBTQIA+ communities are met with empathy and respect.

Identify & Engage with the Communities

LGBTQIA+ people account for an estimated 3% of the total U.S. population.(1) As such, emergency planners must find ways to involve LGBTQIA+ communities and integrate their expertise in preparedness and response activities. Some ways to do that include:

  • Networking with local LGBTQIA+ community leaders, influencers, and health “champions” in your area.
  • Developing and incorporating messages, including images and symbols supportive of LGBTQIA+ communities on websites and social media.
  • Working with LGBTQIA+ community groups and leaders to ensure messages are culturally appropriate.
  • Working with trusted traditional and new media in LGBTQIA+ communities to position messages and educational materials.

LGBTQIA+ communities are diverse. Understanding their needs requires that emergency management and public health agencies develop cultural competencies. There are different ways to achieve this goal, including working with communities to define and address their service needs.

Develop Internal Capabilities

Developing internal capabilities to assess and address people’s health needs and priorities, including LGBTQIA+ communities, increases the chances public health plans and interventions will succeed during emergencies.

It’s important that emergency planners review and revise their plans as necessary to ensure the delivery of inclusive and safe services for LGBTQIA+ people during an emergency. Some ways to do that include:

  • Reaching out to LGBTQIA+ organizations to gain access to culturally responsive training.
  • Recruiting LGBTQIA+ community members and subject matter experts to volunteer at your organization and during emergencies.
  • Working with partners to ensure they are aware of events affecting LGBTQIA+ populations and prepared to offer additional services.

LGBTQIA+ people may avoid disclosing their sexual orientation, gender identity, or gender transition during an emergency. Some may distrust emergency responders and health providers because of prior experiences of discrimination or harassment.

Even the location of a public shelter can increase the chances an LGBTQIA+ person, couple, or family will experience harassment. Hate crimes and other acts of anti-LGBTQIA+ violence can occur during an emergency. These acts can have a traumatic effect on LGBTQIA+ people and communities.

Working proactively with LGBTQIA+ communities, emergency response leaders may identify training opportunities and trusted messengers. Messengers can help create and deliver culturally appropriate messages, strategies, and plans and develop trust among the community members.

Start Conversations

There is no “one size fits all” plan to address the health needs and priorities of all the communities. No single intervention will work with every population, including LGBTQIA+ communities.

LGBTQIA+ inclusion involves getting input from LGBTQIA+ communities. The public health community must engage with LGBTQIA+ communities in conversations to answer questions like:

  • Do our emergency response plans, strategies, and messages appropriately reflect the needs and priorities of LGBTQIA+ communities?
  • How can we make our emergency efforts more welcoming and responsive to the needs of LGBTQIA+ communities?
  • Are there options available for training to better understand and incorporate the needs and priorities of LGBTQIA+ communities?

Getting answers to questions like these can help officials develop emergency plans and interventions that are more accessible, inclusive, and respectful.

Resources:

  • Culture and Language. CDC website focused on cross-cultural communication, language access, and resources.

References

  1. https://www.census.gov/newsroom/press-kits/2020/2020-census-lgbtq.html?msclkid=535bb27ad05b11ecb0bd72487e8965cf

Prep Your Health to Evacuate

A line of vehicles parked along the side of a road at night. A wildfire burns in the distance.

June is a busy time of year for emergency preparedness and response.

June marks the start of the Atlantic hurricane season. It’s also wildfire season.

Hurricanes and wildfires are common causes of evacuations. Both are happening more often and with greater intensity.(1) Annual increases in the number of strong hurricanes and large wildfires likely mean more people will face these threats.

In 2017, more than 8 million people across the country were affected by evacuation orders because of flooding, wildfires, and hurricanes. That includes an estimated 6.8 million residents of Florida who were under evacuation orders in response to Hurricane Irma. It was one of the largest mass evacuations in U.S. history.

Don’t get caught unprepared for an evacuation order. Learn what you can do now to prepare for evacuations and mitigate some of the stress of having to relocate.

Know Your Zone

Different communities plan for evacuations in different ways. It’s important to know the plans and procedures where you live.

Emergency planners in many states and localities subdivide their jurisdictions into numbered or lettered evacuation zones. The City of Ashland, Oregon, for example, is divided into 10 zones. City officials use numbered zones to manage evacuations.(2)

Residents of Ashland are encouraged to know their zone before an evacuation. The city set up an interactive evacuation map where residents can learn their zone by searching their addresses.

Contact your local public safety or emergency management agency to learn how decisions about evacuations are made where you live.

Find the emergency management agency for your state or territory using the free search tool on USA.gov.

Learn the Alerts

It’s as important that you know what to do when you are notified to take protective action, such as evacuating. Ensure you have multiple ways to receive emergency alerts. They might include watching local television, listening to local radio, following trusted sources on social media, and signing up to receive emergency alerts by phone call or text.

Many local governments across the country—primarily in areas at high risk for wildfire—have adopted the Ready. Set. Go! (RSG) program. RSG was developed by the International Association of Fire Chiefs as a way to educate about wildland fire risk, promote wildfire preparedness, and communicate in plain language what to do in the event of a fire.

As the name suggests, there are three steps to RSG.

  • Ready means be prepared. People are asked to gather emergency supplies, make an emergency action plan, sign up for emergency notifications, and stay informed of local hazards.
  • Set is a warning to get organized because of significant danger in the area. People under “set” status should prepare to evacuate. They should pack “go kits” and consider relocating—voluntarily—to a safer location.
  • Go! is the signal to evacuate immediately to a designated shelter or someplace in a safer area. Find out how you can protect yourself and others from COVID-19 when evacuating to a public shelter or the home of friends or family.

How ever your local officials communicate an evacuation, don’t hesitate to leave if given the order. Follow instructions on where to go and how to get there. Your normal route out of your neighborhood may not be the safest during an emergency.

Make An Evacuation Plan

Your emergency care plan is more than a list of names and phone numbers. It’s more accurate to think of it as a user guide for how to stay healthy, informed, and connected during an emergency.

An emergency action plan should include:

  • phone numbers for your physician, pediatrician, pharmacist, counselor, and veterinarian.
  • copies of current personal care plans (e.g., an asthma action plan, a food allergy and anaphylaxis care plan, and an emergency care plan for children and youth with special healthcare needs).
  • a copy of the family reunification plans for your child’s school or daycare.(3)

To help you plan for an evacuation, your emergency action plan might also include a MyEvacuation Plan checklist. This evacuation planning tool guides you through actions you can take to prepare for an evacuation, such as:

  • creating “go bags” for each member of your household.
  • getting an emergency refill on your prescription medicines (if eligible and where available).
  • finding a place where you and your pet can safely stay in an evacuation.
  • having multiple ways to receive evacuation orders and instructions. You will likely get the order to evacuate from local police, fire, or other local officials on the radio, television, social media, and/or by text alert.

Visit the Prep Your Health website for more tips on how you can plan ahead for emergencies.

Emergency Response Planning

People experience disasters differently. Some are at higher risk of impacts because of their economic status, geography, disability status, etc.

The COVID-19 pandemic and other recent emergencies have brought inequities to the forefront of public health. State and local emergency planners must engage with their communities if they are to understand the conditions in the places where people live, learn, work, and play and their effects on emergency preparedness and response.

  • People with lower incomes often live in places that lack the space to shelter in place or financial resources to evacuate.
  • People with disabilities may be unable to evacuate on their own. The percentage of people living with disabilities is highest in the South.(5) This includes the hurricane-prone states of Alabama, Georgia, Florida, Louisiana, Mississippi, North Carolina, South Carolina, and Texas.
  • Some people may be unable to evacuate without help and less prepared to stay in their homes in the aftermath of a major disaster.

The Federal Emergency Management Agency has planning guides to help emergency planners involve the whole community in preparedness.

Resources

References

  1. https://www.usda.gov/media/blog/2019/06/27/wildfires-all-seasons
  2. https://www.ashland.or.us/Page.asp?NavID=13512
  3. https://www.cdc.gov/prepyourhealth/planahead/
  4. https://training.fema.gov/hiedu/docs/ballen%20-%20vulnerable%20populations.pdf
  5. https://www.cdc.gov/ncbddd/disabilityandhealth/infographic-disability-impacts-all.html

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Building Trauma-Informed Communities

holding hands

Many people will experience a traumatic event at some point in their lives. Often unexpected and shocking, it may overwhelm their ability to cope and create a lasting sense of fear, vulnerability, and helplessness.

Traumatic events are scary or dangerous experiences that can affect people emotionally and physically. They include acts of violence (e.g., assault, physical or emotional abuse, war), natural disasters, car crashes, and other accidents.(1)

Trauma is a physical, cognitive, and emotional response caused by a traumatic event, series of events, or set of circumstances that is experienced as harmful or life-threatening.(2) Trauma can have lasting effects, particularly if untreated.callout

A trauma-informed approach to emergency response is about acknowledging past trauma and showing sensitivity to the effects it can have on the survivors of present events. Knowing how to approach a person or group of people after a traumatic event can reduce the likelihood of re-traumatization.

Trauma and Emergencies

Emergencies can be traumatic. If trauma isn’t addressed appropriately, it can have longer and deeper negative effects on individuals, families, and communities. Recovery from a traumatic event can also be an opportunity to develop resiliency and [trauma-informed] tools in preparation for future emergencies or disasters.

Not everyone responds to trauma the same way, and not all people who are exposed to a potentially traumatic event experience trauma. Responses to trauma can last for weeks, months, or even years before people start to feel normal again.

A person’s response to disaster-related trauma may be influenced by the following:

  • Direct exposure to the disaster, such as being evacuated or witnessing others, including family members, in life-threatening situations
  • Prior experience with and exposure to trauma
  • Pre-existing physical or mental health conditions
  • The availability of a strong emotional support network(3)

Taking a Trauma-Informed Approach

Learning how to respond during or after a traumatic event can help your community. Emergency responders should be aware that individuals and communities may have experienced a variety of traumas—including mass trauma or historical trauma. They must also consider a survivor’s physical, psychological, and emotional safety and well-being after a disaster.(3)

The six guiding principles of trauma informed care are:

  1. Safety
  2. Trustworthiness and transparency
  3. Peer support
  4. Collaboration and mutuality
  5. Empowerment and choice
  6. Cultural, historical and gender issues(3)

This approach requires constant attention, sensitivity, and awareness to make sure the community and those affected receive the care they need after an emergency.

The keys to creating a trauma informed approach to care are:

  • Creating a safe environment
  • Hiring and training for a trauma-informed workforce (clinical and non-clinical staff)
  • Preventing secondary traumatic stress in staff
  • Engaging patients in organizational planning
  • Leading and communicating about the transformation process(4)

Adopting trauma-informed practices may require a cultural change at an organizational level. Emergency responders can use a trauma-informed approach to help during or after an emergency.

The Substance Abuse and Mental Health Services Administration (SAMHSA) Disaster Technical Assistance Center helps states, territories, tribes, and local providers plan for and respond to behavioral health needs after a disaster. Learn about trauma-informed care to help others in your community.

Building a Trauma-Informed Community

Building resilient and trauma-informed communities is essential to improving emergency recovery outcomes. No community is safe from the potential impact of unexpected traumatic events. But by being trauma-informed, they can become a safe place for those recovering from distressing events.(5)

Communities can be resilient if they have the right resources available. Unfortunately, resources may not always be available. There may be barriers that can prevent those in a community from accessing resources when they need them. These may include cost, lack of transportation, and availability of resources.

Nonprofit organizations such as United Way offer free services where individuals can reach out to find resources available in their area.

Federally Qualified Health Centers and Rural Health Clinics are community health providers in underserved areas that receive funds from the Health Resources and Services Administration that make their services affordable to patients that need assistance.

In today’s world, resources are not limited to in-person visits. Many mental health providers now offer telehealth services. These services make it possible for patients to access care from the safety, privacy, and convenience of their homes. More work is needed to provide universal broadband access so that persons at highest risk of poor mental and physical health outcomes from emergencies and trauma have access to this form of care. Mental health trainings are also available to help communities strengthen their resilience.

Communities and emergency responders should strive to provide their services with a trauma-informed approach in an effort to make sure people experiencing trauma receive care that promotes healing and avoids re-traumatization. Many resources and training for people who work in fields that support individuals experiencing trauma—for example, emergency medical services, law enforcement, and religious organizations—are available online.

Community members can talk about being trauma-informed with their families, coworkers, children’s teachers, and others within their social networks. Communities that work together to make these resources available to those in need can improve the resiliency of community members.

References

  1. https://www.nimh.nih.gov/health/topics/coping-with-traumatic-events
  2. https://www.samhsa.gov/trauma-violence
  3. https://blogs.cdc.gov/publichealthmatters/2018/07/trauma-care/
  4. https://www.samhsa.gov/sites/default/files/programs_campaigns/childrens_mental_health/atc-whitepaper-040616.pdf
  5. https://store.samhsa.gov/sites/default/files/d7/priv/sma17-5014.pdf

Resources

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Prep Your Health with Advance Care Planning

writing

April is National Donate Life Month. April 16 is National Healthcare Decisions Day.

Emergencies, including personal injury and illness, are often unpredictable. That unpredictability is both a reason to prepare and something to prepare for.

Plan Ahead for Personal Health Emergencies

Many people face decisions about treatments that a medical emergency might leave them incapable of making.(1)

Advance care planning is an important preparedness step toward making sure you get the medical care you would want if you cannot speak forcallout yourself.(2)

While you might prefer to think that you will never need such a plan, advance care planning is a way to care for others if you get ill or are injured.

Advance care planning is not just for older adults. At any age, a medical emergency could leave you too ill or injured to make your own health care decisions.

Advance care planning can save loved ones from confusion, family infighting, and second-guessing if they made the right decisions on your behalf.(3)

Advance care planning involves several steps:

  1. Learn about the types of healthcare decisions that you might need to make.
  2. Consider those decisions ahead of time.
  3. Make your decisions known to others.

Talk to family and a doctor as part of your advance care planning. They can help you understand the choices you may need to make and think through your decisions before you put them in writing.(4)

Organ Donation

Organ donation is one of many important decisions you can make as part of your advance care planning for medical emergencies. Others include deciding when you want emergency medical professionals to use cardiopulmonary resuscitation (CPR) or an automated external defibrillator (AED) to restart your heart.

Organ donation is the process of taking healthy organs and tissues from one person for transplantation into another. Organs you can donate include:

  • Internal organs: Kidneys, heart, liver, pancreas, intestines, lungs
  • Skin
  • Bone and bone marrow
  • Cornea(5)

Learn more about how donation works and the difference you can make when you become an organ donor.

Become a Donor

Anyone can sign up to be an organ donor regardless of age, race, ethnicity, religion, or health status. It only takes a few minutes. Sign up online through your state registry or in person at your local department of motor vehicles. Your donation can save or improve more than 80 lives.(6)

You can update your information on your state’s online donor registry at any time. Most states let you choose which organs and tissues you want to donate.(7)

Make Your Decisions Known

Preparedness isn’t a prediction of the future. There’s no guarantee that you’ll need advance care planning. You may never need others to make healthcare decisions on your behalf.

Once you’ve come to decisions on things like organ donation, you should talk to your family about your decisions and write them down. There are several ways to do that.

Advanced directives, including living wills, are legal documents that go into effect only if you are incapacitated and unable to speak for yourself.(8) You can use them to organize and communicate your decisions about things like end-of-life care and organ donation.

Another way to make your decisions known is to carry a wallet card that explains that you have an advance directive and where it is kept.

Give copies of advance care planning documents to your healthcare proxy, your healthcare providers, your hospital, and anyone you think should have the information.

Create digital duplicates of hardcopy documents. Save them in a password-protected format to a flash or external hard drive or a secure cloud service.

Like most important paperwork, advance directive documents, wallet cards, and even online profiles for decisions like organ donation require occasional maintenance. Periodic proofreading for errors and outdated information will save yourself and others time, frustration, and added worry in an emergency.

References

  1. https://www.nia.nih.gov/health/advance-care-planning-health-care-directives
  2. https://www.cdc.gov/aging/advancecareplanning/index.htm
  3. https://www.cdc.gov/aging/advancecareplanning/
  4. https://www.nia.nih.gov/health/advance-care-planning-health-care-directives
  5. https://medlineplus.gov/organdonation.html
  6. https://www.organdonor.gov/learn/organ-donation-statistics
  7. https://www.organdonor.gov/sign-up
  8. https://www.nia.nih.gov/health/advance-care-planning-health-care-directives#:~:text=These%20preferences%20are%20often%20put,of%20medical%20care%20you%20want

Resources

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

Good Cents: Prep Your Finances for Emergencies

A middle-aged man and woman discussing finances.

This post was written in collaboration with the Consumer Financial Protection Bureau in observance of National Financial Capability Month.

Emergencies—especially when multiple occur at the same time—can test your ability to financially respond and recover. For example, getting back to “normal” after a flood during a pandemic takes financial resources that many people may not have.(1)

Emergencies big and small often feel like they couldn’t happen at a worse time. There are things you can do to improve your financial preparedness that might make the unexpected a little bit less of a disaster.

Building an Emergency Fund

Developing a habit of putting money aside—even if it is a small amount—is the easiest way to develop an emergency fund and build financial resiliency.

Without savings, the financial shock of an emergency—however minor—could affect you, your family, and your community. Research suggests that people who struggle to recover from a financial shock have less savings to help protect against a future emergency. They may rely on credit cards or loans, which can lead to debt. They may also pull from other savings, like retirement funds, to cover these costs.(2)

The Consumer Financial Protection Bureau (CFPB) offers advice and resources on how to financially prepare for an emergency. Here are five strategies for building and maintaining an emergency fund:

  • Create a savings habit. Set some goals for yourself, create a system for making consistent contributions, monitor your progress, and don’t forget to celebrate your successes!
  • Manage your cash flow. Your cash flow is how your money comes in (your income) and what you spend. If you notice gaps where more money is going out, you can work with the people or organizations you owe money to (i.e., your creditors) to get extra time and avoid falling behind with your payments.
  • Save. Take opportunities to put away money whenever possible: a tax refund, or a holiday or birthday gift. Putting away some money, even small amounts, helps you create an emergency fund.
  • Make your saving automatic. Setting up automatic transfers from your checking account to a savings account is a great way to start saving. And you can always adjust the transfers if your situation changes.
  • Save through work. You might be able to split your paycheck between accounts if you have direct deposit set up. Work with your employer to see if there are options to put money aside without having to remember to do it.(3)

A low or no-cost way to prepare for the financial impact of a disaster is to collect important information related to your property and accounts. Download a copy of the “Your Disaster Checklist” (available in multiple languages) to help you keep track of account numbers, valuables, medical information, and more.

An additional set of challenges often affect individuals and populations with limited English proficiency or who are unfamiliar with the nuances of the U.S. financial system and culture. The American Savings Education Council, a coalition of private and public partners offers resources for communities about all aspects of financial security.

MyMoney.gov has information on how to rebuild your finances after a disaster. Call 1-800-FED-INFO to speak to a specialist in English or Spanish. They can answer your questions about federal agencies, programs, benefits, or services related to financial literacy and education.

Other resources include:

Personal and Community Financial Resiliency

Natural disasters are happening with greater will greater frequency and severity. In 2021, there were 20 separate billion-dollar weather and climate disasters.(5)

Experts say the “whole community” must respond by increasing its preparedness, response, and recovery capacities.(6) Everyone has a role in making our communities and our nation more financially resilient.

Working together to address the causes of people’s and communities’ barriers to financial preparedness is essential to developing a stronger, more resilient, and healthier nation. Work with organizations to promote financial education in your community. Homeowner associations, community organizations, adult learning centers, social clubs, places of worship, and other members of the whole community have the potential to increase our resiliency.

Tailoring Financial Preparedness Strategies

The financial readiness needs of a community are closely related to the conditions where members live, play, work, and study and while some communities focus on mastering FEMA’s Emergency Financial First Aid Kit, others may need to start first on increasing access to education and basic financial literacy.

Ultimately, it’s about individuals and communities owning their financial preparedness and building resilience. When they receive the support of their local authorities, our nation becomes more resilient and better prepared to expedite its financial recovery after disasters.

Resources:

References

  1. https://www.census.gov/content/dam/Census/library/publications/2021/demo/p60-273.pdf
  2. https://www.consumerfinance.gov/start-small-save-up/start-saving/an-essential-guide-to-building-an-emergency-fund/#anchor_how-do-i-build-an-emergency-fund
  3. https://www.consumerfinance.gov/an-essential-guide-to-building-an-emergency-fund/
  4. https://www.ncdc.noaa.gov/billions/events
  5. https://coast.noaa.gov/states/fast-facts/hurricane-costs.html
  6. https://www.fema.gov/sites/default/files/2020-07/whole_community_dec2011__2.pdf

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.

 

Callout: What is an emergency fund?

 

An emergency fund is a cash reserve that’s specifically set aside for unplanned expenses or financial emergencies. Some common examples include car repairs, home repairs, medical bills, or a loss of income.

 

In general, emergency savings can be used for large or small unplanned bills or payments that are not part of your routine monthly expenses and spending.

 

Source: https://www.consumerfinance.gov/an-essential-guide-to-building-an-emergency-fund/#anchor_what-is-an-emergency-fund

Creating a Nutritious Emergency Food Supply

Nutrition Facts label

March is National Nutrition Month.

There are several things to think about when picking food to include in your emergency food supplies. They include:

  • Shelf life. Shop for nonperishable items
  • Foods that don’t require cooking, water, or special preparation are best.
  • Does your family have food allergies or other special dietary needs?
  • How much do you need to keep your family fed? Where will you store it?

Often less attention is paid to the nutritional facts of the foods in our emergency kits. But taking care of your body is an important part of self-care during an emergency. One way to do that is to try to eat healthier foods.

Here are a few tips to help you build a nutritious emergency food supply.

Improve Your Food Label Literacy

Knowing how to read food labels is a practical skill that you can use to make decisions about what goes in your emergency food supply.An annotated example of a Nutrition Facts label.

Nutrition Facts labels include information on serving size, calories, and nutrients that can help you make healthier food choices.(1)

Because you can’t know how an emergency will affect your every day, you may want to stock your food supply with more calories than you normally eat. A day spent cleaning up after a disaster expends more calories than one spent sheltering in place.

When using food labels to help make healthier choices consider the serving size, especially how many servings there are in the food package. The number of servings you eat determines the number of calories you’re eating. Eating too many calories per day is linked to overweight and obesity.

Shop Smart

When shopping for food, imagine having to rely on your emergency food supply and emergency water supply. How will you meet your family’s nutritional needs on a limited supply of water and without access to grocery stores and restaurants? Here are some things to think about when buying for your emergency food supply.

Include Fruits and Vegetables

Canned and shelf-stable fruits and vegetables can be a nutritious addition to your emergency food supply. Look for low and no sodium and no-sugar-added options. Also, consider dried fruit and nuts.

Look for Lower Sodium Foods

Sodium (salt) helps to preserve some foods, especially shelf-stable canned items. Salty food can increase your thirst, which could cause you to drink more water than you planned when creating an emergency water supply.

You should store at least 1 gallon of water per person per day for 3 days for drinking and sanitation. Try to store a 2-week supply of water, if possible.

Most of the sodium you eat is added to packaged foods before you purchase them. This makes reading food labels and choosing lower sodium foods even more important.(2)

Different brands of the same foods may have different sodium levels. For example, sodium in chicken noodle soup can vary by as much as 840 mg per serving for different brands. Look for brands that advertise low or reduced sodium. Compare the nutrition facts panels of different brands to choose the lowest sodium option.(2)

Include Protein

Protein is a critical part of our diet. Everyone needs a minimum amount of protein every day, even during an emergency.

Protein also gives you a feeling of fullness. Feeling full can help keep you from eating other foods in your emergency supply and make your emergency food supply last longer.(3)

Protein-rich foods include:

  • canned or pouched fish,
  • canned poultry,
  • beans and legumes,
  • nuts
  • low-fat or non-fat dairy products packaged in shelf-stable packaging. You can usually find these products in the cereal aisle at the grocery store.

Things like canned or packaged tuna, salmon, or chicken; protein bars, nut butters (presuming no one has an allergy), and some non-dairy milk alternatives are good choices for your emergency food supply.

If buying dairy or non-dairy beverages, look for products that are UHT, or Ultra High-Temperature Pasteurization (also referred to as Ultra Pasteurization or UP). These are shelf-stable and do not require refrigeration for safe storage.

If buying canned proteins, look for labels that say canned in water, low sodium, or no salt added.

Avoid Added Sugars

Added sugars include sucrose, dextrose, table sugar, syrups, honey, and sugars from concentrated fruit or vegetable juices.(4)

The leading sources of added sugars in the US diet are sugar-sweetened beverages, such as regular soda (not sugar-free), fruit drinks, and sports drinks, and foods like cookies and cakes.(4)

One way to avoid added sugars in your emergency food supply is to choose foods with little to no added sugar. Examples include fruit canned in its juice or water.

Help Others Create a More Nutritious Food Supply

People get most of their food for an emergency food supply from food retail venues, such as grocery and corner stores, and food pantries. Having healthier food available and making it affordable in places like these empowers people to make healthier food choices every day and when preparing for emergencies.(5)

When nutritious foods are not available, people may settle for foods that are higher in calories and lower in nutritional value.(5)

The whole community can work together to improve access to healthier food in several ways. They include:

  • connecting people to healthier foods by addressing transportation gaps in communities.
  • increasing nutritious food offerings in food service venues
  • bringing partners together to link local food hubs to organizations that sell or serve food in low-income communities.

Learn more ways government, communities, businesses, nonprofit groups, and others can work to improve access to healthier food.

Resources

References

  1. https://www.fda.gov/food/food-labeling-nutrition/changes-nutrition-facts-label
  2. https://www.cdc.gov/salt/index.htm
  3. https://www.health.harvard.edu/blog/extra-protein-is-a-decent-dietary-choice-but-dont-overdo-it-201305016145
  4. https://www.cdc.gov/nutrition/data-statistics/added-sugars.html
  5. https://www.cdc.gov/nutrition/healthy-food-environments/index.html

Thanks in advance for your questions and comments on this Public Health Matters post. Please note that CDC does not give personal medical advice. If you are concerned you have a disease or condition, talk to your doctor.

Have a question for CDC? CDC-INFO (http://www.cdc.gov/cdc-info/index.html) offers live agents by phone and email to help you find the latest, reliable, and science-based health information on more than 750 health topics.