3 Reasons to Phone a Friend Today

Young women video chat with each other.

December 28 is National Call a Friend Day

Many people would rather send a text than make a call and it shows.

Americans spend, on average, five more minutes per day texting (26 minutes) versus calling (21 minutes), by some estimates.(1) Among Americans younger than 50, sending and receiving text messages is the most used method of communication, according to a 2014 Gallup poll.(2)

While we can all admit that texting is an easy way to connect with friends and family, that doesn’t mean it’s always the best way. Here are 3 reasons why you shouldn’t “phone it in” on National Call a Friend Day.

1. You need an Out-of-Town Contact

Seize National Call a Friend Day as an opportunity to ask a friend to be your family’s Out-of-Town Contact during an emergency.

Peace of mind (the kind earned through pre-planning) can help you stay calm in an emergency. If you and your family are separated during or by a sudden disaster, you will want to know where your loved ones are and if they’re okay and vice versa. An Out-of-Town Contact is someone who lives outside of the immediate area—preferably in another state—that can help family members stay connected when it is easier to make a long-distance phone call than a local one.

Include the name and contact information, including social media handles, of your Out-of-Town Contact in your family’s Emergency Action Plan. It’s important that you also write down contact information for your physician, pediatrician, pharmacist, caregiver, veterinarian, and others.

2. Conversation is a powerful coping tool

Connecting with friends and family through phone calls and video chats is a means of self-care that can help you and your loved ones feel less alone or isolated in stressful situations, like the COVID-19 pandemic.

This year’s holiday season may be a difficult and stressful time for many. Being away from family and friends during the winter holidays can be hard.

CDC recommends hosting a virtual celebration with friends and family who do not live with you. A virtual meeting might also be a good time to talk about how you and they are feeling. The How Right Now campaign has tips for how to have a meaningful conversation and listen with compassion any time of year.

Everyone reacts differently to stressful situations. If you or a loved one is feeling overwhelmed, get support. The Disaster Distress Helpline provides 24/7 confidential, free emotional support. If you or someone you know needs emotional support, call or text 1-800-985-5990.

3. Talking improves preparedness

A survey taken by FEMA in 2014 showed that talking about preparedness had a “strong positive relationship with preparedness behavior;” but that less than half of respondents had done so in the 2 years leading up to the survey.(3) The researchers concluded that “opportunities for people to discuss preparedness should be enhanced [sic].”

National Call a Friend Day is an opportunity to talk to your family about how to communicate during a disaster, to your child’s school administrator about their family reunification plans, and to your healthcare provider about how to create an emergency supply of essential prescriptions.

Regular conversations like these about matters of preparedness and response can help you plan ahead in ways that can save you time, money, and worry during an emergency.

For more information on how to prepare your health for emergencies, visit https://www.cdc.gov/prepyourhealth/.



  1. https://www.textmagic.com/blog/text-messaging-statistics-for-businesses/?sscid=c1k4_k2em4
  2. https://news.gallup.com/poll/179288/new-era-communication-americans.aspx
  3. https://www.fema.gov/media-library-data/1409000888026-1e8abc820153a6c8cde24ce42c16e857/20140825_Preparedness_in_America_August_2014_Update_508.pdf


Thanks in advance for your questions and comments on this Public Health Matters post. Please note that the 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.

Asthma Intervention Program Provides Emotional Support to Patients

Stock photo of two women wearing masks during a home health visit.

This student-authored post is published by CPR in partnership with Medill News Service and the Northwestern University Medill School of Journalism, Media, Integrated Marketing Communications. The views and opinions expressed in this article are the author’s own and do not necessarily reflect the views, policies, or positions of CPR or CDC.

Gloria Seals has for the past 20 years seen firsthand how substandard living conditions can worsen asthma symptoms.

Seals, a community health worker for Asthma CarePartners (ACP) and Supervisor of Asthma Education at Sinai Urban Health Institute (SUHI), made house calls to patients with asthma to provide individualized health education. She and other community health workers taught patients how to manage their asthma, explained how to use the needed medical equipment, walked through patients’ homes to identify any environmental hazards that could worsen asthma symptoms, and demonstrated how to use scrubbing pads to patch holes in the walls to keep out pests.

“Some homes on the South and West sides [of Chicago] are just not livable,” Seals says. She has been in homes with mold, cockroaches, and mice, which are all common triggers for people with asthma.

Working with patients in their homes has shown Seals how the environment where people live can lead to repeated asthma episodes, and how stress and loneliness can worsen an illness.

The house calls ended in March when Seals adapted the program to a virtual platform. The virtual platform has allowed Seals to continue to counsel her patients and help prevent the spread of COVID-19 during the pandemic. Health workers also incorporated COVID-19 prevention information into the curriculum.

COVID-19 has hit communities of color in Chicago, like those on the South and West sides, particularly hard. Black and Hispanic people are also more likely to have asthma and other respiratory conditions, which can put a person at increased risk for severe illness from the virus that causes COVID-19.

According to CDC, people with moderate to severe asthma might be at higher risk of getting very sick from COVID-19. COVID-19 can affect the nose, throat, and lungs; cause an asthma attack; and possibly lead to pneumonia and acute respiratory disease. Disinfectants can also trigger an asthma attack.

At first, health workers were worried about how transitioning to virtual visits would affect patient care. Home visits were an important part of the program because they allowed health workers to interact in-person with patients and helped them identify allergens in and around the home.

What they found, though, was that patients depend on community health workers for more than education; they also look to them for emotional support. Community health workers are appreciated as trusted members of the neighborhoods they serve, and patients value their council, even when offered virtually.

“The social support community health workers provide has become really important now, especially for COVID-19 patients,” said Stacy Ignoffo, Director of Community Health Innovations at SUHI. “A familiar voice can give patients a greater sense of security during this crisis,” she added.

Other health experts agree. Dr. Louise Giles, a pediatric pulmonologist at the University of Chicago, said she has noticed an increased need in the community for mental and emotional health care and support.

“Families are extremely worried right now,” Dr. Giles said. “They are looking to providers for both information and emotional care.”

While telemedicine is not a substitute for in-person home visits, Seals is grateful she can still connect with her patients and serve as an additional source of knowledge and support during this time.

“ACP serves people who would not seek out this education on their own,” she said. “Regardless of format, having us come to them makes all the difference in the world.”

As the COVID-19 pandemic continues, SUHI’s community health workers have become an essential source of education and emotional support for many patients. Their compassion and leadership in the face of adversity has built a well-informed, resilient community across the South and West Sides of Chicago.

ACP will remain virtual until an effective COVID-19 vaccine is developed. There is currently no vaccine to prevent COVID-19. The best way to prevent illness is to avoid being exposed to the virus.


Thanks in advance for your questions and comments on this Public Health Matters post. Please note that the 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.

Chicago Community Groups Unite to Help Neighbors During Pandemic

A picture-in-picture of women on a video conference.

This student-authored post is published by CPR in partnership with Medill News Service and the Northwestern University Medill School of Journalism, Media, Integrated Marketing Communications. The views and opinions expressed in this article are the author’s own and do not necessarily reflect the views, policies, or positions of CPR or CDC.

My introduction to phone banking didn’t go as expected. I thought I would be giving advice to people, not getting it.

During one phone call, the older adult woman on the other end asked how I was doing. I admitted to being exhausted by graduate school. She advised me to do a little more praying and a lot more sleeping. Unscripted moments like those are a fringe benefit of working with Community Cares Illinois (IL).

Community Cares IL is a coalition of groups from across the Chicago area that came together to check in on their community members at greatest risk during the COVID-19 pandemic. They host weekly phone bank sessions during which dozens of virtual volunteers connect residents with needed resources to make it easier for them to shelter in place. The service started in March, during the first week of the Illinois stay-at-home order.

“That was the same week the first woman died [of COVID-19] in Chicago,” said Maureen Keane, who leads the coalition alongside Annie Williams and Nicole Miller. “We felt this sense of urgency, but it took us a little bit to get up and running because we wanted to do it well.”

Volunteer sessions take place every Tuesday afternoon via video chat. After a brief review of protocols, volunteers spend an hour clicking through the phone bank, dialing numbers, and using a script to ask community members if they need help getting groceries, medications, or anything else during the pandemic.

Over the summer, Community Cares IL worked with residents in Austin, a neighborhood on Chicago’s West Side whose population is nearly 80% Black. CDC data show that Black and Latino people are contracting the virus at nearly three times the rate of White people, and nearly five times as likely to be hospitalized once they have COVID-19.

After learning that Black people in every age group were also dying from the virus at about the same rate as White people a decade older, according to the Brookings Institution, Keane said she and the other organizers decided they needed to reach out to minorities across a greater age range.

“We bumped down the [age of residents we call] because Black people are dying at age 45 and at age 50,” she said.

To ensure volunteers can provide community members with as many resources as possible, the coalition’s leaders scoured the internet to compile an extensive guide. In just a few months, it has grown into a massive, 33-page document filled with information on everything from the location of food pantries and testing sites to debt relief programs and housing assistance.

“It’s not easy,” said Keane. “But at the same time, it’s important, so it doesn’t feel hard.”

The guide is updated whenever the availability of those resources changes or a resident expresses the need for something during a call that is not yet included. Oftentimes, their needs aren’t material.

“A lot of residents are just thankful that they got a phone call, even if they don’t necessarily need anything,” said 17-year-old Emma Zubak, who volunteers for Community Cares IL. “They’re thankful that they have someone to talk to, even if it was over the phone for five minutes.”

The leaders stressed that everyone has been impacted by the pandemic in some way and that volunteers get just as much out of the calls as those picking up the phone. It’s why every Tuesday afternoon session wraps up with an opportunity for volunteers to socialize with one another.

“The end is my favorite part because we get to share any unusual call we had, best practices that we picked up or connections we made,” said co-leader Annie Williams, adding that the sense of connectedness, albeit virtual, is what keeps volunteers coming back.

Miller said the most important part of their operation, besides the phone bank, is having such dedicated people who consistently show up and keep it going. She said Community Cares IL is fortunate, as a coalition of organizations, to have a large network of devoted people to depend on.

That will become even more important moving forward. The leaders expect the pandemic to worsen in the fall in conjunction with an uptick in flu cases and that the need for campaigns like this will grow as federal assistance dries up and smaller community groups must tap out.

“A lot of people have kind of thrown their hands up and said, ‘well, we can’t do anything,’” said Miller. “But that’s not true. We can call people, we can bring resources together and we can see each other’s smiling faces on video while we do it.”


Thanks in advance for your questions and comments on this Public Health Matters post. Please note that the 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.

Take Care: Prep Your Health Tips for Caregivers

A male caregiver holds the hand of an older woman.

November is National Family Caregivers Month when we celebrate the various and dedicated caregivers in our lives.

Caregiving is an important public health issue that affects the quality of life for millions of individuals. Informal or unpaid caregivers (family members or friends) are the backbone of long-term care provided in people’s homes. While some aspects of caregiving may be rewarding, caregivers can also be at increased risk for negative health consequences. These may include stress, depression, difficulty maintaining a healthy lifestyle, and staying up to date on their own medical appointments.(1)

Emergencies can happen unexpectedly and create more stress for a caregiver. Having supplies set aside and a plan in place can help caregivers cope with disaster-related stress, allowing them to focus more on the health and safety of the person they are caring for.

Caregiver Preparedness & Planning

There are many ways caregivers can prepare themselves and the person they are caring for before an emergency arises. They include stocking up on emergency supplies, learning practical caregiving skills, having a plan, and staying informed.

Care Packages

Family caregivers should talk to the healthcare provider of the person they care for to identify essential supplies that are important to stock up on before an emergency. In addition to food, water, and prescription medications, other personal needs(2) might include:

  • Incontinence undergarments, wipes, and lotions
  • A cooler or insulated bag to keep medications cold
  • A current list of medications and dosage details
  • Copies of important paperwork
  • Recent photos of the person
  • Warm clothing and sturdy shoes
  • Medical equipment and devices, including eyeglasses, hearing aids, and hearing aid batteries

For more information on how to prepare for emergencies, visit the Prepare Your Health website.

Learn Practical Caregiving Skills

Caregivers provide care to people who need some degree of ongoing assistance with everyday tasks on a regular or daily basis. For some caregivers that may include helping with bathing and dressing, paying bills, shopping, and providing transportation. It can also involve emotional support and help with managing a chronic disease or disability.

According to a report from the Home Alone Alliance, many caregivers also manage medications, help with mobility devices, prepare special diets, dress wounds, and perform other tasks typically done by healthcare professionals.(3)

Most people assume that caregivers know how to do all these things, but the truth is most don’t. While caregivers might receive some instruction at discharge, most said they needed more training.(2) It is important that caregivers work with doctors to learn how to safely perform tasks that may need to be done at home if medical services are unavailable because of an emergency.

Develop a Care Plan

A care plan is a document that summarizes a person’s health conditions and current treatments for their care. A plan should include information about the person’s health conditions, medications and healthcare providers, emergency contacts, and a list of caregiver resources.

Caregivers should ask the healthcare provider of the person they care for to help complete the care plan and—at the same time—discuss with them advanced care plan options and resources that are available to help make things easier for you as a caregiver.

It is important that everyone involved in caregiving for a person is familiar with the details of the care plan and the Emergency Action Plan. An Emergency Action Plan should identify where to go with the person receiving care, what supplies to take, what evacuation routes to follow, and who will take them. Caregivers should learn more aboutTalking about respite care emergency plans and register for evacuation assistance programs in the care recipient’s area.

Caregivers should update the plans every year or as the health of or medications prescribed to the person they care for change.

Respite & Self-Care for Caregivers

Although caregiving can be fulfilling, it can also affect caregivers in different ways. Caregivers can experience physical and mental strain from the stress of keeping up with their responsibilities. They can have problems sleeping and changes in appetite; feel anxious, depressed, and lonely; and experience other health problems. Over half (53%) of caregivers indicate that a decline in their health compromises their ability to provide care.(1) Caregivers of people with dementia or Alzheimer’s are particularly at greater risk for anxiety, depression, and lower quality of life compared to caregivers of people with other chronic conditions.

Respite and self-care are two ways of caring for yourself when caring for another.

Respite Care

To be a good caregiver, caregivers need to take care of themselves and learn healthy ways to deal with stressful situations, such as emergencies. One way they can do that is to make sure they take consistent breaks from caregiving responsibilities. This is called a respite.

Respite care allows the caregiver some time off from their caregiving responsibilities. Short breaks can be a key part of maintaining your own health. Research shows that even a few hours of respite a week can improve a caregiver’s well-being.(4)


Self-care isn’t selfish; it’s necessary if you are a caregiver. It’s important that caregivers take care of their physical, mental, and emotional health. Here are some ways that caregivers can better take care of others by first taking care of themselves.

  • Find a support group in your community that you can rely on when you start to feel overwhelmed. If you’re not able to leave your loved one at home but need emotional support, an online support group might be a good option. Be careful not to give out detailed personal, medical, or financial information to anyone online to protect against fraud or scams.
  • Speak with a doctor if you feel anxious or depressed during these tough times. It is okay to ask for help. Go to yearly doctor appointments if you can and stay on top of yearly vaccinations to stay healthy.
  • Eat healthily, stay active, and get enough rest. About half of caregivers don’t get enough restful, continuous sleep, making them feel tired and leading to poor quality of life.

During times like the present, caregivers need more support than ever. Having to social distance with family and friends and worrying about exposing the individual they are caring for to COVID-19 can cause more stress. It is important to lean on each other in different ways by staying connected and knowing that our communities have many resources available to each of us during tough times.


  1. https://www.cdc.gov/aging/caregiving/index.htm
  2. https://www.nia.nih.gov/health/disaster-preparedness-alzheimers-caregivers
  3. https://healthjournalism.org/blog/2019/07/report-caregivers-tackling-complex-medical-tasks-with-little-training/
  4. https://www.cdc.gov/aging/publications/features/caring-for-yourself.html


Gatekeeper training at UC Davis focused on student mental health and illness and everything in between

I went to a really useful training yesterday at UC Davis focusing on mental health and illness off students.  I posted a bunch to Twitter during it.  See the tweet below and the thread linked to it.

Also see this Twitter moment I made: https://twitter.com/i/moments/1154119660377239552?s=13.

Protecting Our Future: Emergency Preparedness and Children’s Mental Health

Sad boy sitting against a brick wall with his face hidden

Among the many lessons learned during the 2017 Hurricane season, we recognized that addressing children’s mental and behavioral health needs is a major concern in hurricane-affected areas.

CDC’s At Risk Task Force (ARTF) was established in 2017 to ensure identification and prioritization of the mental and physical health needs of at-risk populations, including children. ARTF’s first Emergency Operations Center (EOC) activation was on Aug. 31, 2017, in response to Hurricane Harvey, the first of three consecutive hurricanes to hit the United States and its territories in a five-week period. ARTF’s mission was to address the needs of at-risk populations in affected areas throughout the response and recovery phases.

Early in the response, it became clear that the emotional impact of the storms and the mental health needs of people, particularly children, affected were a critical area of focus. ARTF worked closely with federal and non-government agencies to address these needs so that children and families had the best chance for recovery.

October 10 is World Mental Health Day. The theme this year is Young People and Mental Health in a Changing World. In light of this, we want to share our experiences to inform mental health interventions and improve outcomes for children after public health emergencies and natural disasters. First, let’s talk about what makes children more vulnerable in emergencies.

Why are children more vulnerable in emergencies?

Mental stress from a disaster can be harder on children. Children are more vulnerable in emergencies: Because they breathe in more air for their size than adults, children absorb harmful materials from the air more readily. Because they spend more time outside, are lower to the ground, and put their hands in their mouths more often than do adults. Because they may not be able to communicate their symptoms or feelings. Because they need medicines, and specifically designed equipment for emergency situations that are different from adults.Children are more vulnerable in emergencies because of their physical, developmental, behavioral, and emotional differences from adults. Children may have difficulty or may not be able to communicate symptoms or feelings. They may understand less about the situation and feel less able to control the events around them.

The aftermath of an emergency or disaster is also difficult for children because they have less experience coping with difficult situations.

The emotional impact of an emergency depends on a child’s characteristics and experiences, the social and economic circumstances of the family and their community, and the availability of local resources. Other factors may influence the emotional impact on children, causing them to be more vulnerable in emergencies. These include children with mental, behavioral, or developmental disorders. Children who have experienced trauma in the past may also have more difficulty coping with a disaster.  

What does the At Risk Task Force do for children’s mental health during a hurricane response?

During the 2017 hurricane season, the ARTF collaborated with federal and non-government partners to monitor behavioral health in affected areas and disseminate key messages and coping resources for children in schools and vulnerable populations in other contexts. ARTF coordinated a webinar for primary care physicians that focused on identification of common adjustment difficulties in children, provided strategies to promote effective coping skills in children and their parents, and explained the importance of self-care for professionals. The webinar was attended by more than 300 clinicians and other health care providers on Oct 26, 2017.

Public health professionals also play an important role in addressing short-term and enduring mental health needs of the population. Timely and accurate mental and behavioral health surveillance data, that includes specific information on children, could inform intervention efforts to improve developmental outcomes for children in the longer-term aftermath of disasters. It is important that mental health surveillance be incorporated into preparedness planning so that surveillance systems can be established or leveraged immediately when emergency response begins.

What are next steps for CDC?

Children’s mental health needs are a prominent concern in hurricane-Recommendations to help children cope during and after an emergency: • Share age-appropriate information • Encourage children to ask questions • Limit media exposure • Return to a routine • Reunite children with caregivers as soon as possibleaffected areas. There is still a gap in real-time information on mental health needs to inform intervention efforts and improve child outcomes. CDC is working internally to enhance efforts to monitor health impacts during and after natural disasters, including integrating mental health into standard data collection.

CDC is also working with partners to integrate children’s mental health in preparedness planning. Following the 2017 hurricane season, CDC collaborated with the American Academy of Pediatrics to develop an activity book for children and families, Coping after a Disaster, that focuses on feelings children might have after a disaster and coping strategies that may help. This book is part of a series that follows Ready Wrigley, a dog who helps her family prepare for emergencies and their impacts.

CDC is now partnering with the National Hazard Center to develop mental and behavioral health training modules for researchers conducting field research immediately following an extreme event, such as a hurricane. These free, online trainings will provide background information on mental health in the context of disasters, as well as a list of mental health assessment tools used following a disaster for various vulnerable populations (e.g., children, older adults). The trainings and associated resources will address current research gaps in mental health, help to organize research in this area, and share best practices with researchers.

On Sept. 12, 2018, CDC activated the EOC to respond to Hurricane Florence, which made landfall off the coast of North Carolina on Sept. 13. The ARTF was quickly activated to address the needs of vulnerable populations. As the storm decreased in intensity, North Carolina began reporting increased emergency department visits related to stress and anxiety. Mental health concerns in children, similar to 2017, are expected to remain a prominent focus throughout the response and recovery phases. The ARTF continues to monitor the situation and support the mental and behavioral health needs of children and vulnerable populations in affected areas.

Additional Resources:

Yoga, Depression, & Clinical Trial Critique 101

  A study piqued my curiosity in a news feed recently. Yoga could reduce depression symptoms, researchers said – but only if you expected it to (Uebelacker 2018). Yoga for depression, it turns out, is

Using Trauma-Informed Care to Guide Emergency Preparedness and Response

Exposure to a traumatic event or set of circumstances can negatively affect a person’s mental, physical, social, emotional or spiritual well-being for a long time after the initial incident. We know that not all individuals respond to trauma in the same way and we know that individuals with a history of trauma, especially childhood trauma, are more likely to experience psychological distress and are at increased risk for the development of Post-traumatic Stress Disorder (PTSD) with future exposure to trauma.

The chemicals in our bodies change during stressful or traumatic situationsEmergency responders are vulnerable to trauma during or after a disaster the same as survivors. Hazardous work conditions, being away from family, and exposure to human suffering can cause new and intensify existing feelings of stress, anxiety, grief, and worry in responders.

When the body is threatened, stress hormones are released to help you survive (fight or flight response). These hormones cause our bodies to minimize non-essential tasks, including growth, reproduction, and immune function and to maximize body functions that are necessary to prepare the body to fight or flee from a stressor.  Functions such as breathing, heart rate and alertness are useful for the body to survive the stress.   If someone is regularly exposed to trauma, stress hormones are repeatedly released and the brain can become exposed to these powerful stress hormones that would normally be present in the body for short periods of time. Over time repeated exposure to stress may cause your body’s natural stress response system to malfunction and can result in potentially unhealthy mental and physical responses to current or future stress.  These responses can include irritability, emotional reactivity, intrusive thoughts about the event, emotional numbing and avoidance, loss of one’s sense of safety, or diminished capacity to trust others.

Exposure to trauma can affect a person’s normal coping and stress management skills.  A person’s mental health during an emergency may be impacted by:

  • 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 conditions, such as mental health conditions
  • Socioeconomic factors, such as family resources available
  • Family variables, for example, how parents react

Take trauma into account when responding to emergencies

When someone has experienced trauma, he or she can be re-traumatized if emergency medical service providers, healthcare professionals, and community service providers are not aware of and sensitive to the possibility of re-traumatization. Emergency responders should be aware that individuals and communities may have experienced a variety of traumas in their lives and need to consider a survivor’s physical, psychological, and emotional safety and well-being after a disaster.

Trauma-informed organizations and emergency responders need to be sensitive to the potential impact that widespread trauma can have on individuals. An essential underpinning of trauma informed care and approach is the awareness that procedures and interactions can be re-traumatizing.

Training emergency responders in trauma-informed care

The CDC’s Office of Public Health Preparedness and Response (OPHPR) collaborated with SAMHSA to develop a trauma-informed care training for CDC. Working with Mary Blake (SAMHSA) and the Technical Assistance Center, SAMHSA’s National Center for Trauma-Informed Care (NCTIC) developed and led a new training for OPHPR employees about the role of trauma-informed care during public health emergencies. The training aimed to increase responder awareness of the impact that trauma can have in the communities where they work. Participants learned the six principles that guide a trauma-informed approach, including:

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

Adopting a trauma-informed approach is not accomplished through any single particular technique or checklist. It requires constant attention, caring awareness, sensitivity and it may require a cultural change at an organizational level. On-going internal organizational assessment and quality improvement, as well as engagement with community stakeholders, will help to imbed this approach which can be augmented with organizational development and practice improvement. The training provided by OPHPR and NCTIC was the first step for CDC to view emergency preparedness and response through a trauma-informed lens.


After the Storm: Helping Kids Cope

A boy and his mother wait to cross the street on their way to school.

Changing schools is hard for any kid. Imagine picking up without any notice and moving to a new school in a brand new place with a different climate, culture, and maybe even a different primary language.  Harder still is the thought of moving because your home and community have been devastated by a major hurricane. The truth is, this is the reality for the tens of thousands of students from Puerto Rico and the U.S. Virgin Islands (USVI) who moved to the continental U.S. after Hurricane Irma and Hurricane Maria.

Recognizing a need

As a Massachusetts native, I subscribe to news alerts from the Boston area. One morning before heading to work in CDC’s Joint Information Center, I saw a news article about the influx of PuertoCDC's Joint Information Center (JIC): The JIC Outreach Team is responsible for reaching hard-to-reach and at-risk audiences with important health and safety information during and after a public health emergency. Rican children displaced by the hurricanes who were relocating to the cities of Springfield and Holyoke in western Massachusetts.  Both cities have large Puerto Rican populations, and many residents were taking in relatives and friends from the devastated island. Schools in the territories would be closed for months after the storm, so many families were coming to the continental U.S. so their kids could keep going to school.

Children who were displaced as a result of the hurricanes faced the challenges of leaving behind their homes, communities, and schools, family and friends, and even their pets.  Kids in middle and high school were old enough to understand the uncertainty facing their families. They had to stay strong to support their parents and siblings, while finding a routine at a new school and keeping up with their academics.

Understanding the issue

During my meeting with the Hurricane Emergency Response Communication Teams, I brought up the article I had read that morning. Dr. Melissa Mercado-Crespo, a behavioral health scientist at CDC’s National Center for Injury Prevention and Control, took a special interest in the well-being of the families who had been displaced by the hurricanes. Dr. Mercado serves on the StopBullying.gov Editorial Board, and grew up in Puerto Rico. Most of her family and loved ones still live there, and when the storms hit, her husband was deployed to the island with the U.S. Army Reserves.

In collaboration with the CDC At-Risk Task Force, Dr. Mercado and I reached out to federal and local partners to find out how many hurricane-displaced students from Puerto Rico and USVI had enrolled in the middle of the semester. Through media and local sources, we learned that most of the students had enrolled at schools in Florida and New York, as well as cities in western Massachusetts. The Center for Puerto Rican Studies at Hunter College, City University of New York, confirmed our findings. They estimated that after September 20, 2017 – the day Hurricane Maria hit Puerto Rico – 10,324 Puerto Rican students enrolled in Florida schools. The Puerto Rico Department of Education reported that nearly 25,000 students have left the island and are no longer enrolled in the Puerto Rico public school system.

Taking action

My former colleagues in Boston put me in touch with José Claudio of the New North Citizens’ Council, a community organization that provides public and human services to residents in the Springfield area. He mentioned that many of the students were struggling to adapt to their new setting and that there were misunderstandings between the permanent students and their new peers. We wanted to provide teachers and youth organizations with tools and resources that could help make the transition easier for everyone.

To help address these challenges, we pulled together a list of resources to help teachers and youth organization leaders plan activities to prevent and reduce the emotional challenges new students may face and help them cope with the trauma following hurricanes. We published the list in a Spotlight issue of the CDC Emergency Partners Newsletter that was reviewed by CDC behavioral health experts and representatives from StopBullying.gov, SAMHSA, and the National Child Traumatic Stress Network (NCTSN). The newsletter went out to partners, and we received positive feedback from teachers, school counselors, and organizations that serve Hispanic populations in the U.S.

The messaging needs and target audiences change before, during, and after every emergency. We identified a new target audience during the 2017 Hurricane Response – children from Puerto Rico and USVI who left their schools and homes behind after the storms. Our hope is this is the first step in concrete efforts to help ensure they are no longer left behind.

Learn more

Subscribe! CDC Emergency Partners Newsletter

Preparing for College Life: A Healthy Guide

student studying outdoors.

Zoey Brown joined the Office of Public Health Preparedness and Response during this past summer to help with a data analysis project. She saw a number of CDC programs and activities, and authored the following post to the Public Health Matters blog. The views expressed are her own, and do not necessarily represent those of CDC, HHS or other government entities. A number of the links included take those interested in these topics to both CDC and non-CDC sites for more information. The Office was pleased to have this talented young woman on staff for an internship experience.

Zoey BrownAs a rising high school senior, college looms large on my horizon. Everywhere I turn, there’s another form to fill out, essay to write, and decisions to make. And although I’ve had plenty of help during the application process, no one seems especially concerned with what happens after I choose a school. I’ve lived in the same town my whole life; how do I pick up my life and move it to a campus one thousand miles away?

For all the students out there like me, who aren’t quite sure how to prepare for college, I want to share some tips to help you prepare to start this school fall.

You are what you eat

Odds are, your parents have had some control over your food up until now. A lot of kids go to college without any sense of how to manage their diet; hence, the infamous Freshman 15. With that in mind, here’s some helpful tips on maintaining your nutrition on a meal plan.

  • Talk to your doctor. Before you go back to school make sure you understand what your body needs. Everyone has different nutritional needs based on a variety of factors, like age, sex, size, and level of activity.
  • Stay well stocked. Keep your dorm room stocked with healthy snack alternatives. My personal favorites are carrots, cashews, apples, granola bars, and popcorn.
  • Make the swap. Consider switching out some fried foods for grilled versions and soda for juice or water
  • Consistency matters. Develop a consistent meal schedule that complements your schedule. Don’t skip a meal to study or party.

Stay active

If you’re anything like me, finding the motivation to exercise can be tough. Sleeping in a few extra minutes or catching up on Netflix are more tempting than getting in that cardio workout. Without the high school sport or fitness-loving parent to which you’re accustomed, you’ll have to take your health into your own hands. So, what are the best ways to stay in shape on campus?

  • Hit the gym. College is a great place to take advantage of free access to gyms and fitness classes. This is probably one of the last times in your life that you’ll have a free gym membership, so you might as well use it!
  • Get in your steps. Just walking on campus can also be a great source of exercise. Or think about a bike for transportation around your new town.
  • Try out a new sport. If you enjoy playing sports but don’t want to commit to varsity athletics, consider joining an intramural team. There’s no pressure to be an intense athlete, and it’s a great way to let off a little steam.
  • Join the club. Most colleges also offer clubs that go hiking, biking, climbing, and more. These are great way to expand your social circle.

Be mindful

As someone who has struggled with mental health issues over the past few years, I must admit that I’m a little concerned about my transition to college. Luckily, there are a ton of tips out there for maintaining and improving mental health in a new environment.

  • Battle feeling homesick. One of the most common mental health issues new college students experience is homesickness. This can be especially tough if you’ll be attending a college far away from home, like me. There’s no perfect solution, but one of the best things you can do is immerse yourself in college life – join clubs and activities, try to make friends with the people living near you, and make your dorm room feel a little more like home.
  • Avoid anxiety. College is a completely new environment, so it’s understandable that over 40% of college students suffer from anxiety. To help keep anxiety to a minimum make sure you exercise regularly, try to get at least 7 hours of sleep a night, drink less caffeine, and do something you enjoy every day. Of course, if feelings of intense anxiety persist, you should seek help through your school’s health services.
  • Watch your mood. It’s normal to feel down occasionally, but if these feelings persist, you may be suffering from depression. You should visit a counselor at your college’s health service if you experience any of the following for more than two weeks:
    • sleeping problems
    • lack of energy or inability to concentrate
    • eating issues
    • headaches or body aches that persist after appropriate treatment
    • You should also seek help if you are experiencing suicidal thoughts

Know about safe sex

I am fortunate to attend a school with a decent sex education program. However, many teenagers haven’t, so there are a few things that the average college student should know about safe sex.

  • Know it’s a choice. The choice to have sex is yours to make, and abstinence is a completely viable option.
  • Avoid sexually transmitted diseases and pregnancy. If you do choose to have sex, you should take steps to protect yourself. Use condoms, male or female. Be sure to check that the condom is intact and has not expired before use.
  • Talk to your partner. Ask your partner about their sexual health first. If they refuse to answer, they probably don’t deserve to have sex with you.
  • Get tested. If you are already sexually active, you should consider going into your college’s health clinic to get tested.

Drink responsibly

Drinking under the age of 21 is illegal in the US, but that isn’t always the reality on college campuses. With this in mind, I wanted to lay out some of the dangers of drinking on college campuses so everyone can be informed.

  • Beware of binge drinking. One of the biggest concerns regarding drinking on college campuses is the high rate of binge drinking – 90% of underage drinking is binge drinking. Frequent binge drinking in young adults can lead to alcohol dependence, liver problems, brain damage, and heart troubles. Binge drinking can also lead to poor decision making, including driving under the influences.
  • Don’t get hurt. Underage drinking is also linked to unintentional injuries, violence, school performance problems, and other risky behaviors.

Best of luck to those of you heading off to college and thank you to the Office of Public Health Preparedness and Response for the chance to experience public health in action at CDC!