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Strengthening Hospitals and Healthcare Disaster Response Capability by Addressing Vulnerable Populations. Debra Kreisberg, Deborah Thomas, Comilla Sasson, and Morgan Valley Department of Emergency Medicine University of Colorado Denver. Quality Health Care for Culturally Diverse Populations
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Strengthening Hospitals and Healthcare Disaster Response Capability by Addressing Vulnerable Populations
Debra Kreisberg, Deborah Thomas, Comilla Sasson, and Morgan Valley
Department of Emergency Medicine
University of Colorado Denver
Quality Health Care for Culturally Diverse Populations
October 21, 2010
NATIONAL GOAL: A CULTURE OF PREPAREDNESS
Individuals, communities, private industry, nonprofit entities, and all levels of government share responsibility and play a crucial role in preparing for disasters and emergencies.
The United States suffers from extensive Health Disparities perpetuating service delivery structures in which too many Americans cannot get adequate healthcare, with underlying vulnerabilities often linked to geographical, economic, cultural, and racial factors.
Statewide Vulnerability Assessment
Interview of Hospital AdministratorsPilot Project
Informing Hospital Preparedness Planning Incorporating Diverse Populations
1 Extremely Diverse (3.8%)
3 Moderately Diverse (31.6%)
4 Somewhat Diverse (35.4%)
6 Very Little Diversity (8.9%)
1 Extremely Concerned (6.3%)
3 Moderately Concerned (22.8%)
4 Somewhat Concerned (32.9%)
6 Very Little Concerned (16.5%Interviews: Hospital Perspective
To what degree has your senior administration identified cultural/linguistic competence as a concern?
“We’re a really small community with few economic resources, and it’s well known that the community hospital isn’t equipped for most things. And they can’t handle most situations, and I think that in a disaster there really isn’t much they could do.”
“What I noticed, is that they assist you if you have insurance in a matter of seconds, when you have insurance it’s a few seconds, just like that. It’s not fair, no, it’s not.”
“With me, when they notice I speak English, that I understand, they treat me differently. I feel like they help me more. They don’t ignore me.”
“…. I personally think that our community would not be ready in the event of an emergency and the community hospital would not be ready to assist even one fourth of the people. …. people who are used to going to other counties to see their doctors wouldn’t be able to do it. And then, what happens? They wouldn’t get medical treatment.”
“The hospital is like a horrible game of roulette because you don’t know what you are going to get.”
“… a community with scarce economic resources, so even people who are trained, and even if they wanted to live here, it’s not good for them because they’re not offered a good salary. So we don’t have stable doctors. We don’t have paramedics, stable nurses, and they’re always coming and going.”Agency and Structural Considerations
“I would take my family, like I said before, because of safety reasons so that we can be all together. You know that we Latinos have very tight-knit families. No matter what happens we are always together.”Collectivism & Individualism
“I believe that family members would all get together in the house that is farthest from the chemical spill…. If one or two start to feel bad, then one of the adults could take them to the hospital.”
“I think you have to weigh the situation and analyze whether the people going with you are in danger by going to the hospital with the injured person, or to see if it’s better to keep them home, so that they’ll stay there.”
No matter who ends up on the hospital doorstep in a disaster, the best care possible can be delivered with cultural sensitivity to varied populations in all types of disasters