Even though the elderly are known to be at increased risk of disaster-related morbidity and mortality, several studies have shown that they are alarmingly underprepared for disasters. Although the risk factors for lack of preparedness in this population are not well characterized, there is some evidence that certain psychosocial factors, such as risk perception and self-efficacy, may play an important role. We recently examined this issue in a subset of urban, community-dwelling elderly at particularly high risk of adverse outcomes associated with disaster events - those receiving in-home supportive care.
The purpose of our study was to determine the role of social and behavioral factors with respect to disaster preparedness of vulnerable elderly. A sample of 50 elderly homecare recipients living in San Francisco were recruited to participate in 1.5-hour long in-depth interviews in their homes. An interview guide was developed that addressed the main constructs of a social-cognitive theory of preparedness, including: personal characteristics (e.g., functional health and disability status, socioeconomic status, language and culture, etc.), predisposing social-cognitive factors (e.g., knowledge, attitudes, beliefs, perceptions, response self-efficacy, etc.) and social factors (e.g., social support, family structure, dependence on social services, housing and the built environment, etc.). Our goal was to identify factors that served as barriers or facilitators to preparedness. We found that in this sample, serious health problems; financial and resource limitations; sense of isolation, futility, and inevitability; and lack of social support all served as barriers to preparedness. Elderly homecare recipients who had strong social support (care givers, family members, neighbors) were more likely to prepare for disasters. Information from this study will inform policies and practice of governmental and non-governmental agencies serving the elderly in San Francisco, and may have similar utility in other urban areas.
IV. Urbanism, Health and Wellbeing 4.1 Built environment 4.2 Pollution: air, noise, etc