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Community Participation is Key to Handling Health Emergencies

Officials Urged to Tap Community Resources in Advance of Epidemics and Disasters

APRIL 3, 2007 – Baltimore, MD – Citizen preparedness for health emergencies must look beyond the individual and the home. So says a blue ribbon panel whose report is published today in the journal Biosecurity and Bioterrorism. The Working Group on Community Engagement in Health Emergency Planning challenges the conventional wisdom that boils down citizen readiness to a checklist of canned goods, drinking water, medicine, and phone numbers in case of an emergency.

Organized by the Center for Biosecurity of the University of Pittsburgh Medical Center, the Working Group includes decision makers at all levels of government; public health and safety practitioners who have dealt with high-profile events including the anthrax letter attacks, tornados, and earthquakes; heads of community-based partnerships; and subject matter experts in infectious diseases, disaster management, community development, and risk communication. Their report, “Community Engagement: Leadership Tool for Catastrophic Health Events,” instructs mayors, governors, and health and safety officials in why and how to involve community partners in disaster- and epidemic-related policymaking.

“Preparedness means more than personal stockpiling,” says Monica Schoch-Spana, PhD, a social scientist with the Center for Biosecurity who chaired the Working Group. “Encouraging self-sufficiency can be counterproductive when the entire community’s well-being is at stake. Officials need to work with citizens and civic groups before disaster strikes to promote all the ways the public can contribute, including taking part in policy decisions, building volunteer networks, getting support for tax or bond measures that limit vulnerability and improve health and safety agencies, and, yes, having family emergency plans, too.”

Among the findings of the Working Group:

  • Members of the public are “first responders,” too—Family, friends, coworkers, neighbors, and bystanders are often the first people on the scene and provide rescue efforts and aid before police, firefighters, and other officials arrive. Volunteers have also helped quell infectious disease outbreaks.
  • The civic infrastructure—people who live, vote, play, work, and worship together—should be involved in emergency planning and act before, during, and after an event. Civic groups can help officials decide in advance who gets scarce medical resources, give aid when the professionals can’t be there, and comfort survivors over time.
  • Good leaders will actively engage the community before an event. Communication must be two-way, not just leaders sending out information and directions. A dialogue with community partners in advance will garner public trust and improve emergency plans.
  • Outreach to the community must include groups who are usually not at the table. Leaders must take deliberate action to include the perspectives of poor and working class people, people of color, recent immigrants, and seniors, among others.
  • The community needs strong health and safety institutions with which to partner. Getting input from local opinion leaders will require public officials and agencies to have a different set of skills and staff, which are presently in short supply.

The Working Group looked at both recent and historic examples of successful community engagement in policymaking, including:

  • Montgomery County’s health department is working with civic organizations and homeowners’ associations in Maryland to promote “neighborhood support teams” and to improve communications between county residents and officials during a health emergency like pandemic influenza.
  • The Public Health Agency of Canada is convening 11 citizen and stakeholder dialogues, including one among First Nations people, to get advice on whether governments should stockpile publicly funded antivirals for prophylaxis for a flu pandemic.
  • CARD—Collaborating Agencies Responding to Disasters (Alameda County, CA)— emerged after the 1989 Loma Prieta earthquake to train and unite service providers as a safety net for people with limited ability to address their own disaster-related needs: seniors, children, the disabled, the homeless, non-English speakers, and low-income families.
  • Residents of Grand Bayou (LA), a Cajun and Native American ocean-farming community, have partnered with state and local government, business, the faith community, and university-based experts to tackle mounting coastal dangers; one effort is hazard mapping that incorporates indigenous knowledge about historic environmental transformations.
  • During the 1947 smallpox outbreak, NYC health officials vaccinated more than 6.3 million people in 4 weeks using private physicians and volunteers from the Red Cross, teachers’ groups, women’s clubs, and civil defense groups.

 “Community Engagement: Leadership Tool for Catastrophic Health Events,” by Monica Schoch-Spana et al. on behalf of the Working Group on Community Engagement in Health Emergency Planning, appears in the Spring 2007 issue of Biosecurity and Bioterrorism. The full text is available by contacting Molly D’Esopo at


The Center for Biosecurity of the University of Pittsburgh Medical Center (UPMC) works to prevent the development and use of biological weapons, to catalyze advances in science and governance that diminish the power of biological weapons as agents of mass destruction, and to lessen the human suffering that would result if prevention fails.



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