Tuesday, November 13, 2012

And officials ask why residents don't follow evacuation advice!

Before and after Hurricane Sandy hit officials at every level (Governors, Mayors, emergency management) urged residents to evacuate...and bemoaned that less than 50% headed their warnings.  

Historically residents have been reluctant to leave their homes for any number of reasons: nowhere to go, no money to get there, not being physically well enough, not wanting to go to a shelter, not wanting to leave their pets, fear of looting while they're gone, to say nothing of the powerful emotional and psychological attachment we have with "home".

Post Katrina, and the fiasco of official directions to " go to the Convention Center", many, especially low income and minority residents lack TRUST in officials and their judgements.
(photo below Daily News/11/13/12)

And now we have the head of NYCHA telling residents that getting a rent reduction for the time they suffer few living back in the 18th century a "nice little Christmas present." 

Clumsy statement or worse, this callousness goes a long way to extinguishing any remnants of trust people in Red Hook and elsewhere have.

Eroding public trust in the commons, won't help us out when the next complex emergency is on our doorstep. 

Saturday, November 10, 2012

States Rush to get Health Exchanges Up and Running

Now that Pres. Obama has been re-elected (a positive call to action for those of us in public health!), states are going to be in a rush to get their health exchanges up and running (NYT 11/10/12). Many states were playing a wait-and-see game, doing little to plan for their exchange. 

By Jan. 1, 2014 the Fed Gov’t.  is requiring most Americans to have health insurance.  Every state is supposed to have an exchange by Jan. 1, 2014.  

How Will the Health Exchanges Operate?
Great question!
That's much less clear.  
If states want to run their own exchanges, they have until Dec. 14 ( with extensions, now maybe until Feb. 15)  to submit applications, or blueprints. Right now, less than half the states say they are going to run their own exchanges.  In that case the Federal govt. will run the exchanges.

Consumers May Be the Losers
Unless the health exchanges are up to the task of really assisting consumers understand health plans and choose wisely, consumers may be the losers.

We’ve known from research over the last two decades, that choosing a health plan is a difficult and confusing task for consumers.  See “What’s Behind the Door: Consumers’ Difficulties Choosing a Health Plan, Consumers Union) -

(Consumers Union, 2012; Sofaer and Hibbard, 2010; I too worked on an AHRQ SBIR 1997,creating health plan choice tools for underserved and low literate populations) as just some examples.

Most consumers don’t know enough about health plans and their products, (often due to plan information written in a very difficult manner) and have a near impossible time trying to compare plans and make the best choice for themselves and their families (Council of Economic Advisors, 1994; OTA, 1988).

The Health Exchanges, the materials the produce, the hiring and training of the staff they have to assist consumers will play a very key role in the successful entry of millions of people into the health system.  They must do the heavy lifting when it comes to getting consumers ready to choose and use a health plan – a key cost control criteria.

Health Exchanges need to be on top of their game when it comes to understanding that the majority of new health plan consumers are likely low health literate - 50% of adults in the US are, and disproportionately so if they are poorer or less educate.  Clear communication and effective decision-making tools will be absolutely vital.

Can the health exchanges get consumers ready?

Will they use the best practices we’ve been developing in health literacy?

Monday, October 29, 2012

Why people don't go to Hurricane Evacuation Centers - Reasons #4

Trust.  If you're not going to have a police state - where people are carted off the beaches and boardwalks, or forced out of their apartments in Zone A - you need to rely on a public that understands and trusts the directions they are getting in an emergency.

I'm sure we could put together a very long list of what prevents many New York residents from trusting emergency management officials:

I'll start with one:
I'll call it...
But Wardrobe Malfunction #1

Officials say that public safety is very, very important to them.  They don't want residents getting hurt and they don't want first responders, trying to rescue residents, in harms way.

Got it!  Makes sense.

But as residents are asking today, why aren't the 12,000 prisoners on Riker's Island being evacuated? 
What about the floating jail at Hunt's Point - 800 prisoners?
Check out Michael Howard Saul's blog today in the WSJ.  Particularly the comments posted by loved ones and friends of those prisoners.

Or Solitary Watch

Then talk to me  me about trust.

Civic literacy- plays an important role in the public's overall health and safety literacy.  civic literacy consists of the things we learn about what sources of information to trust, who to go to for reliable information, how we understand power relationships - is a dynamic process.

Sadly, in this particularly situation, we are "teaching" a very counter-productive lesson in civic literacy.

And we continue to wonder why residents, many of them from diverse communities, don't want to get on the evacuation busses.

Hurricane - why people aren't going to the evacuation centers - Reason # 3

Our own wonderful Channel 1 and others are reporting that most of the buses that are waiting in Zone A to take residents to shelters are empty.  Why are we surprised at this.
As many Harlem residents have said to our research team post Katrina - "you're not going to see me going to any convention center."

To me, this is a very serious problem that we need to solve.
Any ideas?


Hurricane: Why people don't go to evacuation centers - Reason #2

Reason #2

Now I'm a quick learner, but each time I've tried to use the  Hurricane Evacuation Zone Finder on the OEM website to determine if I am in a Flood Area - ( specifically for Hurricane Sand - Zone A) - I invariably don't type in my location exactly the way this low-tolerance search program wants it.

You try.

Someone just reported that the site isn't working right now.

Hurricane Response: Why many don't go to evacuation centers - Reason #1

One Reason - try interpreting the flood area map 

Each time we face a complex emergency here in New York, you can see improvements in pre-planning, coordination and response readiness.  That's a good thing.

Broadcast media are constantly reporting updates and directions.  And New Yorkers are tuned in. 
But for detailed information you're referred to official sources: 

I'm going to focus on the critical information that is widely distributed in the leading websites:  NYC OEM, MTA , NYCDOHMH, and others. 
You can be the judge of how easy to read and use these critical sources are: 

In 2007  we published the findings of a study we did using intercept interviews in Harlem, showing people the then current evacuation map GIS Maps to Communicate Emergency Preparedness: How Useable Are They for Inner City Residents? ( Journal of Homeland Security and Emergency Management)

The vast majority of residents (83%) who hadn't completed High School ( nearly 50% of Harlem residents) could not use the map to determine if they lived in a Flood Area, nor could they find where the closest Evacuation Center was. 

Any ideas on how to make it much easier for New Yorkers to find out if they're in a flood zone? 

Any ideas on improving on the current maps? 

Friday, August 10, 2012

Find Your Greatness - Nike did in this Ad

I've been a keen watcher of Olympic ads for quite a while and have a library of them I perennial use in my communication classes.  Whether it's the compelling messages about the environmental and sustainability of the Summer games in 1992 when even Anheuser Bush portrayed itself as green to the core, or Nike's "Just Do It" ads in Winter 2002.      I'm a sucker for the pull of the uniquely emotive advertising during just about any Olympics. They never disappoint.
And they never fail to supply me with examples of powerful communication to bring into my public health classrooms.

This Summer Olympics has not disappointed. Nike gets my vote for the best Find Your Greatness.  And one that will open my Fall semester.

Over 1 million views on YouTube and hundreds of people weighing in one the image of a 200 pound 12 year old struggling as he jogs down a lonely road toward the camera.

It made me think of the way we are generally framing obesity messages ( for young people).  In my lab files I an obesity campaign the state of Alabama's launched last year Strong4Life. ( Acknowledgment and thanks here to grad student Colleen Bowan, for her analysis of this campaign).  The original images and messages were all dire and accusatory.  

When was the last time we talked about a person's greatness in a public health messages - especially in our obesity messages?

Saturday, June 23, 2012

The Mediterranean Diet these days in Syntagma Square, Athens. The new definition of "ethnic foods".  And according to public health experts I've been speaking with this week, Athens and most major US cities share a common characteristic - rising obesity rates.

Sunday, June 17, 2012

From Chinglish to Greekglish

I'm always drawn to what right-minded folks do when they translate information - especially important information.  On the island of Crete this week, at a beach known for its unique pink sand, Elafonissi, I came upon this.  Something to be said for language and the staggering profusion of of possibilities our tinkering yields.