Integrating Mental Health and Disability Into Public Health Disaster Preparedness and Response - Chapter 4 The impacts of disasters on people with disabilities and chronic physical and mental health conditions

This chapter focuses on the impacts of emergencies, disasters, and the COVID-19 pandemic on people with disabilities, chronic and mental health conditions. History has shown that disabled people experience disproportionately more negative outcomes from emergencies than people without disabilities. The chapter provides examples of some of these negative impacts and examines them from multiple points of view: (1) health disparities; (2) disruptions to daily life; and (3) inequitable access to emergency services and resources. For example, if someone can’t hear or understand evacuation instructions, then they are unlikely to get themselves to safety. Someone who can follow the instructions may evacuate, but if they can’t bring along vital equipment like a mobility device, ventilator, or feeding supplies their physical or mental health may worsen and/or they may lose their independence. Considering the health disparities that disabled people experience on “blue sky” (ordinary) days, the severity of disaster impacts on them becomes clearer. That these negative impacts happen despite strong civil rights laws and exhortations for inclusion is hard to understand. The chapter reviews potentially explanatory factors. Disabled people may have gaps related to preparedness planning or may lack understanding about the US emergency system, creating potentially unreasonable expectations. Emergency managers and public health personnel may lack knowledge or experience with the disability community, inclusive emergency management and/or civil rights law implementation, leading to gaps in plans and practices. And when people with disabilities lack access to the emergency planning table, then emergency plans and processes may not address their needs.