FOR RELEASE AFTER 10:00 AM SEPTEMBER 8, 2003

MORE THAN $5 BILLION SPENT ON BIOTERRORISM PREPAREDNESS, BUT
AMERICANS REMAIN DEEPLY CONCERNED ABOUT SAFETY AND A MAJORITY LACK CONFIDENCE IN GOVERNMENT AND HEALTH SYSTEM
TO RESPOND EFFECTIVELY

A New Survey from the National Center for Disaster Preparedness at
Columbia’s Mailman School of Public Health Finds that Americans Lack Effective
Emergency Preparedness Plans in Homes, Schools, and Workplaces

(NEW YORK) – September 8, 2003 – Two years after the terrorist attacks of September 11, 76% of Americans nationwide are concerned about more terrorism in the U.S., but a majority lack confidence in the U.S. health system’s capacity to respond effectively to a biological, chemical, or nuclear attack. Furthermore, fewer than one in four families (23%) nationally have a basic emergency plan, finds a new study from the National Center for Disaster Preparedness (NCDP) at Columbia University’s Mailman School of Public Health in collaboration with The Children’s Health Fund (CHF).

The NCDP and the CHF commissioned the Marist Institute for Public Opinion to conduct the survey of adults both nationally and in New York City in August 2003. Specific questions from four previous surveys conducted for CHF were repeated in order to identify trends in public attitudes and perceptions over time.

More than one-third (35%) of adults nationally, and about half (49%) in New York City, lack confidence in the government’s ability to protect their community in the event of another attack. These confidence levels are virtually unchanged compared with one year ago.

While general “confidence in government” levels remain low, but essentially similar in 2002 and 2003, there was one notable change: the survey found a significant decline in public confidence that the U.S. health system could respond effectively to a biological, chemical, or nuclear attack—from 53% of Americans in 2002 to 46% in 2003. This trend was most dramatic in New York City, where 53% of New Yorkers were confident in the health system in 2002, but only 36% of New Yorkers expressed confidence in 2003.

Nationally, nearly half of parents reported being more concerned about personal and family safety in the wake of terrorism and only 35% of people nationally and 23% of New Yorkers believe that their community has had an adequate emergency response plan in place.

Despite these concerns, fewer than one in four (23%) families nationally have a basic emergency plan with the bare minimum of components: at least two days of food and water, a flashlight, a portable radio and spare batteries, emergency phone numbers, and a meeting place for family members in case of evacuation. In New York City only 14% of families have made basic preparations.

“This survey reflects an extraordinary lack of public confidence in the nation’s level of preparedness for bioterrorism and major disasters. And, the fact is that we have not made the kind of progress in these areas that might have been expected two years after 9/11,” said Dr. Irwin Redlener, Director of the National Center for Disaster Preparedness at Columbia University’s Mailman School of Public Health. “People are very concerned about the possibility of bioterrorism in America, but the lack of confidence in our ability to prevent or respond to future attacks may undermine the likelihood of people cooperating with authorities at the time of an actual crisis.”

When asked specifically about whom people trust to get reliable and accurate information, medical experts inspire the most trust, with 83% of Americans choosing a doctor with expertise in bioterrorism. More than three-fourths (76%) of those surveyed identified the U.S. Surgeon General as the most reliable single public official when it comes to information about bioterrorism. Officials from the Centers for Disease Control and Prevention (CDC), at 84%, had the highest trust level for reliable and accurate information of any government agency.

In contrast, President Bush, Attorney General Ashcroft, Secretaries Ridge and Thompson were trusted to provide reliable and accurate information by between 65% and 69% of respondents.

The survey reveals that many Americans are unaware of emergency plans in schools or at the workplace. Nationally, only 58% of parents, and 53% of parents in New York City, are aware of any emergency or evacuation plans at their child’s school. Further, only 19% nationally and 15% in New York City were very familiar with the details of the school plan.

"The survey results further illustrate the need for the federal government to provide local communities with the resources that they need to establish sweeping preparedness plans. Cities and towns are struggling to balance their budgets and they need a federal guarantee that funds will reach them directly so they can cover security and preparedness costs," said Senator Hillary Clinton. "I applaud the efforts made by both the Mailman School of Public Health at Columbia University and The Children's Health Fund in not only revealing people's attitudes about their safety and concerns about terrorism, but also, for their pro-active approach to establishing a model community-based preparedness plan that approaches preparedness on the local level," Clinton said.

The federal Occupational Safety and Health Administration (OSHA) mandates that any company with 11 or more employees must have an emergency evacuation plan. Nationally, while 70% of people working in companies where this mandate applies reported being aware of emergency evacuation plans, only 42% were very familiar with the details. In New York City, the situation is even worse. Only 59% report awareness of a workplace evacuation plan, and 28% are very familiar with the details of the plan.

Of great potential concern to emergency evacuation planners, the overwhelming majority of Americans (90%) will not evacuate immediately if directed to do so by officials. The most prevalent concern (66% of Americans and 62% of New Yorkers) was the desire to account for the whereabouts and safety of family or other dependents. Since there may be instances in which immediate evacuation is necessary, emergency planning coordinators will need to address the specific factors contributing to the reluctance to evacuate immediately. Enhanced family preparedness planning will contribute to the larger public health goal of disaster preparedness.

“People clearly need unambiguous and reliable information about what would happen in the event of a major terrorist event. This starts with the reality of having workable plans in place, but part of the process is communicating effectively to the public,” said Dr. David Markenson, deputy director of the NCDP and director of its program on pediatric preparedness. He added, “As of today, many people are certainly concerned about terrorism, but lack information about what they need to do or know to protect themselves, and their loved ones, should a significant terrorist attack occur.”

The overwhelming majority of Americans will not evacuate immediately if asked or ordered to do so. There may be instances in which immediate evacuation is necessary, so the reasons why they will not – which generally involve the need to ensure the safety of those close to them – must be addressed. Enhanced family preparedness planning will contribute to the larger public health goal of disaster preparedness. This planning, however, needs to explicitly address the issues that would concern the public in a crisis such as being reassured about plans to protect children and reunite them with parents, clear information about what would be available to assist elderly or disabled relatives or friends and how to accommodate pets.

The full survey results are available at www.ncdp.mailman.columbia.edu.
The August 2003 national survey was conducted from August 5th through 14th, and 18th through 20th, 2003. In the national survey, 1,373 adults eighteen years of age or older within the continental United States were interviewed by telephone, of which 484 were parents with children age four through eighteen living in their household. There were 663 interviews with people employed by a company with 11 or more employees. In the New York City survey, 1,317 adults 18 years of age or older were interviewed, of which 456 were parents with children age four through eighteen living in their household. There were 640 interviews with people employed by a company with 11 or more employees. Telephone numbers were selected based on a complete list of telephone exchanges (nationally or within New York City) and selected for representation in proportion to the population. The results of the entire survey are statistically significant at +/-3%, +/- 4.5% for parents with children aged four through eighteen, and +/-4% for employees. Interviews were conducted in English or Spanish as necessary.

The National Center for Disaster Preparedness at the Mailman School of Public Health is an academically-based, inter-disciplinary program focused on the nation’s capacity to prevent and respond to terrorism and major disasters. The NCDP provides curriculum development in bioterrorism, training for public health professionals and other first responders, development of model programs, a wide-ranging research agenda and public policy analysis around issues germane to disaster preparedness. www.ncdp.mailman.columbia.edu

The only accredited school of public health in New York City, and among the first in the nation, Columbia University’s Mailman School of Public Health provides instruction and research opportunities to more than 800 graduate students in pursuit of masters and doctoral degrees. Its students and more than 200 multi-disciplinary faculty engage in research and service in the city, nation, and around the world, concentrating on biostatistics, environmental health sciences, epidemiology, health policy and management, population and family health, and sociomedical sciences. www.mailman.hs.columbia.edu

The Children’s Health Fund, founded in 1987, works to provide medical care to the nation’s most medically underserved population – homeless and disadvantaged children. To date, The Children’s Health Fund’s national network of 16 pediatric programs has treated more than 300,000 children. More information can be found at The Children’s Health Fund website at www.childrenshealthfund.org.