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A new survey by the Mailman School of Public Health's National Center for Disaster Preparedness (NCDP) in collaboration with the Children's Health Fund (CHF) has found that a majority of Americans lack confidence in the U.S. health system's capacity to respond effectively to a biological, chemical, or nuclear attack.

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. The survey found that more than one-third of adults nationally and about half 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 to one year ago.

"This survey reflects an extraordinary lack of public confidence in the nation's level of preparedness for bioterrorism and major disasters," says Dr. Irwin Redlener, director of the NCDP. "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. 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."

In addition, the survey found that many Americans lack effective emergency preparedness plans in homes, schools and workplaces. For example, the survey revealed that nationally, only 58 percent of parents, and 53 percent of parents in New York City, are aware of any emergency or evacuation plans at their child's school.

In a Sept. 8 press conference at Columbia to announce the survey results, Sen. Hilary Clinton said: "The survey results further illustrate the need for the federal government to provide local communities with the resources 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. I applaud the efforts by both the Mailman School and the Children's Health Fund in not only revealing people's attitudes about their safety and concerns about terrorism, but also for their proactive approach to establishing a model community-based preparedness plan that approaches preparedness on the local level."

The survey recommended improvements in:
Community and Individual Involvement
It is essential that the general public be more informed about and participate in preparedness planning. Individual, family and community-based strategies would be empowering to and well accepted by the public and should be part of disaster planning at every level.
Evacuation Planning
Since the overwhelming majority of Americans will not evacuate immediately if asked or ordered, enhanced family preparedness planning will contribute to the larger public health goal of disaster preparedness. The planning needs to explicitly address the issues of concern to the public during a crisis.
Workplace Preparedness
OSHA should step up its efforts to develop workplace preparedness, emphasizing worker awareness programs and workplace training drills.
School Preparedness
Schools must develop comprehensive disaster and evacuation plans, and parents must be informed about the details of these plans.
Training of Health Professionals
Bioterrorism training of public health leaders and health professionals in general should be greatly enhanced.

Based on the survey results, the NCDP and the CHF also recommend that the primary spokesperson for the federal government should be the U.S. Surgeon General, and the lead federal government agency should be the Centers for Disease Control and Prevention.

For more information on curriculum development in bioterrorism, training of public health professionals, development of model programs, research and public policy issues on disaster preparedness, visit the National Center for Disaster Preparedness web site at: www.ncdp.mailman.columbia.edu.


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