Using references drawn from the professional literature, news media, or trade pe

Question

Using references drawn from the professional literature, news media, or trade periodicals, please describe some aspect the surge activity(ies) undertaken by public health and medical authorities to respond to an actual emergency. Such emergencies could be the Boston Marathon bombing, the mass shootings and killings at Pulse in Orlando or at Charlie Hebdo in Paris, the bombing at the airport in Brussels, Hurricanes Katrina, Sandy, Harvey, Irma, etc. Unfortunately, there are many situations you can choose from. They also do NOT have to be major world events like those mentioned above. Please be sure to respond to the following questions:

What was the nature of the emergency/disaster?

What was the surge need you will describe?

How did authorities determine this to be a need?

How did authorities identify the additional resources needed to meet the demands of the situation? How did the authorities determine that it was time to “demobilize” and return to a baseline level of staffing?

Explanation / Answer

In societies susceptible to experiencing adverse impacts from, for example, volcanic, wildfire, and seismic activity, the management of the associated risk is afforded a high priority. A key component of risk management is encouraging the adoption of protective measures (e.g. storing food and water, household emergency planning) to reduce the risk of injury and damage and facilitate people’s capacity to cope with hazard consequences (Paton et al., 2003, 2006). Despite the efforts of emergency planners, based on the assumption that providing people with information about hazards will motivate the adoption of protective actions, people living in communities at risk from natural hazards continue to demonstrate poor knowledge of risk mitigation procedures and a reticence to adopt protective measures (Paton et al., 2000). One reason for this has been the failure to accommodate the fact that it is not information per se that determines action, but how people interpret it in the context of experiences, beliefs and expectations that develop in and are sustained by the community and societal contexts in which they live (Marris et al., 1998; Rippl, 2002). An important, but oft neglected, issue in this regard is the relationship between the community and the source (rather than the content) of information and advice on disaster preparedness. Because of the complexity and uncertainty associated with natural hazards, information on mitigation measures typically comes from the societal mechanisms established for this purpose. That is, from civic emergency management agencies. The greater the uncertainty they face, the more people attribute weight to their trust beliefs about a source of information (Johnson-George and Swap, 1982; Sjo¨berg, 1999). Trust influences perception of other’s motives, their competence and the credibility of the information they provide (Earle, 2004; Kee and Knox, 1970). As such, it would be expected to play a prominent role in mediating relationships concerned with acquiring information about, understanding, and taking action to mitigate infrequently-occurring natural hazard consequences. While considerable attention has been directed to the content of risk communication, the role of people’s perceptions of agencies that provide the information has been less extensively researched. This paper examines how trust in the civic agencies that provide risk communication influences hazard preparedness. When dealing with natural hazard issues, people rely on sources (e.g. emergency planners) with whom they have a general relationship (e.g. their being officers of local councils or other civic agencies) that extends beyond natural hazard issues. Hence, the quality of trust developed in general contexts (e.g. in relation to people’s experience of council/civic services, their dealings with council officers) may influence trusting in the context of risk communication about infrequent natural hazard events. The specific relationship between trust in civic emergency planners and the quality of risk communication has not been systematically examined. The relationship between trust and hazard mitigation is examined using a model developed by Kee and Knox (1970) and Mayer et al. (1995) that views trust as a process influenced by situational (familiarity, information availability) and structural (e.g. community competence) factors. Two predictions of this model are examined. The first considers how situational factors (familiarity, information) influence the relative importance of trust as a predictor of the effectiveness of risk communication. This is examined with regard to its role in predicting the adoption of protective measures. The second examines the proposed relationship between community characteristics and levels of social trust. The importance of the latter derives from recognition that people’s perception of risk is influenced by social context (Earle, 2004; Poortinga and Pidgeon, 2004). It is proposed that trust will be influenced by community characteristics that influence people’s capacity to confront the uncertainty associated with complex, infrequently-occurring natural hazards. The paper commences with an analysis of situational factors.

Study one: situational factors

With respect to whether trust influences people’s decision making, two aspects of the situation have been identified as being important (Mayer et al., 1995; Siegrist and Cvetkovich, 2000). The first concerns familiarity with a situation. The second involves the availability of information. The importance of social trust, according to this view, is inversely related to familiarity with the hazard, and the availability of information about the hazard. As frequency and experience increase, the more information will be directly available to the person or accessible from within their community, negating the need to acquire and evaluate information from other sources. Consequently, it is only in unfamiliar situations, in which reliance upon external expert sources is greater, that trust in the source of information becomes a component in decision making about mitigation. While this relationship has been found for several technological hazards (Siegrist and Cvetkovich, 2000), its applicability to infrequently-occurring natural hazards has not been examined. This issue is explored here by comparing responses from populations exposed to bushfire, volcanic and earthquake hazards. The communities differ with regard to their relative familiarity (based on frequency of exposure) with each hazard.

Procedure Bushfire data were collected from areas in Hobart (Australia in 2004) that experience this hazard annually. It is, consequently, a high familiarity hazard. For the low familiarity hazards, volcanic (Auckland, New Zealand in 2005: Paton et al., 1999) and earthquake (Napier, New Zealand in 2005: Paton et al., 2003) scenarios were selected. The lack of damaging volcanic activity in Auckland and infrequent (last in 1931) damaging seismic activity in Napier renders them appropriate choices as low familiarity hazard scenarios. For both hazards, people are reliant on external sources (rather their own or others’ direct experiences) for the information they need. The second situational predictor proposed in the model concerns the availability of information. This is not easy to assess. It cannot be judged on the basis of information made available. An alternative is to measure the extent to which relevant information is freely available within the social domain amongst community members at risk (Earle, 2004). Levels of information availability were estimated by asking respondents to describe how often they discuss hazard issues with others in their community. While some 52 percent of bushfire residents discussed hazards monthly and 25 percent discussed them weekly, the corresponding levels of discussion for those in earthquake areas was 24 percent and 8 percent respectively. No volcanic residents discussed issues weekly, and only 2 percent discussed them on a monthly basis. For bushfire residents, situational cues (familiarity and information availability) were more prevalent and accessible than was the case for their volcanic and earthquake counterparts. Accordingly, it was hypothesized that trust would be a less significant predictor of the adoption of protective measures in the bushfire group. Building on previous work (Paton et al., 2005), the extent to which critical awareness, outcome expectancy, action coping and trust predicted intention to prepare was examined. Critical awareness describes the salience of hazard issues amongst community members (Dalton et al., 2001; Hardin and Higgins, 1996). Outcome Expectancy assesses people’s beliefs about whether personal actions can mitigate the consequences of potentially catastrophic events (McClure et al., 1999. Action coping is a measure of problem solving beliefs (Carver et al., 1989). The final variable examined was a measure of trust in civic agencies developed for a study of earthquake preparedness (Paton et al., 2005). Although information on actual preparedness was collected, intention was used as the dependent variable (Paton et al., 2005). This was done to increase comparability and accommodate inequality in levels of preparation that reflect differences in frequency of exposure between the hazard scenarios. With the volcanic sample, this was justified on pragmatic grounds; levels of actual preparedness were so low as to preclude its meaningful analysis. Given the very infrequency of volcanic activity in the area, this was not surprising. The inclusion of intention as the dependent variable is consistent with a model that argues that intentions precede actions (Mayer et al., 1995). Participants were informed that the surveys were undertaken on behalf of the civic agencies responsible for risk communication. In so doing, it was intended that this would contribute to the creation of a context within which the survey could tap into how trust mediates the relationship between people’s beliefs and the source of information (i.e. civic emergency planning agencies).

Findings Multiple regression analyses revealed that in the high familiarity/high information condition, trust in civic agencies was not a significant predictor (Table I). In contrast, in the low familiarity/low information (volcanic and earthquake) conditions, trust was a significant predictor of preparedness intentions.

Discussion: study one Interviews with sub-samples of bushfire and earthquake participants provided confirmation of the role of available information in guiding hazard knowledge and protective actions. Bushfire residents described how sharing stories of bushfires and how to deal with them with others in their community provided information on fire and what protective actions to take. They also believed that it normalised these actions and encouraged preparing to become established within the culture of their community. These comments reiterate the importance of discourse in the process of how people construct models of environmental risk and its management (e.g. Lion et al., 2002). For the earthquake group, low levels of trust were attributed to dissatisfaction with the information available (e.g. lack of detailed information on hazard characteristics) and inconsistencies between information from different (e.g. emergency management and media) sources. Inconsistency reduces the credibility of risk information, dilutes its ability to assist decision making, and reduces levels of future trust in these sources (Kee and Knox, 1970; Poortinga and Pidgeon, 2004; Siegrist and Cvetkovich, 2000). Trust can also be undermined by the inferences people make regarding the motivations of those providing information (Earle, 2004; Kee and Knox, 1970). Johnston et al. (2005) found that trust declined when residents attributed the perceived inadequacies in information about tsunami risk to civic agencies putting economic factors ahead of community welfare. That is, they believed that information was being withheld in order to minimise the risk of hazard information adversely affecting economic and real estate activity.

The analyses presented here support the utility of the proposed model as a means of understanding how social trust influences risk communication about natural hazards. The postulated role of situational and structural factors was supported, as was a role for trust in civic institutions in people’s decision making regarding adoption of protective measures (see Figure 1: based on a volcanic scenario). Trust is contingent on situational cue (familiarity/information) availability. However, any conclusions regarding the relative contributions of familiarity and information availability remain tentative as this stage. Familiarity was assessed here on the basis of the frequency of hazard occurrence and information-availability by the level of community discourse about hazard issues, but their relative contributions could not be examined separately. They are inextricably linked to levels of experience. The qualitative analysis tends to favour information-availability as the driver. For example, bushfire residents described information sharing (rather than hazard experience per se) as an important determinant of the development of a culture of preparing within the community. While differentiation may be feasible with more prevalent technological hazards, it is unlikely that levels of familiarity for most natural hazards would be able to emulate those of their technological counterparts. The analyses also highlighted the need to view relationships between emergency management functions and the community as reciprocal (examined here using the construct of empowerment) rather than prescriptive. When dealing with infrequent natural hazards, information will be evaluated in terms of people’s generalized beliefs regarding trust in the social institutions providing information. Risk communication is not just about providing information. The social construction of risk and its management must be considered, and future research should encompass both the information made available and the community and societal contexts within which it is disseminated. Currently, risk communication programs in the areas studied do not create contexts conducive to either encouraging discourse about natural hazards or facilitating citizens’ active involvement in developing and implementing sustained mitigation practices. These findings reiterate the need for risk communication to be based on community engagement principles (Paton et al., 2005) and encourage discussion of hazard issues within established community forums (e.g. religious groups, social action groups) in ways that empower community members to identify the implications of hazard activity for them and facilitate their ability to confront those issues (Paton, 2006; Paton and Bishop, 1996). When emergency management agencies engage community members about hazards, levels of trust, satisfaction with communication, risk acceptance, willingness to take responsibility for their own safety, and collective commitment to confront hazard consequences will increase.

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