Apr 18 2014
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Faces of Public Health: Esther Chernak, Drexel University School of Public Health

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The Center for Public Health Readiness and Communication (CPHRC) at the Drexel University School of Public Health in Philadelphia recently re-launched DiversityPreparedness.org, a clearinghouse of resources and an information exchange portal to facilitate communication, networking and collaboration to improve preparedness, build resilience and eliminate disparities for culturally diverse communities across all phases of an emergency. The site had originally been developed by Dennis Andrulis, now at the Texas Health Institute, and Jonathan Purtle, who co-writes a blog on public health for the Philadelphia Inquirer.

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NewPublicHealth recently spoke with Esther Chernak, MD, MPH, the head of CPHRC, about the re-launched site and her work in preparedness.

NewPublicHealth: Tell us a little bit about your background and how you came to lead the Center for Public Health Readiness and Communication.

Esther Chernak: I’m an infectious disease physician by training and pretty much have been working in public health since I finished my infectious disease fellowship in 1991 at the University of Pennsylvania. I started working in the Philadelphia Department of Public Health in its city clinic system doing HIV/AIDS care, and then became the Clinical Director of HIV Clinical Programs for the health centers back in the early ’90s when the epidemic was obviously very different. I then moved to working in infectious disease epidemiology as a staff doctor in the acute communicable disease control program and was involved in infectious disease surveillance and outbreak investigations for a number of years.

Then in 1999, I took a job with the City Health Department in what was then called bioterrorism preparedness. That was the time when major cities in the country were just beginning to be funded to do bioterrorism response plans. Groups that were involved in bioterrorism preparedness recognized relatively quickly that despite the fact that we were dealing with planning for novel strains of influenza and pandemic preparedness and SARS and smallpox, we were also dealing with many, many really significant infectious disease outbreaks, and then ultimately non-infectious disease related issues that had huge impacts on public health, such as earthquakes and hurricanes. Those links helped prepare me for my role at the Center.

NPH: What was the evolution of DiversityPreparedness.org?

Chernak: The site was a project of the Drexel Center for Health and was launched with a grant from the Office of Minority Health within U.S. Department of Health and Human Services (HHS). It had a very clear purpose to provide resources related to emergency preparedness for culturally diverse and communities. It very much came out of the work that Dennis Andrulis was doing at the time around health disparities after disasters. Remember this was in the wake of Katrina, which put a spotlight on the huge cultural and racial disparities that existed after disasters for a variety of reasons. When I came on board the funding no longer existed. It has been a great resource for many people involved in the work of disaster planning, in particular people interested in social justice, health disparities and community resilience. But we got the feedback that the site was complex and perhaps a bit cumbersome to navigate for the user, and we also found it to be complex and cumbersome to maintain in terms of uploading new resources. So we worked with Drexel to use some existing platforms to try to make it a little bit more accessible and really refine it based on many comments we received.

Also, as a part of the revised interface, we found that a lot of the work around disaster preparedness today focuses not just on culturally diverse communities, but also other at risk communities or communities that are “at risk for other reasons”—i.e. they have functional needs, they have access mobility challenges, they’re non-English speakers, they are children, they’re seniors, they have special medical needs. We’ve learned certainly in the disasters in the last several years that those populations have unique considerations, and in the interest of trying to create a kind of one-stop shop place for folks looking for resources, we decided to augment the resources around those populations as well on the website.

In the last year as we’ve transferred the site to the Drexel interface, we reviewed every single resource on the old site and either added to it or discarded it. And we’re still uploading new resources. We chose the second week of April for the re-launch for a number of reasons—because of Minority Health Awareness Month, and we wanted it to coincide with National Public Health Week. Tuesday of that week was “Don’t Panic: Disaster Preparedness Starts with Community-wide Commitment and Action.”

NPH: Hurricane season starts June 1. What would you like people to know about the site in preparing for hurricane season?

Chernak: I think general population messages are incredibly important, but I think we also have to focus on people who rely on electricity and assistive technology or would have other impediments to simply evacuating on their own. We need to make sure that those folks who are really at uniquely high risk for suffering severe consequences from disasters such as hurricanes have plans in place.

Some of the plans might be early notification, which is huge when it comes to hurricanes because there’s time to evacuate, time to have backup plans and time to have generators in place. Making sure that high-risk folks are plugged into early warning systems—whether they’re public or with a network set up by government agencies such as emergency management communication platforms—is critical.

And while we talk a lot about kits and supplies, the patients that I take care of in my own clinic can’t afford those things, but they all have cell phones and they all have social networks and families and friends and neighbors, and I think we need to take responsibility for each other in disasters. Look at what happened in Sandy. Look at how people fared when they were stranded in high rises and it tended to be spontaneous volunteers from the neighborhood or building superintendents who realized that there were high vulnerable people on the top floors of buildings. We need to come up with community plans to make sure that you check in on the highest risk folks in your community, that somebody checks in on you if you’re high risk. I think those are actions people need to think about when it comes to disaster preparedness.

NPH: What else is on your list of things to work on to help make those communities more resilient or prepare them better for disasters?

Chernak: We have had a major project in the last two to three years for the state health department in Pennsylvania focused on integrating community-based medical practices into disaster planning as a part of the state’s efforts to build community preparedness capability. A big part of what we’ve done—which actually reflects my own background both with respect to working at a local public health department for over 20 years, but also in a primary care setting—has been collaborating with the state of Pennsylvania’s American Academy of Pediatrics chapter to work with them to integrate community-based pediatricians into the work of disaster planning to enhance resources for kids in communities in disasters, and we’re continuing to do that work with the state health department. We’re helping to convene a statewide inter-agency working group around child health and disasters.

In this last year we extended that project to the rest of the universe of primary care clinicians—community health center clinicians, family medicine physicians and general practice internists—to try to build them into the work of disaster preparedness. We’ve developed toolkits for medical practices to ensure they have disaster plans. We also work with them to ensure that they know their important role in the lives of their patients, particularly patients with special health care needs such as chronic illness or reliance on assistive technologies, to help promote disaster planning. So much of planning around special needs populations has focused on enlisting the support of social service and human service agencies, but while they have tremendous resources and reach into communities, there are thousands of people with special health care needs, who have no relationship at all with a social or human service agency.

But my bet is that almost all of those folks have a primary care physician. There’s great work that we think the primary care medical community can do both to work with patients in disasters, as well as to prepare them for disasters and to maintain communications. Our toolkit includes not just an emergency management template plan, but also tools to allow patients to maintain communication with their doctor during disasters using voice messaging and websites and social media. It also includes really succinct checklists that doctors can use during an office visit o guide their patients with respect to disaster preparedness, particularly their high risk patients with special healthcare needs.

Tags: Disasters, Emergency Preparedness and Response, Faces of Public Health, Health disparities, Q&A