title: Confidence in the fairness of local public health systems’ response to disasters: the US Veterans’ perspective.
abstract: OBJECTIVE
  The effectiveness of local public health systems in emergency management depends on trust from the entire community. However, the failure of some government agencies to respond effectively to several major disasters has had a disproportionate impact on certain groups-racial/ethnic minorities, in particular-that are well-represented in the veteran population. Many veterans belong to multiple vulnerable populations at greater risk of harm during disasters. This study examines confidence that local public health systems will respond fairly to disasters in a diverse sample of US veterans.
  
  
  METHODS
  This study is an analysis of cross-sectional data on 5955 veterans in the 2009 California Health Interview Survey. Respondents were asked about their confidence that public health systems would respond fairly to their needs in the event of a disaster, regardless of their race/ethnicity or other personal characteristics. Multivariable regression analysis was used to identify variables on respondent characteristics that were independently associated with confidence. The hypothesis was that there would be less confidence in county public health systems among respondents who were racial/ethnic minorities, had less than a college degree, and were of low-income backgrounds.
  
  
  RESULTS
  Approximately 79% of veterans were confident that public health systems would respond fairly. The hypothesis was unsupported, with no differences in confidence by race/ethnicity, education, or income. Also, no differences were noted between men and women or between veterans with and without disabilities. However, confidence was associated with continent of birth, age, homeownership, and marital status.
  
  
  CONCLUSIONS
  If confidence affects veterans’ willingness to accept disaster preparedness communications or to give proper consideration to recommended emergency countermeasures, then local health departments that issue such information to veterans are not likely to encounter barriers by race/ethnicity, income, education, disability status, or gender.
authors.forename: Kevin C
authors.initials: KC
authors.lastname: Heslin
authors.forename: Deborah
authors.initials: D
authors.lastname: Riopelle
authors.forename: June L
authors.initials: JL
authors.lastname: Gin
authors.forename: John
authors.initials: J
authors.lastname: Ordunez
authors.forename: Diana E
authors.initials: DE
authors.lastname: Naranjo
authors.forename: Aram
authors.initials: A
authors.lastname: Dobalian
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California; D003142:Communication; D003430:Cross-Sectional Studies; D004189:Disaster Planning; D004190:Disasters; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D015980:Public Health Practice / Q000592:standards*; D011639:Public Opinion; D044469:Racial Groups / Q000706:statistics & numerical data; D014481:United States; D014728:Veterans / Q000523:psychology*; D035862:Vulnerable Populations