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Language Barrier in Disaster Planning—theBellevue Hospital Center ExperienceKa Ming Ngai, MD, MPH1,2Matthew McCarty2, Sila...
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Ngai Language Barrier in Disaster Planning


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Language barrier in disaster planning, the Bellevue Hospital experience after Hurricane Irene

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  1. 1. Language Barrier in Disaster Planning—theBellevue Hospital Center ExperienceKa Ming Ngai, MD, MPH1,2Matthew McCarty2, Silas Smith, MD2Sch1The Icahn School of Medicine at MOUNT SINAI, New York City, USA2Bellevue Hospital/NYU Langone Medical Center, New York City, USAThis work was partially supported by the National Heart Lung and Blood Institute,Mount Sinai Emergency Medicine Research Career Development Program5K12HL109005-02Previous studies ofdisaster responsessuggest that vulnerablepopulations (such aslimited English proficiency(LEP) patients) sufferdisproportionally. Effectivedisaster plans mustaccount for socio-economic and languagebarriers. In addition, little isknown regarding thecharacteristics of patientsvisiting urban tertiary careemergency departments,which provide a uniquesafety net for populationsmore severely affected inthe aftermath ofcatastrophes.Identify the uniquechallenges and needs ofthe LEP population forfuture hurricane relatedand natural disasterplanning.A prospective surveycontaining 38 questionsincluding demographic,vulnerability, and personaldisaster preparedness wasadministered to aconvenience sample of1,000 patients presenting tothe New York UniversityLangone Medical Center(NYULMC) or BellevueHospital Center (BHC)Emergency Department inNew York City, New York,between February andOctober 2012. The studywas terminated prior tocompletion due to themandatory evacuation andclosure of the two hospitalsupon Hurricane Sandy’slandfall on October 29,2012.248 surveys were completed at NYULMC and 511were completed at BHC. Of the 759 completedsurveys, 494 (65.1%) subjects knew their SLOSH(Sea, Lake, and Overland Surges from Hurricanes)Zone. 553 (72.9%) subjects were in NYC duringHurricane Irene. 55 (10%) of the 553 subjects whoremained in NYC received mandatory evacuationorders, only 28 (50.9%) of them evacuated (chi-square=28.32, p<0.001).The five most common non-English languages amongBHC patients are Spanish (57%), Mandarin Chinese(17%), Cantonese Chinese (5.7%), Bengali (4.3%),and Polish (4.1%). Of the 511 surveys conducted atBHC, 41 (8.0%) LEP patients comprised a smallerproportion of respondents than the expected 28.6%,based on historic demographic data (chi-squaregoodness of fit test with one degree of freedom =105.95, p<0.001).The challenges of investigating, understanding andsubsequently providing care for the LEP populationis highlighted in the non-representative proportion ofLEP patients in the survey respondents. This isdespite the survey being conducted in anenvironment where LEP patients comprise asignificant proportion of the population sample andwhere previous studies suggest that LEP patientsare most likely to seek care. Understanding theunique characteristics of this vulnerable populationwould provide policy makers the opportunity to moreeffectively plan and respond during a disaster toensure continuity of healthcare to thesecommunities. However, as this study demonstrates,significant challenges remain in elucidating the truehealthcare needs of LEP populations.BackgroundObjectiveMethodResultsAcknowledgementsConclusions