Examining Factors Associated with Emergency Preparedness Among People with Disabilities in China

Background and Purpose: Being prepared for emergencies has never been so critical in recent decades. Natural disasters have been more frequent and will continue to pose serious risks to public health and safety (Leaning & Guha-Sapir, 2013; Keim, 2008). People with disabilities (PWDs) have a higher risk of being adversely affected by disasters and are less prepared than people without disabilities (Smith & Notaro, 2009; Stough, 2015). However, little is known about the emergency preparedness of PWDs in developing countries, albeit these countries often suffer greater acute consequences from natural disasters than developed countries (Alcántara-Ayala, 2002; Strobl, 2012; Kurk, 2008). China is located in the most disaster-prone region globally (United Nations Population Fund, 2018). Despite the disaster-prone location, China's household preparedness is generally low due to negative attitudes to preparedness and a lack of motivation and knowledge (Chen et al., 2019). However, to the best of our knowledge, there are no empirical studies on emergency preparedness among PWDs in China, which has the largest population of PWDs (about 80.296 million) amongst all the countries and regions in the world (the Government of China, 2010). This paper explores how individual and environmental factors are associated with emergency preparedness among PWD in China.

Methods: We distributed an online cross-sectional survey on the level of emergency preparedness among PWDs in China. The study included 248 PWDs. We conducted a hierarchical logistic regression to examine which environmental-level factors are associated with emergency preparedness after controlling individual-level factors. Individual-level factors include demographic characteristics, disability and perceived health, self-efficacy in emergency preparedness. Environmental level factors include perceived accessibility of their city, whether the city is a first-tier city or not, and participation in online peer support disability groups

Results: Results show that when entering only individual-level factors, self-efficacy in evacuation (OR=5.62, 95% CI 2.51-12.58) and previous emergency experiences (OR=2.76, 95% CI 1.27-5.98) are significant factors associated with being prepared. After including the environmental-level factors, self-efficacy (OR=5.28, 95% CI 2.29-12.19) remains significant. PWDs who have a physical disability (OR=0.43, 95% CI 0.21-0.91), and those from Hubei province (OR=0.22, 95% CI 0.06-0.79) compared to respondents from the rest of China, are less likely to be prepared. Another protective factor other than self-efficacy is being part of an online disability peer-support group (OR=2.37, 95% CI 1-5.62).

Conclusions and Implications: Our findings on the significant association between environmental-level factors and emergency preparedness among PWDs in China affirm the importance of considering social-environmental influences on emergency preparedness. Looking at the social-environmental barriers helps shift the traditional medical view that deems disability is located in the individual rather than a disabling environment without accessible infrastructure and social support for inclusion. PWDs continue to be excluded from being actively involved in emergency planning. It is urgent for government, NGOs, and disability service providers to raise awareness of emergency plans and support preparedness through proactive outreach and public health interventions. Interventions should be designed with environmental and social factors in mind instead of solely relying on individual-level factors.