Communication inequalities during public health disasters: Katrina's wake

SYNOPSIS
Objectives
Students of communication have recently argued that vulnerability stemming from low socioeconomic position (SEP) manifests in the form of inequitable access and exposure to effective information, which may influence health-related outcomes, including risk perceptions.  We explore the effects of communication inequalities on African American Hurricane Katrina victims’ abilities to evacuate, after controlling for socio-economic –demographic profiles. 

 Specifically, we evaluate whether socio-economic position and social networks affected access to and processing of evacuation orders. We further explore whether SEP, mediating/moderating conditions, and communication access and processing outcomes affected risk perceptions of the storm’s severity and compliance with evacuation orders. 

 Methods
Guided by the Structural Influence Model of health communication, we conducted stepwise logistic regression analyses using survey data collected in September 2005, among respondents in shelters throughout Houston, Texas area. The survey instrument was jointly designed by the Washington Post, the Kaiser Family Foundation, and the Harvard School of Public Health. We analyzed a sample of 621 Black American respondents.

 Results
Having few social networks, being unemployed, and being of younger age were significantly associated with information access and processing barriers.  Moreover, communication access and processing barriers were the most significant predictor of not having left before the storm hit, after controlling for other factors.  Finally, older people and homeowners were more likely than others to underestimate the storm’s severity. 

 Conclusion
The results of this study have implications for: a) targeted public health emergency preparedness campaigns and b) future research considerations to understand the effects of structural influences on communication inequalities and public health preparedness.