IT'S NOT ABOUT THE KIT

The most common approach to emergency preparedness (EP) is mass messaging from government agencies and other organizations, built around acquisition as an early step if not an ultimate objective (e.g., “buy a kit, make a plan, get informed”). This has formed the basis of public EP campaigns for decades, despite little evidence that the objectives, content, or delivery are effective in creating a more “prepared” population. Public EP campaigns commonly combine informing (i.e., hazard communication), changing personal beliefs (i.e., existence or relevance of hazards or their effects or ability to affect outcomes), and changing behavior (e.g., hazard mitigation, emergency supplies) and use the same approach for those distinct objectives. Most PE campaigns compete with entrenched obstacles, including risk perception, unrealistic expectations on the part of the public, cognitive bias, preference for a single action rather than an ongoing series of actions, focus on immediate rather than potential concerns, and economic limitations.

Despite the wide range of hazards, most disasters and lesser emergencies have common effects that generate most death and injury: loss of electrical power and shelter, transportation and communication disruption, loss of healthcare access, and other disruption of daily routine. Most PE campaigns address immediate pre- and post-impact rather than long-term recovery, so guidance should focus on what is most likely to reduce death and injury. By definition, standardized prefabricated kits for purchase can’t address user-specific needs but may create a false sense of security. Post-disaster exacerbation of pre-existing medical conditions generates far more death and disability than lack of canned or freeze-dried food; people with dependent children, elders, and/or pets, with personal medical needs (e.g., prescription medications, home O₂ use), and/or on specialty diets, require more than prefab kits.

Prevention and mitigation are far more likely to reduce disaster effects than EP campaigns, but they can be made (more) useful by incorporating risk perception, behavioral principles, and economic reality, focusing on what actually kills and disables people after disasters, tailoring them to multiple audiences, and putting more resources into meaningful evaluation.