Abstract
Objectives:
Preparation for disasters at an individual level is one of the most fundamental and least expensive methods to prepare for disasters. We investigated predictors for individual-level natural disaster preparedness and trust in disaster assistance among adults aged ≥18 years in the United States.
Methods:
To examine individual-level preparedness for natural disasters in the United States, we conducted an online survey grounded in the theory of planned behavior from April 24 through June 3, 2024. We used logistic regression models to analyze relationships between individual-level preparedness outcomes and demographic and socioeconomic characteristics (P < .05 indicated significance).
Results:
A total of 2898 individuals completed the survey. Individual-level preparedness for natural disasters and trust in disaster assistance were significantly higher among respondents previously affected by a natural disaster, who were 233% and 134% more likely to have an evacuation plan and an emergency kit, respectively, than respondents with no disaster experience. Female respondents were 21% and 19% less likely to have an evacuation plan and an emergency kit, respectively, than male respondents, and unemployed respondents were 41% and 47% less likely to have an evacuation plan and an emergency kit, respectively, than employed respondents. Age, annual household income, and political affiliation were also significant predictors for selected aspects of individual-level preparedness. For example, respondents aged ≥65 years were 63% more likely to state confidence in knowing where to get disaster information than respondents aged 18 to 34 years.
Conclusions:
With a likelihood of more frequent and severe disasters in the future, public health officials should recognize differences among predictors of individual-level preparedness for disasters and develop strategies to address gaps in preparedness across demographic groups and subpopulations.
Keywords: natural disasters, disaster preparedness, trust, disaster response
The United States is one of the most disaster-prone countries in the world with regard to both natural disaster frequency and associated economic losses. 1 According to the National Centers for Environmental Information, 28 disaster events with overall damages that reached or exceeded $1 billion occurred in 2023; these events included extreme weather, floods, tropical cyclones, tornados, a winter storm, a wildfire, and a drought with heat wave and resulted in an estimated total of $92.9 billion in damages. 2 These types of events are projected to become more frequent and severe in the future as a result of climate change. 3
Previous research has documented numerous immediate health risks (drowning, trauma, hypothermia), intermediate health risks (cardiac disease complications, lack of clean water, wound infections), and long-term health risks (posttraumatic stress disorder, depression, adverse birth outcomes for women pregnant during events) of natural disasters.4-8 The health effects of a disaster can create chronic conditions or disabilities for those affected by disasters, and most fatalities and injuries caused by disasters are preventable with appropriate preparedness actions. 9 In addition, up to 50% of deaths during disasters could be prevented with proper first aid, demonstrating the importance of specific types of preparedness actions, such as having an appropriately stocked emergency kit and personal medications.10,11
Effectively mitigating the effects of natural disasters requires both institutional and individual preparedness efforts. 12 Although organizational and institutional preparedness efforts are vital to mitigating the effects of natural disasters, 13 efforts at the individual level are one of the most fundamental and least expensive methods to prepare for disasters. 14
The Healthy People 2030 framework has several objectives related to emergency preparedness, which include increasing the proportion of adults who know how to evacuate in case of a natural disaster and increasing the proportion of adults who have an emergency disaster plan. 15 However, initial data on measures to address these objectives are limited. Furthermore, much of the previous research on individual preparedness dates before 2020, and existing research has recognized a need for more nuanced efforts to understand how social determinants of health can affect emergency preparedness.16-18 In addition, the COVID-19 pandemic demonstrated the effects of political polarization on outbreak preparedness and response efforts.19,20 This observed politicization of a health emergency underlies the need to understand whether political affiliation also affects attitudes toward natural disaster preparedness and response.
Given the importance of updating our understanding of disaster preparedness and response, including the effect that political affiliation may have on these efforts, we investigated demographic and socioeconomic predictors for individual-level natural disaster preparedness and trust in disaster assistance among adults in the United States.
Methods
Survey Development
We developed a survey grounded in the theory of planned behavior to examine individual-level preparedness for natural disasters. 21 We designed primary questions to address the primary areas of the theory of planned behavior (ie, attitudes, subjective norms, and perceived behavior control) and designed additional questions to better understand risk perceptions and trust in disaster response among survey respondents. Our final survey contained 7 subsections related to demographic characteristics, perceived risk presented by natural disasters, attitudes toward preparedness, behavioral intentions during disaster response, subjective norms, perceived behavioral control, and trust in disaster response assistance among respondents. More specifically, we asked respondents whether they (1) had a personal or family evacuation plan in case of a natural disaster, (2) had an emergency kit in their home, (3) felt that they knew where to get emergency information in case of a natural disaster, (4) felt that they had the supplies they needed if they were to be affected by a natural disaster, (5) felt confident that they knew how to protect themselves during a natural disaster, and (6) felt that they could rely on their neighbors, their local government, the National Guard, or the federal government for assistance during or after a natural disaster. We included demographic questions on state of residence, sex, age, race and ethnicity, annual household income, level of education, employment status, and political affiliation. Three authors (C.C.B., M.R., K.N.) developed all survey and demographic questions in a collaborative manner.
For the purposes of this survey, we defined natural disasters as a naturally arising event that posed hazards to human health and safety, including but not limited to blizzards, floods, hurricanes, tornados, avalanches, earthquakes, and landslides. We defined “other” in race and ethnicity as people who identified as American Indian or Alaska Native, Native Hawaiian or Pacific Islander, or any other racial or ethnic group not listed in the survey. For employment status, we included full- or part-time employment, unemployed, retired, or other, which included full-time students and stay-at-home caregivers. We asked respondents to select their state of residence, which we later coded into regions using US Census Bureau definitions. 22
The Texas A&M University Institutional Review Board approved the study as exempt from review (no. STUDY2024-0265). Before completion of the online survey, we presented potential survey respondents with an informed consent page in which they could click an “I agree” or “I disagree” button. Potential respondents who clicked “I agree” provided their informed consent to participate in the study and could begin the survey questions. Potential respondents who clicked “I disagree” received an acknowledgment for their time, after which the survey ended.
Survey Distribution
We uploaded the survey to the Qualtrics XM platform and distributed the survey online by using the Lucid survey platform to recruit respondents. Lucid reaches millions of potential survey respondents by using an online marketplace that provides incentives to respondents and relies primarily on double opt-in panels but also uses multiple sourcing methods and recruitment techniques. Before we launched the survey, we worked with Lucid to ensure the feasibility of the study based on quotas, survey length, and the required number of respondents. Because of the reach of Lucid and the proven quality of the data provided, we determined that Lucid was an appropriate recruitment platform for our study. We conducted the survey from April 24 through June 3, 2024, and administered surveys in English and Spanish. We limited eligibility criteria to people (1) residing in the United States and (2) aged ≥18 years. We implemented quotas among respondents for age, sex, race and ethnicity, and US Census region to ensure a diverse study population.
Data Analysis
We conducted descriptive data analysis to characterize the study population and outcomes of interest. We used logistic regression models with robust SEs to analyze the relationship between the outcomes of interest and various predictor variables. We considered α = .05 to be significant for all data analyses (P < .05). We analyzed data in September 2024 by using Stata SE version 18 (StataCorp LLC).
Results
A total of 2898 individuals completed the survey. Respondents most often identified as female sex, were aged ≤34 years, were non-Hispanic White, had a high school diploma or less, were employed on a full- or part-time basis, reported an annual household income of <$25 000, resided in the South, and identified politically as Democrat (Table 1). Among the respondents, 1250 (41.8%) reported that they were previously affected by a disaster, 2673 (89.4%) reported believing preparedness for natural disasters to be important, 1659 (55.5%) reported having an evacuation plan, and 1786 (59.8%) reported having an emergency kit (Table 1). In addition, 2023 respondents (67.7%) reported confidence that they knew where to get emergency information in case of a natural disaster, 1703 (57.0%) reported confidence that they had the supplies they needed should they be affected by a natural disaster, and 1898 (63.5%) reported confidence that they knew how to protect themselves during a natural disaster (eTable 1 in the Supplement). Furthermore, 1799 (60.2%), 1930 (64.6%), 1907 (63.8%), and 1637 (54.8%) reported that they could rely on assistance provided by neighbors, local governments, the National Guard, and the federal government, respectively, during or after a natural disaster.
Table 1.
Demographic and socioeconomic characteristics of respondents to a survey about natural disaster preparedness, United States, April 24–June 3, 2024 a
| Variable | No. (%) |
|---|---|
| No. of survey respondents | 2989 |
| Sex | |
| Female | 1550 (51.9) |
| Male | 1439 (48.1) |
| Age, y | |
| 18-34 | 899 (30.1) |
| 35-44 | 523 (17.5) |
| 45-54 | 479 (16.0) |
| 55-64 | 496 (16.6) |
| ≥65 | 592 (19.8) |
| Race and ethnicity | |
| Hispanic or Latino | 550 (18.4) |
| Non-Hispanic Asian | 130 (4.4) |
| Non-Hispanic Black or African American | 377 (12.6) |
| Non-Hispanic White | 1794 (60.0) |
| Other b | 56 (1.9) |
| ≥2 Races or ethnicities | 82 (2.7) |
| Education | |
| ≤High school diploma | 1109 (37.1) |
| Some college | 739 (24.7) |
| Associate or bachelor’s degree | 879 (29.4) |
| Graduate degree | 262 (8.8) |
| Employment status | |
| Employed | 1549 (51.8) |
| Unemployed | 516 (17.3) |
| Retired | 694 (23.2) |
| Other c | 230 (7.7) |
| Annual household income, $ | |
| <25 000 | 923 (30.9) |
| 25 000-49 999 | 761 (25.5) |
| 50 000-74 999 | 539 (18.0) |
| 75 000-99 999 | 356 (11.9) |
| ≥100 000 | 410 (13.7) |
| US region d | |
| Northeast | 529 (17.7) |
| Midwest | 555 (18.6) |
| South | 1178 (39.4) |
| West | 727 (24.3) |
| Political identity | |
| Democrat | 1152 (38.5) |
| Republican | 938 (31.4) |
| Independent | 899 (30.1) |
| Experience with disasters | |
| Not previously affected | 1739 (58.2) |
| Previously affected | 1250 (41.8) |
| Believes preparedness to be important | |
| Yes | 2673 (89.4) |
| No | 52 (1.7) |
| Unsure | 264 (8.8) |
| Has a personal or family evacuation plan | |
| Yes | 1659 (55.5) |
| No | 1330 (44.5) |
| Has an emergency kit in home | |
| Yes | 1786 (59.8) |
| No | 1203 (40.3) |
Natural disasters were defined as naturally arising events that posed hazards to human health and safety, including but not limited to blizzards, floods, hurricanes, tornados, avalanches, earthquakes, and landslides.
Includes American Indian or Alaska Native, Native Hawaiian or Pacific Islander, or any other racial or ethnic group not listed in the survey.
Includes full-time students and stay-at-home caregivers.
US regions were determined from states indicated by respondents with US Census Bureau definitions. 22
Univariate logistic regression models suggested a significant relationship between various preparedness behaviors, preparedness perceptions, and trust in response assistance and sex, age, race and ethnicity, education level, employment status, annual household income, US region, political identity, and previous experience with natural disasters (eTables 2-4 in the Supplement). Multiple logistic regression models suggested that, as compared with their respective reference groups, women (vs men) and respondents who were unemployed (vs employed) had significantly lower odds of having an evacuation plan, whereas respondents residing in the Midwest, the South, and the West (vs the Northeast) and those with previous disaster experience (vs without previous disaster experience) had significantly higher odds of having an evacuation plan (Table 2). Multiple logistic regression models that investigated having an emergency kit suggested that women, respondents who were unemployed, and respondents who were full-time students or stay-at-home caregivers (ie, other employment status) had significantly lower odds (19%, 47%, and 31%, respectively) than men and employed respondents, respectively, whereas non-Hispanic Black respondents, those with an annual household income of $75 000 to $99 999, those with an annual household income of ≥$100 000, and those with previous disaster experience had significantly higher odds (35%, 73%, 63%, and 134%, respectively) than non-Hispanic White respondents, respondents with an annual household income of <$25 000, and respondents who have not previously experienced a disaster, respectively.
Table 2.
Association between characteristics of survey respondents (N = 2989) and having a personal or family evacuation plan or an emergency kit in case of a natural disaster, in a survey of natural diasaster preparedness, United States, April 24–June 3, 2024 a
| Characteristic | AOR (95% CI) | |
|---|---|---|
| Have an evacuation plan | Have an emergency kit | |
| Sex | ||
| Female | 0.79 b (0.66-0.93) | 0.81 b (0.69-0.96) |
| Male | 1 [Reference] | 1 [Reference] |
| Age, y | ||
| 18-34 | 1 [Reference] | 1 [Reference] |
| 35-44 | 0.98 (0.77-1.24) | 1.10 (0.87-1.38) |
| 45-54 | 0.83 (0.65-1.06) | 1.01 (0.79-1.29) |
| 55-64 | 0.81 (0.63-1.06) | 1.04 (0.80-1.35) |
| ≥65 | 0.78 (0.57-1.07) | 0.89 (0.65-1.22) |
| Race and ethnicity | ||
| Hispanic or Latino | 1.12 (0.90-1.40) | 1.07 (0.85-1.33) |
| Non-Hispanic Asian | 0.70 (0.47-1.04) | 1.27 (0.83-1.94) |
| Non-Hispanic Black or African American | 0.87 (0.68-1.11) | 1.35 b (1.04-1.73) |
| Non-Hispanic White | 1 [Reference] | 1 [Reference] |
| Other c | 1.46 (0.78-2.73) | 1.35 (0.75-2.44) |
| ≥2 Races or ethnicities | 1.01 (0.63-1.62) | 1.04 (0.66-1.64) |
| Education | ||
| ≤High school diploma | 1 [Reference] | 1 [Reference] |
| Some college | 1.10 (0.89-1.35) | 0.98 (0.80-1.20) |
| Associate or bachelor’s degree | 0.96 (0.78-1.18) | 1.00 (0.82-1.23) |
| Graduate degree | 1.12 (0.80-1.56) | 1.17 (0.83-1.65) |
| Employment status | ||
| Employed | 1 [Reference] | 1 [Reference] |
| Unemployed | 0.59 b (0.47-0.74) | 0.53 b (0.42-0.66) |
| Retired | 0.89 (0.67-1.17) | 0.83 (0.63-1.10) |
| Other d | 0.82 (0.61-1.12) | 0.69 b (0.51-0.93) |
| Annual household income, $ | ||
| <25 000 | 1 [Reference] | 1 [Reference] |
| 25 000-49 999 | 0.94 (0.76-1.16) | 0.93 (0.75-1.14) |
| 50 000-74 999 | 1.15 (0.90-1.48) | 1.25 (0.98-1.60) |
| 75 000-99 999 | 1.25 (0.94-1.66) | 1.73 b (1.28-2.32) |
| ≥100 000 | 1.13 (0.84-1.51) | 1.63 b (1.21-2.20) |
| US region e | ||
| Northeast | 1 [Reference] | 1 [Reference] |
| Midwest | 1.67 b (1.29-2.17) | 1.02 (0.80-1.31) |
| South | 2.08 b (1.67-2.59) | 1.24 (0.99-1.54) |
| West | 1.36 b (1.07-1.73) | 1.20 (0.94-1.53) |
| Political identity | ||
| Democrat | 1 [Reference] | 1 [Reference] |
| Republican | 0.89 (0.73-1.07) | 0.89 (0.74-1.08) |
| Independent | 1.06 (0.87-1.29) | 1.14 (0.93-1.39) |
| Experience with disasters | ||
| Not previously affected | 1 [Reference] | 1 [Reference] |
| Previously affected | 3.33 b (2.84-3.90) | 2.34 b (2.00-2.74) |
Abbreviation: AOR, adjusted odds ratio.
Natural disasters were defined as naturally arising events that posed hazards to human health and safety, including but not limited to blizzards, floods, hurricanes, tornados, avalanches, earthquakes, and landslides.
Significant at P < .05, in logistic regression models.
Includes American Indian or Alaska Native, Native Hawaiian or Pacific Islander, or any other racial or ethnic group not listed in the survey.
Includes full-time students and stay-at-home caregivers.
US regions were determined from states indicated by respondents with US Census Bureau definitions. 22
Multiple logistic regression models that investigated preparedness perceptions suggested that women, respondents who were unemployed, and Republican respondents had significantly lower odds of knowing where to get emergency information than men, employed respondents, and Democrats, respectively. In contrast, the odds of feeling confident in knowledge of where to get emergency information were significantly higher among respondents aged ≥45 years, those with a graduate degree, and those with previous disaster experience than among respondents aged ≤34 years, those with a high school diploma or less, and those without previous disaster experience, respectively (Table 3). The regression model that investigated having emergency supplies suggested that women and people who were unemployed had significantly lower odds of having necessary supplies than men and respondents who were employed, whereas non-Hispanic Black respondents and those with previous disaster experience had significantly higher odds than non-Hispanic White respondents and respondents without previous disaster experience. The regression model investigating protection knowledge suggested that women, respondents who were unemployed, and those with an annual household income of $25 000 to $49 999 had significantly lower odds of reporting confidence about how to protect themselves during a natural disaster than men, respondents who were employed, and those with an annual household income <$25 000, respectively, whereas those aged 55 to 64 years and those with previous disaster experience had significantly higher odds than those aged ≤34 years and those without previous disaster experience, respectively.
Table 3.
Association between characteristics of survey respondents (N = 2989) and confidence in various individual preparedness aspects, in a survey of natural disaster preparedness, United States, April 24–June 3, 2024 a
| Characteristic | AOR (95% CI) | ||
|---|---|---|---|
| Knew how to access information | Had necessary supplies | Had knowledge to protect during a natural disaster | |
| Sex | |||
| Female | 0.74 b (0.63-0.89) | 0.75 b (0.63-0.88) | 0.67 b (0.57-0.79) |
| Male | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Age, y | |||
| 18-34 | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 35-44 | 1.11 (0.88-1.41) | 0.98 (0.78-1.23) | 1.12 (0.89-1.42) |
| 45-54 | 1.32 b (1.03-1.69) | 1.07 (0.85-1.36) | 1.17 (0.92-1.50) |
| 55-64 | 1.66 b (1.27-2.16) | 1.24 (0.96-1.59) | 1.35 b (1.04-1.75) |
| ≥65 | 1.63 b (1.19-2.25) | 1.27 (0.94-1.71) | 1.16 (0.86-1.58) |
| Race and ethnicity | |||
| Hispanic or Latino | 0.98 (0.78-1.24) | 1.14 (0.92-1.41) | 1.02 (0.82-1.28) |
| Non-Hispanic Asian | 0.84 (0.57-1.26) | 0.86 (0.59-1.27) | 0.85 (0.57-1.27) |
| Non-Hispanic Black or African American | 0.99 (0.77-1.28) | 1.29 b (1.01-1.64) | 1.01 (0.79-1.29) |
| Non-Hispanic White | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Other c | 0.87 (0.49-1.54) | 1.08 (0.60-1.94) | 1.31 (0.73-2.37) |
| ≥2 Races or ethnicities | 1.22 (0.74-2.02) | 1.11 (0.71-1.73) | 1.24 (0.77-1.98) |
| Education | |||
| ≤High school diploma | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Some college | 1.02 (0.83-1.26) | 0.97 (0.80-1.18) | 1.05 (0.85-1.29) |
| Associate or bachelor’s degree | 1.16 (0.94-1.43) | 0.93 (0.76-1.13) | 0.97 (0.79-1.19) |
| Graduate degree | 1.55 b (1.07-2.24) | 1.31 (0.94-1.82) | 1.37 (0.97-1.94) |
| Employment status | |||
| Employed | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Unemployed | 0.75 b (0.60-0.95) | 0.65 b (0.52-0.81) | 0.61 b (0.49-0.76) |
| Retired | 1.18 (0.89-1.56) | 1.02 (0.78-1.32) | 1.10 (0.84-1.43) |
| Other d | 1.00 (0.74-1.35) | 0.92 (0.69-1.23) | 0.88 (0.66-1.19) |
| Annual household income, $ | |||
| <25 000 | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 25 000-49 999 | 0.81 (0.65-1.01) | 0.87 (0.71-1.07) | 0.81 (0.65-1.00) |
| 50 000-74 999 | 0.79 (0.62-1.01) | 1.11 (0.88-1.41) | 0.86 (0.67-1.09) |
| 75 000-99 999 | 0.94 (0.70-1.27) | 1.27 (0.96-1.68) | 0.98 (0.73-1.30) |
| ≥100 000 | 0.99 (0.72-1.35) | 1.36 (1.02-1.81) | 0.99 (0.73-1.33) |
| US region e | |||
| Northeast | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Midwest | 1.17 (0.90-1.53) | 1.07 (0.84-1.37) | 1.26 (0.98-1.63) |
| South | 1.18 (0.94-1.48) | 1.03 (0.83-1.28) | 1.19 (0.96-1.48) |
| West | 1.05 (0.82-1.35) | 0.90 (0.71-1.14) | 0.98 (0.77-1.24) |
| Political identity | |||
| Democrat | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Republican | 0.68 b (0.56-0.83) | 0.90 (0.75-1.09) | 0.92 (0.76-1.11) |
| Independent | 0.91 (0.74-1.11) | 1.11 (0.92-1.35) | 1.17 (0.95-1.42) |
| Experience with disasters | |||
| Not previously affected | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Previously affected | 1.77 b (1.51-2.08) | 1.74 b (1.49-2.03) | 1.93 b (1.65-2.26) |
Abbreviation: AOR, adjusted odds ratio.
Natural disasters were defined as naturally arising events that posed hazards to human health and safety, including but not limited to blizzards, floods, hurricanes, tornados, avalanches, earthquakes, and landslides.
Significant at P < .05, in logistic regression models.
Includes American Indian or Alaska Native, Native Hawaiian or Pacific Islander, or any other racial or ethnic group not listed in the survey.
Includes full-time students and stay-at-home caregivers.
US regions were determined from states indicated by respondents with US Census Bureau definitions. 22
Multiple logistic regression models investigating assistance offered during or after natural disasters suggested that the odds of trusting assistance offered by neighbors was significantly lower among women, those with an associate or bachelor’s degree, respondents who were unemployed, and Republican respondents (vs men, respondents with a high school diploma or less, respondents who were employed, and Democrats, respectively), whereas trust was significantly higher among respondents with an annual household income ≥$100 000 (vs <$25 000) and respondents with previous disaster experience (vs without previous disaster experience) (Table 4). Respondents who identified as other with regard to race and ethnicity (vs non-Hispanic White), were unemployed (vs employed), and identified as Republican (vs Democrat) had significantly lower odds of trusting assistance offered by local governments, whereas respondents aged ≥55 years (vs <34 y) and those with previous disaster experience (vs without previous disaster experience) had significantly higher odds of trusting assistance offered by local governments. Women, respondents who were unemployed, and Republican respondents (vs men, respondents who were employed, and Democrats, respectively) had significantly lower odds of trusting assistance offered by the National Guard, whereas respondents aged ≥55 years (vs <34 y) and those with previous disaster experience (vs without previous disaster experience) had significantly higher odds of trusting assistance offered by the National Guard. The odds of trusting assistance offered by the federal government were significantly lower among women, respondents who were unemployed, and Republican or independent respondents (vs men, respondents who were employed, and Democratic respondents, respectively), whereas the odds were significantly higher among those with a graduate degree (vs ≤high school diploma) and those with previous disaster experience (vs those without previous disaster experience).
Table 4.
Association between characteristics of survey respondents (N = 2989) and trusting assistance offered by various groups during responses to natural disasters, in a survey of natural disaster preparedness, United States, April 24–June 3, 2024 a
| Characteristic | AOR (95% CI) | |||
|---|---|---|---|---|
| Neighbor | Local government | National Guard | Federal government | |
| Sex | ||||
| Female | 0.80 b (0.68-0.94) | 0.90 (0.76-1.07) | 0.83 b (0.70-0.98) | 0.81 b (0.69-0.95) |
| Male | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Age, y | ||||
| 18-34 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 35-44 | 0.96 (0.76-1.20) | 1.02 (0.82-1.28) | 1.21 (0.96-1.52) | 0.95 (0.76-1.19) |
| 45-54 | 0.90 (0.71-1.14) | 1.01 (0.80-1.28) | 1.13 (0.89-1.44) | 0.99 (0.79-1.25) |
| 55-64 | 0.86 (0.67-1.10) | 1.36 b (1.06-1.76) | 1.80 b (1.39-2.33) | 1.06 (0.83-1.35) |
| ≥65 | 0.96 (0.71-1.31) | 1.80 b (1.31-2.47) | 1.47 b (1.07-2.03) | 1.12 (0.83-1.51) |
| Race and ethnicity | ||||
| Hispanic or Latino | 0.95 (0.76-1.18) | 0.94 (0.76-1.18) | 1.07 (0.85-1.33) | 1.14 (0.92-1.41) |
| Non-Hispanic Asian | 0.93 (0.64-1.36) | 0.83 (0.57-1.21) | 0.79 (0.54-1.15) | 1.30 (0.89-1.91) |
| Non-Hispanic Black or African American | 1.09 (0.85-1.39) | 1.01 (0.79-1.30) | 1.02 (0.80-1.31) | 1.18 (0.92-1.50) |
| Non-Hispanic White | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Other c | 0.63 (0.37-1.09) | 0.52 b (0.30-0.90) | 0.87 (0.50-1.52) | 0.64 (0.37-1.11) |
| ≥2 Races or ethnicities | 0.88 (0.55-1.42) | 0.86 (0.54-1.37) | 0.99 (0.62-1.57) | 0.83 (0.52-1.31) |
| Education | ||||
| ≤High school diploma | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Some college | 0.87 (0.71-1.06) | 0.92 (0.75-1.13) | 0.99 (0.81-1.21) | 0.86 (0.71-1.04) |
| Associate or bachelor’s degree | 0.76 b (0.62-0.93) | 0.85 (0.69-1.04) | 0.85 (0.70-1.04) | 0.99 (0.81-1.20) |
| Graduate degree | 0.93 (0.67-1.29) | 0.92 (0.66-1.29) | 1.37 (0.98-1.96) | 1.48 b (1.07-2.05) |
| Employment status | ||||
| Employed | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Unemployed | 0.62 b (0.50-0.78) | 0.68 b (0.54-0.85) | 0.69 b (0.56-0.87) | 0.77 b (0.62-0.96) |
| Retired | 1.06 (0.81-1.38) | 0.96 (0.72-1.27) | 0.86 (0.65-1.14) | 0.84 (0.65-1.10) |
| Other d | 0.85 (0.63-1.15) | 0.85 (0.63-1.15) | 0.93 (0.69-1.24) | 0.84 (0.63-1.12) |
| Annual household income, $ | ||||
| <25 000 | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| 25 000-49 999 | 0.87 (0.71-1.07) | 0.83 (0.67-1.02) | 0.91 (0.74-1.12) | 0.85 (0.70-1.04) |
| 50 000-74 999 | 1.05 (0.83-1.33) | 0.80 (0.63-1.01) | 0.83 (0.65-1.06) | 0.92 (0.73-1.17) |
| 75 000-99 999 | 1.23 (0.93-1.63) | 1.22 (0.91-1.63) | 1.30 (0.97-1.74) | 1.01 (0.77-1.33) |
| ≥100 000 | 1.54 b (1.15-2.06) | 1.09 (0.81-1.47) | 1.06 (0.79-1.42) | 0.80 (0.61-1.06) |
| US region e | ||||
| Northeast | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Midwest | 1.03 (0.80-1.32) | 1.09 (0.85-1.41) | 1.15 (0.90-1.49) | 1.05 (0.82-1.35) |
| South | 1.11 (0.89-1.38) | 0.99 (0.79-1.24) | 1.18 (0.95-1.47) | 0.99 (0.80-1.23) |
| West | 0.79 (0.62-1.01) | 0.91 (0.71-1.16) | 0.89 (0.70-1.14) | 0.86 (0.68-1.09) |
| Political identity | ||||
| Democrat | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Republican | 0.67 b (0.56-0.80) | 0.65 b (0.54-0.78) | 0.70 b (0.58-0.84) | 0.53 b (0.44-0.63) |
| Independent | 1.04 (0.85-1.26) | 0.85 (0.69-1.03) | 0.93 (0.76-1.13) | 0.71 b (0.59-0.86) |
| Experience with disasters | ||||
| Not previously affected | 1 [Reference] | 1 [Reference] | 1 [Reference] | 1 [Reference] |
| Previously affected | 1.22 b (1.05-1.43) | 1.31 b (1.12-1.54) | 1.29 b (1.10-1.51) | 1.22 b (1.05-1.42) |
Abbreviation: AOR, adjusted odds ratio.
Natural disasters were defined as naturally arising events that posed hazards to human health and safety, including but not limited to blizzards, floods, hurricanes, tornados, avalanches, earthquakes, and landslides.
Significant at P < .05, in logistic regression models.
Includes American Indian or Alaska Native, Native Hawaiian or Pacific Islander, or any other racial or ethnic group not listed in the survey.
Includes full-time students and stay-at-home caregivers.
US regions were determined from states indicated by respondents with US Census Bureau definitions. 22
Discussion
Our findings suggest that being previously affected by a natural disaster predicts individual-level preparedness. Among survey respondents who had been affected by a disaster (vs survey respondents who had not been affected by a disaster), the odds of having an evacuation plan were more than 3 times greater; the odds of having an emergency kit were more than 2 times greater; the odds of knowing where to get emergency information, having required supplies, and feeling confident about knowing how to protect oneself were more than 1.5 times greater; and trust in assistance offered by neighbors, the local government, the National Guard, and the federal government were all 1.2 times greater. These results align with findings from research in which people with previous disaster experience (vs those without previous disaster experience) were more likely to prepare for future disasters.23,24 Our findings on relationships between previous disaster experience and trust in government align with results that suggested that people who experienced a disaster believed that the government would provide them with assistance in the aftermath of future disasters. 25
Our findings also suggest that, compared with male survey respondents, female survey respondents had lower odds of having an evacuation plan or an emergency kit, feeling confident in their knowledge about where to access information, having the necessary supplies, knowing how to protect themselves, and trusting assistance offered by neighbors, the National Guard, and the federal government during response efforts. Our results align with research that reported that women were less likely than men to be prepared for disasters. 26 These results underscore a need for emergency managers and policy makers to be aware of differences in disaster preparedness between men and women.
We found that employment status was also associated with disaster preparedness. Survey respondents who were not employed (vs employed full- or part-time) had significantly lower odds of having an evacuation plan, having an emergency kit, reporting confidence in knowledge about where to access information, having necessary supplies, knowing how to protect oneself during a natural disaster, and trusting assistance offered by neighbors, the local government, the National Guard, or the federal government. These results were independent of annual household income, suggesting that employment status was particularly relevant for preparedness. However, respondents who reported being unemployed may have also had a disability, because individuals with disabilities are more likely to be unemployed than individuals without a disability. 27 Our study did not ask about disability status, and additional research is needed to examine the role that disability status may play in individual-level preparedness, especially when considering that people with disabilities are more vulnerable to disasters than people without disabilities because of a reduced ability to evacuate as a result of functional limitations, a lack of evacuation support, and poor accessibility to emergency shelter facilities. 28
Although we found that annual household income predicted having a home emergency kit, annual household income did not influence the likelihood of having a personal or family evacuation plan. This finding could be the result of the cost of assembling an emergency kit, which may be an obstacle for people with a low annual household income. Local emergency managers or disaster response organizations may consider offering events or providing supplies to help residents with low annual household income create home emergency kits to better prepare for natural disasters.
Age also predicted individual-level preparedness. Our results suggest that older age (aged ≥55 y) was a significant predictor for confidence in knowing where to access emergency information, knowing how to protect oneself during a natural disaster, and trusting the assistance offered by local governments and the National Guard. These results are notable given previous findings showing that most adults aged ≥50 years in the United States did not have an emergency plan, had not participated in educational programs on disaster preparedness, and were not aware of relevant resources. 29 However, our results do align with a previous study on age and trust in government-issued evacuation orders, which showed that adults aged ≥55 years generally expressed greater levels of trust in government-issued evacuation orders than adults who were aged ≤54 years. 30
Previous research has also discussed how structural racism has complicated emergency preparedness and response efforts as a result of factors such as language barriers, community isolation, and cultural insensitivities.31,32 In general, we found no meaningful relationships between race and disaster preparedness. However, we did find that non-Hispanic Black survey respondents had significantly higher odds of having an emergency preparedness kit and significantly higher confidence in having necessary supplies needed in case of a disaster than non-Hispanic White respondents and that survey respondents who were classified as other race and ethnicity had significantly lower confidence in assistance offered by local governments than non-Hispanic White respondents. Additional research is needed to examine how race and ethnicity affect preparedness and the response experiences and mechanisms among racial and ethnic minority groups. 33
Political polarization has become an increasingly important public health consideration in the aftermath of the COVID-19 pandemic response. 34 Our study included self-reported political party affiliation as a measure to investigate whether this politicization extended to preparedness for natural disasters. Notably, political party affiliation was not significantly associated with the odds of having an evacuation plan or having an emergency kit, suggesting that these aspects of preparedness have not decayed as a result of partisan valuation processes. Still, our findings do show that the odds of reporting feeling confident about how to access emergency information were lower among survey respondents who identified as Republican than among survey respondents who identified as Democrat. These results raise questions about whether this finding is truly related to a lack of knowledge or a lack of trust in information sources. We suggest that future studies examine the nuances of this result, because this result has implications for both disaster preparedness and response messaging. In addition, compared with Democrat survey respondents, Republican survey respondents expressed lower levels of trust in assistance from all groups (neighbor, local government, National Guard, and federal government) but had low levels of trust in assistance from the federal government. Our findings may support previous research that showed that Republican residents in the US South Atlantic and Gulf Coast generally viewed disaster preparedness as a personal responsibility rather than a responsibility of the federal government. 35
Limitations
Our study had several limitations. First, because of the cross-sectional study design, our results were prone to biases and confounding. We attempted to address these concerns methodologically by implementing response quotas, but residual biases that we did not account for may have remained. Relatedly, extrapolation of our results temporally was not appropriate, although future research may wish to investigate individual-level preparedness across longer periods.
Second, although eligibility criteria only included being a US resident and being aged ≥18 years, we distributed the survey via an online tool in either English or Spanish. Consequently, implicit criteria included written language fluency, internet access, and an internet-enabled device. Although these technologies are increasingly ubiquitous across most sociodemographic groups in the United States, our results should not be generalized to other countries, children, or populations.
Third, at the time this study was conducted, the president was a member of the Democratic party and the Democratic party controlled the US Senate, which may have affected the trust outcomes in our survey.
Conclusions
Previous experiences with natural disasters, male/female sex, employment status, annual household income level, age, race and ethnicity, and political affiliation played significant roles in various aspects of individual-level preparedness. In the face of more frequent and severe natural disasters, emergency managers, public health practitioners, and policy makers should note these differences and devise practical strategies to close gaps in disaster preparedness. For example, with women and people who were unemployed showing low levels of individual-level preparedness, opportunities that integrate aspects of disaster preparedness with routine women’s health services or social unemployment services could yield meaningful improvements for individual-level preparedness for natural disasters.
Supplemental Material
Supplemental material, sj-docx-1-phr-10.1177_00333549251341236 for Predictors of Individual-Level Preparedness for Natural Disasters and Trust in Disaster Assistance in the United States, 2024 by Christine Crudo Blackburn, Matthew R. Boyce, Mayra Rico, Kirk Niekamp, Jason Moats, Tiffany Radcliff and Elizabeth Thomas in Public Health Reports
Footnotes
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Texas A&M Health Science Center Seedling Grant Program.
ORCID iD: Christine Crudo Blackburn, PhD 
https://orcid.org/0000-0001-9893-6058
Supplemental Material: Supplemental material for this article is available online. The authors have provided these supplemental materials to give readers additional information about their work. These materials have not been edited or formatted by Public Health Reports’s scientific editors and, thus, may not conform to the guidelines of the AMA Manual of Style, 11th Edition.
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Supplementary Materials
Supplemental material, sj-docx-1-phr-10.1177_00333549251341236 for Predictors of Individual-Level Preparedness for Natural Disasters and Trust in Disaster Assistance in the United States, 2024 by Christine Crudo Blackburn, Matthew R. Boyce, Mayra Rico, Kirk Niekamp, Jason Moats, Tiffany Radcliff and Elizabeth Thomas in Public Health Reports