What to know
The "Prepare" objective focuses on planning public health activities to account for the unique aspects of chronic environmental contamination (CEC).
Overview
Prepare's primary objective: Understand the unique ways in which CEC has impacted and continues to impact this particular community.
Compared to a natural disaster, CEC typically follows a unique time course and sequence of events.
One-time natural disasters tend to follow a fairly predictable sequence. There is often some warning of a threat prior to the disaster itself and its impact. Following the impact, there is a period of recovery and rehabilitation. Natural disasters can cause chronic stress reactions, especially when they happen in succession.
In contrast, a CEC experience can last decades. Community members can feel caught in a loop of repeated warning, threat, and impact cycles. This can occur as people learn about local contamination, new contaminants of concern emerge, or possible long-term health effects become evident. As a result, some community members may experience chronic stress.
Understand CEC in a community
CEC is unique in relation to other disaster events. Additionally, every contamination event will be unique, in part because each community is different.
- Plan for the unique time course of CEC.
- Gather information about and assess community resources.
- Learn about the nature of CEC-related stress and how to intervene in this context.
Example: Many materials designed to help strengthen community resilience were originally designed for after natural disasters and other acutely traumatic events. Thus, they may need to be modified for use in the context of CEC.
Similarly, the public health response should incorporate health equity objectives, particularly when the community has previously documented health disparities.
Secondary objectives
The "Prepare" objective has three secondary objectives:
- Learn about the community and its needs before addressing stress.
- Build lasting relationships and interventions.
- Be aware of chronic stress, conflict, and retraumatization.
Learn about the community and its needs before addressing stress
Engage with community members to assess their needs and assets. Determine whether they want assistance with psychosocial issues as part of this process. Learn how community members receive health information and about important centers of cohesion or support. Communities vary in terms of which sources of information they trust. Cultural differences often influence who is seen as primarily responsible for the physical and mental health of the community.
Build lasting relationships and interventions
Cultivate and maintain relationships with community leaders and local helping professionals. This helps build capacity and resources for continuing services. Such services include informational or mental health support, even after the institutions involved in the initial response conclude their activities.
Be aware of chronic stress, conflict, and retraumatization
Interventions to increase community resilience are unlikely to succeed unless public health professionals or other intervening individuals engage the community. They must do so with an understanding of the psychosocial impact of CEC. Chronic stress can affect people's health and behavior. Community conflict over how to define and respond to contamination can be a major "secondary" stressor. An example would be whether or not to relocate the community.
Some community members may experience re-traumatization as they experience or observe health effects they attribute to exposures. This can also happen as new contaminating incidents occur, or as new public health activities begin.