MPH 600 Week 3 Populations at Greatest Risk Analysis Example

Confined to Bed, Living Alone, Dependent on Power: Identifying the Residents at Greatest Risk When Disaster Strikes a Southern Colorado County

[Student Name]

University of Phoenix

MPH/600: Community Resiliency and Response Preparedness

Week 3 Assignment

[Instructor Name]

[Date]

The county's health department, programs, device counts and outreach details are composites written for a model paper; county disability estimates come from CDC PLACES, and research findings come from the sources cited.

During a July heat warning, a home care nurse called the county health department with a question. Her agency would check on its own clients, but she knew of neighbors who were older, lived alone, rarely left home and were not anyone's clients. Who would check on them? The question exposed a gap in the county's preparedness: it did not know where many of its most at-risk residents were. This paper identifies the populations at greatest risk and how to reach them.

A Functional Needs Approach

Emergency managers increasingly define risk by function rather than label. Instead of asking whether someone has a diagnosis, planners ask whether a person can receive and understand warnings, maintain health and medications, remain independent, get support and supervision and find transportation. This approach captures people with disabilities, older adults, people with chronic illness, limited English speakers and others whose needs rise in emergencies.

Sizing the Population

Local data show how many residents may need help. CDC's PLACES estimates for 2023 show that 35.2% of adults in Pueblo County, whose data anchor this analysis, reported any disability; 15.0% had a mobility disability, 16.6% a cognitive disability, 8.3% a hearing disability, 6.3% a vision disability, 8.6% difficulty living independently and 4.3% difficulty with self-care (Centers for Disease Control and Prevention [CDC], 2025). These groups overlap, but even the smallest represents thousands of adults.

Lessons From the Chicago Heat Wave

Real disasters show who dies. During a record-setting heat wave in Chicago in July 1995, at least 700 excess deaths occurred. A case-control study comparing 339 people who died with neighborhood and age-matched controls found that the strongest risk factors for heat-related death were being confined to bed, with an odds ratio of 8.2, and living alone, 2.3, while working air conditioners and access to transportation each reduced risk, with odds ratios of 0.3; having social contacts such as group activities or friends nearby was also protective (Semenza et al., 1996). The people most likely to die were the ones least likely to be seen.

Poverty Across the Phases of Disaster

Low income raises risk throughout a disaster. A review of sociological research on poverty and disasters in the United States found that poor households face greater harm across the phases of disaster, from risk perception, preparedness and response to warnings, through physical and psychological impacts and emergency response, to recovery and reconstruction (Fothergill & Peek, 2004).

Group One: Older Adults Living Alone

Older adults who live alone combine several risk factors from the Chicago study: isolation, chronic illness and limited mobility. Many live in older homes without central air conditioning. The county's aging services agency estimates several thousand residents 65 and older live alone.

Group Two: People With Disabilities

People with mobility disabilities may need help evacuating; those with hearing or vision disabilities may miss warnings; people with cognitive disabilities may need support to understand and act on instructions. Shelters must be accessible and able to accommodate service animals, equipment and caregivers.

Group Three: People Who Depend on Electricity

Residents using oxygen concentrators, ventilators, home dialysis or powered wheelchairs face immediate danger during power outages. Federal data on Medicare beneficiaries using electricity-dependent equipment, available to health departments for planning, showed about 2,100 such residents in the county.

Group Four: People Experiencing Homelessness

People without housing face heat, cold, smoke and floods with no shelter and often with untreated chronic illness. Many camp along the creek that flooded in the summer, and shelters that require sobriety or separate families from pets turn some people away. Outreach teams from homeless service providers are the most reliable way to deliver warnings and supplies.

Group Five: Limited English Speakers

Warnings delivered only in English miss residents who speak mainly Spanish. The summer flood proved the point: families who spoke mainly Spanish missed the English alert, and some heard about aid only weeks afterward.

Group Six: Outdoor Workers

Farmworkers and construction workers face heat and smoke on the job, often without control over their schedules. Some are paid by the piece or the job, which discourages breaks, and some fear losing work if they complain about conditions.

Group Seven: Low-Income Renters

Renters with low incomes have little control over home repairs, less insurance and fewer savings for temporary housing, which lengthens displacement after disasters.

Group Eight: Children and Pregnant Residents

Children depend on adults to act on warnings, breathe more air relative to their size and are separated from parents when disasters strike during school hours. Pregnant residents face added risk from heat, smoke and disruption of prenatal care. Schools and child care centers need reunification plans, and prenatal clinics need a way to reach patients during emergencies.

Group Nine: People With Mental Illness or Substance Use Disorders

Emergencies can interrupt medications, counseling and treatment for opioid use disorder. People taking certain psychiatric medications are more sensitive to heat. Treatment programs need plans to continue dosing during closures, and shelters need staff trained to support people in crisis.

Overlapping Risks

Risks compound. An older woman who lives alone in a south side rental, speaks mainly Spanish, uses oxygen and has no car combines nearly every factor on this list. Planning must find such people, not just count categories.

Finding People Before Emergencies

The department will build relationships with partners who already know at-risk residents: home care and hospice agencies, aging services, the community health center, dialysis centers, medical equipment suppliers, meals programs, promotoras and congregations. Each partner will be asked to maintain contact plans for clients during emergencies.

A Voluntary Registry

A voluntary registry, with clear consent and privacy protections, will allow residents who need help during evacuations or outages to sign up. Registries have limits; many people never enroll, so the registry will supplement partner networks rather than replace them.

Check-In Networks

Building on the Chicago evidence that social contact protects, the department will organize a volunteer check-in network for older adults living alone during heat, cold and outages, working through congregations and neighborhood groups.

Communication

Alerts will go out in English and Spanish, through the Spanish radio station and school messaging systems and through partners who can reach people by phone or in person. Messages will include specific actions and where to get help.

Hearing From Affected Residents

The department will convene an advisory group of residents with disabilities, older adults and Spanish speakers to review plans. People with lived experience identify barriers planners overlook.

Conclusion

The residents at greatest risk in emergencies are those least likely to be seen: older adults living alone, people with disabilities, people who depend on power for medical devices, people without housing, limited English speakers, outdoor workers and low-income renters. Local data size the groups, the Chicago heat wave shows which factors kill and research on poverty shows how disadvantage raises harm at every stage. Finding people through trusted partners before disaster strikes is the core strategy.

References

Centers for Disease Control and Prevention. (2025). PLACES: Local data for better health, county data, 2025 release [Data set]. https://data.cdc.gov/d/swc5-untb

Fothergill, A., & Peek, L. A. (2004). Poverty and disasters in the United States: A review of recent sociological findings. Natural Hazards, 32(1), 89-110. https://doi.org/10.1023/B:NHAZ.0000026792.76181.d9

Semenza, J. C., Rubin, C. H., Falter, K. H., Selanikio, J. D., Flanders, W. D., Howe, H. L., & Wilhelm, J. L. (1996). Heat-related deaths during the July 1995 heat wave in Chicago. New England Journal of Medicine, 335(2), 84-90. https://doi.org/10.1056/NEJM199607113350203