Cultural and Linguistic Competency for Disaster Preparedness Planning and Crisis Response

The racial and ethnic diversity of the United States population is increasing. An inclusive and integrated approach to disaster and emergency preparedness, response, and recovery activities ensures that culturally and linguistically diverse populations are not overlooked or misunderstood. Public health officials and emergency managers who are prepared to address the cultural needs of communities affected by adverse events can be instrumental in reducing people’s psychological distress and meeting the community’s needs to recovery effectively. This webpage will introduce and connect you to resources and tools that enhance and address cultural and linguistic competency to help mitigate the impact of disasters and emergency events.

Office of the Assistant Secretary for Preparedness and Response (ASPR)

Cultural and Linguistic Competency in Disaster Preparedness and Response Fact Sheet
This fact sheet details the importance of developing cultural and linguistic competency for public health officials and emergency managers to better meet the needs of diverse populations and to improve the quality of services and health outcomes during and after a disaster.  The fact sheet also provides a framework of the five elements of cultural competency within disaster preparedness.

American Indian and Alaskan Native Disaster Preparedness Resource
This tool provides some basic resources and best practices to help disaster behavioral health and emergency responders better understand the general status of tribal behavioral health issues, and also provides information on emergency disaster services and/or organizations that support tribal communities. The goal is to provide a beginning frame of reference and several resources that will promote responders’ cultural awareness, as well as help introduce some of the rich culture, values, and traditions that are so important for respectfully assisting tribal communities.

Office of Minority Health (OMH)

Continuing Education Programs

Think Cultural Health (TCH) is a flagship initiative of the OMH Center for Linguistic and Cultural Competence in Health Care.  TCH is dedicated to advancing health equity at every point of contact through the development and promotion of culturally and linguistically appropriate services.  TCH provides the latest resources and tools to promote cultural and linguistic competency in health care.  As part of these resources, TCH offers four free and accredited continuing education programs to help individuals at all levels and in a variety of professions to promote health and health equity.  The programs offered include:

• A Physician’s Practical Guide to Culturally Competent Care
• Culturally Competent Nursing Care: A Cornerstone of Caring
• Culturally Competency Curriculum for Disaster Preparedness and Crisis Response
• Cultural Competency Program for Oral Health Professionals
  

Accessing Health and Medical Services

• Industry Collaboration Effort: Cultural and Linguistic Workgroup
• Better Communication, Better Care: Provider Tools to Care for Diverse Populations: This toolkit provides health care professionals with resources to address the challenges of delivering high quality, effective, and compassionate health care to a diverse patient population.  The toolkit also focuses on increasing awareness of cultural backgrounds and enhancing communication with diverse populations.
• Federal Emergency Management Agency (FEMA)
• Help After a Disaster: Applicant’s Guide to the Individuals and Households Program: This program guide details FEMA’s disaster assistance program, including how to apply for assistance.  The guide is available for download in 20 different languages.
• Substance Abuse and Mental Health Services Administration (SAMHSA)
• CultureCard: A Guide to Build Cultural Awareness: American Indian and Alaska Native: This guide is intended to serve as a general briefing to federal disaster responders and other service providers to enhance cultural competency while providing services to American Indian and Alaska Native communities.
• National Health Care for the Homeless Council
• Addressing Cultural and Linguistic Competence in the Health Care for Homeless Setting: A Brief Guide: This guide provides a framework for understanding the basic requirements of providing culturally and linguistically competent health care.
  

Behavioral Health

• American Psychological Association
• Guidelines on Multicultural Education, Training, Research, Practice, and Organizational Change for Psychologists: This resource enhances the abilities of behavioral health clinicians to work with diverse populations in disaster relief operations.
• Centers for Disease Control and Prevention
• Disaster Mental Health For States: Key Principles, Issue, and Questions: This webpage provides information about areas to consider, such as culture and other community characteristics, when developing a state disaster mental health plan.
• National Association of School of Psychologists
• Culturally Competent Crisis Response: Information for School Psychologists and Crisis Teams: This webpage contains information for school psychologists and other disaster behavioral health professionals who may be part of a crisis response team for a school.
• National Center for PTSD
• General Cross-Cultural Considerations: This 1 hour on-line course enhances providers’ understanding of how to incorporate cultural factors into the assessment and treatment of trauma-related disorders.  In addition, the National Center for PTSD has compiled several courses on working with at-risk populations in order to provide culturally sensitive behavioral health services to those with PTSD.
• The National Child Traumatic Stress Network
• Culture and Trauma: This webpage provides an extensive list of resources and references to enhance cultural awareness and sensitivity for responders and organizations working with children and families affected by trauma.  Several of these resources are also available in multiple languages.
• SAMHSA
• Developing Cultural Competence in Disaster Mental Health Programs: The guide provides operational definitions of cultural competency as well as recommendations for primary and behavioral health care providers working with disaster survivors in multicultural communities.
• Applying Cultural Awareness to Disaster Behavioral Health: Participants in this archived webinar will learn about tools that they can use to assess and strengthen cultural awareness practices in disaster behavioral health services.
  

Communication

• Centers for Disease Control and Prevention (CDC)
• Public Health Workbook: To Define, Locate, and Reach Special, Vulnerable, and At-risk Populations in an Emergency: This document describes a process that will help planners develop a Community Outreach Information Network (COIN) – a grassroots network of people and trusted leaders who can help with emergency response planning and delivering information to at-risk populations in emergencies.  Additional tools are included to provide resources for more inclusive communication planning that will offer time-saving assistance for state, local, tribal, and territorial public health and emergency management planners in their efforts to reach at-risk populations in day-to-day communication and during emergency situations.
• Federal Emergency Management Agency (FEMA)
• Tips for Effectively Communicating with Protected Populations during Response and Recovery: This guide provides practices regarding effective communication to help jurisdictions meet their obligations to carry out their disaster related activities in a non-discriminatory manner.
• Maryland Department of Health and Mental Hygiene
• A Guide to Enhance Grassroots Risk Communication Among Low-Income Populations: This guide is intended to enhance current risk communication systems at the local and state levels by helping these systems to become more proficient in addressing the needs of low-income populations. The guide serves as a resource for public health and emergency management practitioners who plan and implement emergency and disaster preparedness activities.  A key component of the guide is demonstrating the need for culturally and linguistically appropriate messages as part of effective risk communication systems that address the unique needs of low-income communities.
• National Disability Navigator Resource Collaborative
• Disability Etiquette – Tips for Interacting with People with Disabilities: This fact sheet offers guidance on communicating more effectively with people with disabilities.
• Pennsylvania Department of Health and Drexel University
• Communicating with Patients During Public Health Emergencies: Toolkit for Primary Care Medical Practices: This toolkit provides health care professionals, and the organizations that represent them, with communication checklists, templates, and examples of messaging using telephone voice messaging, websites, and social media.  It is intended to assist health care practitioners with expanding their capacity to communicate with their patients during disasters and continue the important work of providing medical care and advice when it is most needed.
• Communicating with Limited English Proficiency Populations: This archived webinar looks at how to establish communication plans with communities with limited English proficiency in advance of an emergency.

Cultural and Linguistic Laws and Policies

• Executive Order 13166: Executive Order 13166, “Improving Access to Services with Persons with Limited English Proficiency,” requires federal agencies to examine the services they provide, identify any need for services to those with limited English proficiency (LEP), and develop and implement a system to provide those services so persons with LEP can have meaningful access.
• Section 504 of the Rehabilitation Act of 1973: Section 504 is a national law that protects qualified individuals from discrimination based on their disability.  The nondiscrimination requirements of the law apply to employers and organizations that receive financial assistance from any federal department or agency.
• The Legal Framework for Language Access in Healthcare Settings: Title VI and Beyond: This Journal of General Internal Medicine article describes the federal mandates for language rights in health care, provides a broad overview of existing state laws, and recent legal developments addressing language barriers.  The article also provides an analysis of key policy initiatives that would improve health care for patients with limited English proficiency.
• Title VI of the 1964 Civil Rights Act: Title VI prohibits discrimination on the basis of race, color, and national origin in programs and activities receiving federal financial assistance.
  

General Resources

• Federal Emergency Management Agency (FEMA)
• Emergency Resources for Other Languages: This webpage contains flyers, brochures, tri-folds, press releases, and public service announcements tailored to provide disaster preparedness, response, recovery, and mitigation information in a number of languages.
• Healthy Roads Media
• Translated Materials: Emergencies: This site contains health education materials in a number of languages and a variety of formats.  They were developed to provide health information for diverse populations in a variety of settings.
• Georgetown University
• National Center for Cultural Competence (NCCC):  The NCCC is a cooperative agreement funded as part of the Family-Professional Partnerships Program administered by the Maternal and Child Health Bureau of the Health and Human Services Administration. The NCCC provides national leadership and contributes to the body of knowledge on cultural and linguistic competency within systems and organizations.
• Federal Interagency Working Group on Limited English Proficiency (LEP) Website
• Limited English Proficiency (LEP): A Federal Interagency Website: This website provides a wide range of resources related to individuals with limited English proficiency, including frequently asked questions, information on Executive Order 13166, resources, and demographic data.
• Emergency Preparedness: This webpage provides links to resources related to emergency preparedness and individuals with limited English proficiency and their communities.
• Office of Minority Health (OMH)
• National Standards for Culturally and Linguistically Appropriate Services in Health and health Care (The National CLAS Standards): The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by providing a blueprint for individuals and health care organizations to implement culturally and linguistically appropriate services.
• U.S. National Library of Medicine
• HealthReach: Health Information in Many Languages: HealthReach is a national collaborative partnership that has created a resource of quality multilingual, multicultural public health information for those working with or providing care to individuals with limited English proficiency.
• Multi-Cultural Resources for Health Information: Cultural Competency: This webpage provides a wide selection of resources, including fact sheets, guidebooks, and training materials, related to cultural competency.
  
  

Addressing the Access and Functional Needs of At-Risk Individuals

• Access and Functional Needs: Cross Cutting Resources
• Older Adults and People with Disabilities
• Maternal-Child Health and Gender Issues
• Cultural Competency and Limited English Proficiency
• People Experiencing Homelessness