Addressing the Gaps in Child-Focused Disaster Preparedness and Response
Topic:
Children make up a significant portion of the United States: 22% of the population, or about 74 million individuals under the age of 18. Yet, despite their numbers, the unique needs of children are underrepresented in disaster preparedness and emergency medical response.
Most emergency systems are designed around adult physiology, psychology, and logistics, leaving critical gaps for our youngest and most vulnerable citizens. The HHS Administration for Strategic Preparedness and Response (ASPR) is working to evolve our systems through Pediatric Disaster Care Centers of Excellence.
Children Are Not Just Small Adults
Children are unique with fragile physiology that differs from adults in vital ways that profoundly impact their care during emergencies. Among other differences, their airways are smaller and more pliable, their metabolic rates are higher, their high body surface area, and their organ systems are less mature, making them more susceptible to rapid deterioration in crises. Children also communicate differently, often struggling to articulate symptoms or needs, which can delay diagnosis and treatment. Psychological trauma, family separation, and the need for age-appropriate equipment and medications further complicate their care.
For children with special healthcare needs – nearly one in five in the U.S. – these risks are magnified. Many rely on medical devices, medications, or specialized support, making power outages, evacuations, and supply shortages especially dangerous.
The Gap in Pediatric Disaster Preparedness
Despite these differences, fewer than half of the over 6,200 hospitals in the US have disaster plans that specifically address pediatric patients. Most disaster response protocols, training, and resources are built with a focus on adults, leaving children especially vulnerable during hurricanes, wildfires, pandemics, and mass casualty events. This gap puts millions of children at risk of inadequate care and poorer outcomes during emergencies.
ASPR’s Pediatric Disaster Care Centers of Excellence: Leading the Way
Recognizing these challenges, ASPR has sought our public/private partnerships to establish three regional Pediatric Disaster Care Centers of Excellence to build a robust, child-focused disaster response infrastructure. These centers serve as national models, developing and disseminating best practices in pediatric disaster preparedness, response, and recovery on a regional level.
The Three Centers of Excellence
| Western Regional Alliance for Pediatric Emergency Management (WRAP-EM) | Region V for Kids (formerly EGLPCDR) | Gulf 7 Pediatric Disaster Network |
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Why These Centers Matter
The ASPR Pediatric Centers of Excellence are vital for several reasons:
- Specialized Training: They equip healthcare professionals with the skills and knowledge to recognize and treat pediatric emergencies, which differ significantly from adult cases.
- Resource Coordination: These centers develop and share best practices, facilitate resource sharing, provide technical assistance, and coordinate regional responses to pediatric surges.
- Disaster-Specific Pediatric Focus: They are specifically dedicated to improving emergency care for children during disasters and public health emergencies when healthcare systems are overwhelmed, resources are limited, and standard care pathways may be disrupted.
- Family and Community Support: They provide guidance for families, especially those with children with special healthcare needs, to prepare for and navigate disasters.
- Policy and Advocacy: By highlighting the unique vulnerabilities of children, these centers influence disaster planning at every level, ensuring that children are not an afterthought in emergency preparedness.
Call to Action
Children are our nation’s future. Their unique needs demand dedicated attention, resources, and expertise, especially in times of crisis. The ASPR Pediatric Disaster Care Centers of Excellence are leading the way, but continued support from Congress, advocates, and the public is essential to ensure children are protected when disaster strikes.
Investing in child-focused disaster medicine isn’t just the right thing to do, it’s a critical step toward a safer, more resilient nation for all.
Dr Michael Anderson is a pediatric critical care physician, a professor of pediatrics, and a dedicated child advocate. His work in disaster response has spanned almost three decades and he has served in numerous private sector and government contractor roles in the space. He currently helps lead the three ASPR PDCOEs and is a key subject matter expert for children’s issues in ASPR.
