Currently, numerous resources are dedicated to the topics of disaster preparedness and emergency response. A major educational, technical, and financial resource is the federal government. The topic of disaster preparedness is addressed by multiple federal agencies, including the Centers for Disease Control and Prevention (CDC), the Department of Homeland Security (DHS), and the Federal Emergency Management Agency (FEMA). The most available and widespread resources provided by these agencies are information and educational tools for public health professionals and the general public. These tools are disseminated on their websites and updated on a regular basis.
Much of the technical and financial resources of CDC and Health Resources and Services Administration (HRSA) under the Department of Health and Human Services (DHHS), and FEMA within the DHHS are dedicated to strengthening national public health infrastructure. State and local public health agencies have been urged by federal agencies to develop bioterrorism and emergency response plans. Since the attacks of 9/11, more resources have been made available to state and local jurisdictions, and progress has been made in developing local preparedness plans.1
Despite all the resources that have been dedicated to the preparedness arena, research has shown that there are still significant gaps in state and local infrastructure.2–5
These studies illustrate that additional resources are needed to provide local public health agencies with more frontline workers to mitigate and respond to threat agents.6
Of increasing concern in public health is the exclusion of LEP populations in public health preparedness planning, notably in critical areas such as disaster/emergency situations. According to the 2004 American Community Survey Data Profile Highlights, in King County, the most populous county in Washington State, 21.7% of those aged 5 years and older speak a language other than English at home, including (in order of prevalence spoken) Spanish, Chinese, Vietnamese, Tagalog, and Korean. This statistic compares nationally to 18.7% of those aged 5 years and older who speak a language other than English at home.7
Thus, the gap in adequately addressing disaster preparation, planning, and response for LEP populations is particularly critical given the U.S./Katrina experiences and current public attention regarding a pandemic flu outbreak.
To date, little information exists on the involvement of medical interpreters as stakeholders in health-care planning, the public health role of interpreters, and the perspectives and training needs of medical interpreters. The literature on medical interpretation and interpreters is primarily focused on the effects of medical interpretation, implementation of medical interpretation services, the quality of medical interpretation, and provider/clinician training on use of medical interpreters.8–13
These studies on the emerging field of medical interpretation, along with a growing focus on cultural competency in health care and laws requiring the provision of health-care interpretation, have stimulated a growing interest in research on interpretation services.14–16
There are several gaps in the literature that are of consequence for LEP populations in public health planning: (1
) the possible roles of medical interpreters as culture brokers and gatekeepers for their language communities, (2
) medical interpreters' perspectives of and experiences in their professional role as interpreters, and (3
) the training, support, and resource needs of interpreters.17
Finally, medical interpreters are an untapped, strategic planning resource in disaster preparedness/emergency response for LEP populations. Current planning drills and exercises have not integrated an approach to addressing the needs of LEP populations, such as tabletop exercises and hospital disaster drills. While translation of target public health disaster information into select languages has occurred, issues such as literacy variation within and between language groups and information access by LEP communities to written materials continue to present planning and systems response challenges.