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Human rabies transmitted by dogs still kills thousands of people each year worldwide. Dog bites are common in the city of Beni (Democratic Republic of Congo), which shows low rabies vaccination coverage. This study aimed to determine the factors associated with the rabies vaccination status of dogs. A cross-sectional analytical study was conducted in the town of Beni among dog owners, during a household survey selected using a multistage sampling. The information sought concerned the knowledge and characteristics of the dog owners as well as the vaccination status of these dogs. Logistic regression was used to investigate associations between the vaccination status of the dogs and the main independent factors. Rabies vaccination coverage in Beni was 26% (95% confidence interval [CI]: 22% - 30%). The main factors associated with the rabies vaccination status of the dog were primary education level of household head (adjusted odds ratio [aOR]:4.8; 95% CI: 1.2- 19.8); university education level of household head (aOR: 5.9; 95% CI: 1.6-22); perceived rabies severity (aOR: 44. 4; 95% CI: 10.4-188), having more than one dog in the household (aOR: 2.6; 95% CI: 1.6-4.3); age range 7-12 months (aOR: 0.2; 95% CI: 0.1-0.6) and confined dog breeding (aOR: 3.9; 95% CI: 1.1-14.9). The low vaccination coverage in Beni requires mass vaccination campaigns against canine rabies targeting the dog owners with low education levels, those raising more than one dog, with stray dogs or dogs less than 12 months old.

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PURPOSE: We investigated the relationship between disability and food security in South Africa using data from the General Household Survey (GHS). MATERIALS AND METHODS: Regression models were utilised with GHS data (2014-2018) to gauge the likelihood of food insecurity (the dependent variable) among individuals with disabilities. Socioeconomic and demographic traits of the 2018 GHS sample were analysed. All estimates were weighted and represented nationally at the individual level. RESULTS: In this study population (32 187) of food insecure people, 9.64% are disabled. Food insecurity impacts more Black people with disabilities (91%) versus those without disabilities (90%), and disabled women (65%) versus nondisabled women (58%). Most reside in KwaZulu-Natal. Those with disability grants lower food insecurity odds, while child support grant recipients face higher odds. Household size and education are significant predictors, while marital status and gender are not. CONCLUSION: This study data justifies the need for disability-inclusive food security programmes in South Africa, especially amid crises like COVID-19. Significantly, there is a nil data finding about people with eating/swallowing disabilities whose needs intersect with food security. This emphasises the need for inclusive data collection that operates within a food sovereignty framework to increase the visibility of people with disabilities.

South African national surveys and censuses should include data on people with disabilities, particularly those with eating and swallowing disabilities.Updated metrics, such as the Food Insecurity Experience Scale (FIES), if used, will facilitate easier cross-country comparisons and helps monitor progress towards achieving zero hungerThe study underscores the necessity for disability-inclusive food security programmes in South Africa, and the importance of a food sovereignty framework to enhance visibility.

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Introduction: Existing estimates of rates of childhood disability in Kenya are based on data with important limitations. Individual-level data on childhood disability at the local level is also lacking, leaving critical knowledge gaps for clinical and programmatic development. Objectives: We aimed to estimate the rates of children at-risk for disability, examine the external factors related to risk of childhood disability, and gain a better understanding of the challenges experienced by children at-risk for disabilities and their families within western Kenya. Methods: We conducted a small, cross-sectional randomized community survey to assess the rates of childhood disability across six administrative locations in Uasin Gishu County, Kenya, and to understand the experiences of these children and their caretakers. Results: Rate of childhood disability in Uasin Gishu county was estimated to be 5%, with the most common disabilities being mood disorders. Caretakers reported several barriers to accessing treatment for their children at-risk of having disabilities, including financial concerns and lack of transportation. Conclusions: Our findings suggest a need for improved access to care in this region, including addressing significant barriers to accessing care such as stigma and socioeconomic challenges. These community-level data will inform the development of future infrastructure and programming for this population.

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This article studies from a conceptual, theoretical and empirical point of view the link between civic sense and recycling activities in Italy related to the years 1998, 2012, 2018, 2019. It establishes a link among the concepts of civic sense, whose essential components are behaviours, attitudes and interactions, with it being a typical traditional theoretical approach with perfectly rational and perfectly informed agents, along with a standard empirical analyses on the determinants of (household) waste recycling. Starting from a game-theoretic model of contribution with particular features related to the objective function of agents and a heterogeneity in their costs, the article aims to highlight how certain theoretical results get together with empirical evidence. In the empirical analysis, using the micro-data of a "Multipurpose Survey on Households" provided by the Italian National Statistical Office and an ordered probit model, the article finds a positive, robust and stable correlation between civic sense and household recycling activities The findings show that a higher civic sense is related to an increase in household recycling activities, respectively, of 1.2 percentage points in 1998, 4.3 percentage points in 2012, and 3.8 percentage points in both 2018 and 2019.

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While it is possible to detect cognitive decline before the age of 60, and there is a report indicating that certain cognitive abilities peak in one's 30s, the evidence regarding cognitive problems in populations younger than 65 years is scarce. This study aims to (1) determine the proportion of community-dwelling adults with different cognitive status, and (2) determine the prevalence of neuropsychiatric behaviors. A population-based survey was conducted in Chiang Mai, Thailand. Individuals aged 30 to 65 were recruited and assessed for demographic data, memory complaints, cognitive performance, and neuropsychiatric symptoms using self-reported questionnaires. In a total of 539 participants, 33.95% had mild cognitive impairment (MCI), 7.05% had subjective cognitive decline (SCD), and 52.50% had neuropsychiatric symptoms. The risk of MCI increased with age, and neuropsychiatric symptoms were significantly higher in those with MCI or SCD than in those without (p < 0.001). The most common complaints were sleep problems, anxiety, and irritability. Screening for MCI in adults aged < 65 years might be useful. However, further investigation on the appropriate age to screen and the program's cost-effectiveness is suggested.

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Rats are an understudied stressor for people in urban environments around the world but the effects may not be distributed equally among residents. In this study, we examined associations between residential rat sightings and mental health in Chicago, where rat complaints are the highest of any American city. We examined how this relationship varied by frequency of rat sightings, race, ethnicity, income, home ownership, and gender and explored potential psychosocial pathways (e.g., feelings about the home) between rat sightings and mental distress. We conducted a randomized household survey along an income gradient in 2021 and asked about depressive symptoms in the past week (i.e., Center for Epidemiologic Studies Depression scale), frequency of rat sightings in/around the home, perceptions of rats, neighborhood conditions, and socio-demographic characteristics. We used logistic regression to assess relationships among these variables for our entire sample and for specific demographics using stratified models. Respondents (n = 589; 409 complete cases) who saw rats in/around the home daily/almost daily had 5.5 times higher odds of reporting high depressive symptoms relative to respondents who saw rats less frequently after accounting for socio-demographics and neighborhood conditions. This relationship was significant for men and respondents with lower incomes or race or ethnicity other than white. Our results show that rat infestations should be considered a threat to mental health among urban residents. Increased mental health support for residents living in rat-infested housing may improve public health in cities.

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Large-scale desertification combatting programs (DCPs) are crucial tools for addressing climate change and improving the ecological environment. Despite existing research having predominantly focused on assessing the ecological benefits of DCPs, the understanding of their impacts on surrounding socioeconomic aspects remains limited, particularly at the household level. To comprehensively evaluate the returns of DCPs, this study chose the representative desertification control area of the Gonghe Basin on the Qinghai-Tibet Plateau as the research region and identified the dual benefits in terms of ecological environment and socioeconomic gains. Firstly, two essential ecosystem services, carbon sequestration (CS) and wind erosion prevention (WEP), were assessed using the MODIS NPP dataset and the RWEQ model from 2001 to 2021. Household surveys were conducted in 36 villages across 14 townships within the Gonghe Basin to gain a deeper understanding of the residents' socioeconomic conditions. Through regression analysis, the study assessed the impact of DCPs on the regional ecological environment and household socioeconomic status. The research findings revealed significant improvements in CS and WEP across a significant portion of the study area from 2001 to 2021. Upon analyzing data from 401 household questionnaires, it was generally perceived by residents in the Gonghe Basin that the implementation of DCPs led to environmental improvements and increased their income levels. Further regression analysis revealed a significant impact of both natural factors and the extent of resident participation in the projects on the ecological environment surrounding the villages and on household socioeconomic aspects. With increased resident engagement in the projects, the likelihood of increased household income and life satisfaction was higher. The diverse array of DCPs implemented in the Gonghe Basin not only improved the regional ecological environment but also stimulated socioeconomic development. In future projects, it is imperative to consider regional characteristics, align ecological effects, ensure the sustainability of livelihoods, and maximize the role of social capital.

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The impact of the COVID-19 pandemic was diverse and disproportionate among nations, and population segments. The impacts of the disease and the containment strategies adopted are broad and cut across multiple facets of life, society, and the economy, which are intimately interlinked. Therefore, a large household survey was conducted to ascertain the socioeconomic impact and human behavior changes due to the pandemic and the containment strategies covering all provinces of Sri Lanka. The ramifications on mobility and human behavior, income, economic status, food consumption, education, access to health services and information, and cultural and psychological changes were explored, and the data are reported in this paper. The survey was conducted on 3020 households, selected using a multistage clustering technique, to assess the impacts of the pandemic through three distinctly identified waves/phases of the pandemic in Sri Lanka. This dataset will enable researchers and policymakers to analyze the impact of the pandemic through a multifaceted perspective enabling a more holistic approach to decision-making.

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BACKGROUND: Routine childhood immunisation is one of the most important life-saving public health interventions. However, many children still have inadequate access to these vaccines and millions remain (partially) unvaccinated globally. As the COVID-19 pandemic disrupted health systems worldwide, its effects on immunisation have become apparent. This study aimed to estimate routine immunisation coverage among children under two in Sierra Leone and to identify factors associated with incomplete immunisation during the COVID-19 pandemic. METHODS: A cross-sectional household survey was conducted in three districts in Sierra Leone: Bombali, Tonkolili and Port Loko. A three-stage cluster sampling method was followed to enrol children aged 10-23 months. Information regarding immunisation status was based on vaccination cards or caretaker's recall. Using WHO's definition, a fully immunised child received one BCG dose, three oral polio vaccine doses, three pentavalent vaccine doses and one measles-containing vaccine dose. Following the national schedule, full immunisation status can be achieved at 9 months of age. Data were weighted to reflect the survey's sampling design. Associations between incomplete immunisation and sociodemographic characteristics were assessed through multivariable logistic regression. RESULTS: A total of 720 children were enrolled between November and December 2021. Full vaccination coverage was estimated at 65.8% (95% CI 60.3%-71.0%). Coverage estimates were highest for vaccines administered at birth and decreased with doses administered subsequently. Adjusting for age, the lowest estimated coverage was 40.7% (95% CI 34.5%-47.2%) for the second dose of the measles-containing vaccine. Factors found to be associated with incomplete immunisation status were: living in Port Loko district (aOR = 3.47, 95% CI = 2.00-6.06; p-value < 0.001), the interviewed caretaker being Muslim (aOR = 1.94, 95% CI = 1.25-3.02; p-value = 0.015) and the interviewed caretaker being male (aOR = 1.93, 95% CI = 1.03-3.59, p-value = 0.039). CONCLUSION: Though full immunisation coverage at district level improved compared with pre-pandemic district estimates from 2019, around one in three surveyed children had missed at least one basic routine vaccination and over half of eligible children had not received the recommended two doses of a measles-containing vaccine. These findings highlight the need to strengthen health systems to improve vaccination uptake in Sierra Leone, and to further explore barriers that may jeopardise equitable access to these life-saving interventions.

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BACKGROUND: Previous research has well-documented that family functioning is an important predictor of individuals' physical and mental health. However, relatively little research has explored family functioning at the family and population levels, such as changes in family functioning across years and whether predictors of family functioning differ across different family structures. Understanding of the changes in family functioning across years and factors promoting family functioning will inform the development of preventive measures to enhance family health and resilience. Objectives of the study were: (1) to examine the changes in family functioning across a 6-year study period and (2) to study protective factors associated with family functioning and the extent to which the factors are the same or different across different family structures. METHOD: The study involved secondary data analysis of the biannual Family Survey carried out by the Family Council, an advisory body to the Hong Kong government. A series of ANOVA and regression analyses were conducted using data of four population-based cross-sectional household surveys conducted in Hong Kong in 2011, 2013, 2015, and 2017. RESULTS: There were some fluctuations in overall family functioning scores across the study period, but no significant difference was found between the scores in 2011 and 2017. Different predictors of family functioning were found for different family types, and frequent family communication was a common protective factor for most family types, including never married, married/cohabiting with children, and married/cohabiting with no children. CONCLUSION: The study is among the first to examine changes in family functioning at the population level. Monitoring and addressing family functioning may help tackle various social problems and future public health crises. Interventions to promote family functioning should address both common and different protective factors of different family types.

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Pilot testing is crucial when preparing any community-based vaccination coverage survey. In this paper, we use the term pilot test to mean informative work conducted before a survey protocol has been finalized for the purpose of guiding decisions about how the work will be conducted. We summarize findings from seven pilot tests and provide practical guidance for piloting similar studies. We selected these particular pilots because they are excellent models of preliminary efforts that informed the refinement of data collection protocols and instruments. We recommend survey coordinators devote time and budget to identify aspects of the protocol where testing could mitigate project risk and ensure timely assessment yields, credible estimates of vaccination coverage and related indicators. We list specific items that may benefit from pilot work and provide guidance on how to prioritize what to pilot test when resources are limited.

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Critical infrastructures are ubiquitous and their interdependencies have become more complex leading to their uncertain behaviors in the aftermath of disasters. The article develops an integrated economic input-output model that incorporates household-level survey data from Hurricane Sandy, which made its landfall in 2012. In this survey, 427 respondents who were living in the state of New Jersey during Hurricane Sandy were used in the study. The integration of their responses allowed us to show the probability and duration of various types of critical infrastructure failures due to a catastrophic hurricane event and estimate the economic losses across different sectors. The percentage of disruption and recovery period for various infrastructure systems were extracted from the survey, which were then utilized in the economic input-output model comprising of 71 economic sectors. Sectors were then ranked according to: (i) inoperability, the percentage in which a sector is disrupted relative to its ideal level, and (ii) economic loss, the monetary worth of business interruption caused by the disaster. With the combined infrastructure disruptions in the state of New Jersey, the model estimated an economic loss of $36 billion, which is consistent with published estimates. Results from this article can provide insights for future disaster preparedness and resilience planning.

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Background: The coexistence of stunting and wasting in a child increases the risk of mortality and requires more intensive treatment and care. However, there is limited research on the burden of concurrent stunting and wasting among children and the socioeconomic factors that are correlated with having both conditions. Aim: To understand the prevalence and sociodemographic correlates of stunting, wasting, and concurrent stunting and wasting among a sample of children ages 6-144 months experiencing poverty in the Philippines. Methods: Cross-sectional data were drawn from nutrition screening and sociodemographic surveys conducted by International Care Ministries in 2018-2019. Descriptive statistics were calculated to determine the prevalence of stunting, wasting, and concurrent stunting and wasting. Multilevel logistic regression modelling was conducted to understand the sociodemographic factors that were associated with stunting and wasting. Results: Among the 3005 children in this sample, the prevalence of stunting, wasting, and concurrent stunting and wasting was 49.9%, 9.3%, and 4.6%, respectively. Children experiencing concurrent stunting and wasting lived in households in lower wealth index quintiles, had a household head with fewer years of education, and were more likely to experience food insecurity compared to children who were not stunted or wasted. The education of the household head, the number of household members, and the wealth of the household were correlated with stunting across age groups, while food insecurity was correlated with wasting among younger children. Conclusion: The presence of concurrent stunting and wasting among children provides the impetus to integrate both conditions into nutrition monitoring, prevention, and treatment interventions.

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BACKGROUND: Over 150 million people, mostly from low and middle-income countries (LMICs) suffer from catastrophic health expenditure (CHE) every year because of high out-of-pocket (OOP) payments. In Tanzania, OOP payments account for about a quarter of the total health expenditure. This paper compares healthcare utilization and the incidence of CHE among improved Community Health Fund (iCHF) members and non-members in central Tanzania. METHODS: A survey was conducted in 722 households in Bahi and Chamwino districts in Dodoma region. CHE was defined as a household health expenditure exceeding 40% of total non-food expenditure (capacity to pay). Concentration index (CI) and logistic regression were used to assess the socioeconomic inequalities in the distribution of healthcare utilization and the association between CHE and iCHF enrollment status, respectively. RESULTS: 50% of the members and 29% of the non-members utilized outpatient care in the previous month, while 19% (members) and 15% (non-members) utilized inpatient care in the previous twelve months. The degree of inequality for utilization of inpatient care was higher (insured, CI = 0.38; noninsured CI = 0.29) than for outpatient care (insured, CI = 0.09; noninsured CI = 0.16). Overall, 15% of the households experienced CHE, however, when disaggregated by enrollment status, the incidence of CHE was 13% and 15% among members and non-members, respectively. The odds of iCHF-members incurring CHE were 0.4 times less compared to non-members (OR = 0.41, 95%CI: 0.27-0.63). The key determinants of CHE were iCHF enrollment status, health status, socioeconomic status, chronic illness, and the utilization of inpatient and outpatient care. CONCLUSION: The utilization of healthcare services was higher while the incidence of CHE was lower among households enrolled in the iCHF insurance scheme relative to those not enrolled. More studies are needed to establish the reasons for the relatively high incidence of CHE among iCHF members and the low degree of healthcare utilization among households with low socioeconomic status.

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BACKGROUND: Post abortion contraceptive use is an important area in provisioning of services associated with child birth planning. This study examines the factors related to the type and timing of initiation of contraception adoption among women who had undergone induced abortion. Study also tries to identify the role of personnel who provided the abortion service on decision of family planning adoption using complementary log-log model in India. METHODOLOGY: The study uses the secondary data from the fifth round of the National Family Household Survey conducted during 2019-21. For, the analysis, we have used five-year women's reproductive calendar to extract information on contraceptive use, post last induced abortion among women. We used complementary log-log regression models, to estimate relative risk ratios and its 95% Confidence intervals (CI). RESULTS: According to NFHS-5, out of all the last pregnancies (2,55,549), about three percent resulted in abortion. Most of the abortion occurred in private facilities (55%), with the help of health professionals (71%). From the women's reproductive calendar, it was found that around 40% of the women adopted modern methods of contraception, with maximum adopting spacing method (33%), and only handful adopted permanent method (7%). It was also found that the likelihood of early adoption of permanent method increased to two times when the abortion is done by health professional compared to others [95% CI (1.25-3.30)]. CONCLUSION: This emphasises a need for quality counselling related to timing and types of family planning as an essential part of the family planning program ensuring client centric approach suited to their needs and contexts that helps in alleviating any apprehensions associated with adverse effects of modern contraceptive methods.

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INTRODUCTION: After a period of stagnation, alcohol policy in Australia has received increased attention in the past decade, with Sydney's lockout laws and Queensland's restrictions on trading hours garnering media attention. This study will investigate any changing trends in support towards alcohol policy and identify any demographic-specific shifts. METHODS: Respondents from the National Drug Strategy Household Survey (conducted every 3 years from 2004 to 2019) were asked to gauge their level of support for 16 alcohol policy items proposed to reduce the problems associated with excessive alcohol use. Mean levels of support for various policy options, as well as demographic predictors of support, were assessed. RESULTS: After an increase from 2004 to 2013, support for more evidence-based policies on alcohol (e.g., restricting the availability of alcohol) has decreased since 2013. Support for policy items that focus less on the restriction of the availability of alcohol and more on education remained relatively stable in comparison. While demographic groups continue to vary in their extent of support, shifts appear to be occurring fairly uniformly across sex, age, states and drinking groups. DISCUSSION AND CONCLUSIONS: Support for public health-oriented alcohol policies has been decreasing since 2013. The introduction of high-profile policies and less of a media focus on alcohol may be contributing to decreases in support.

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The ideal approach for calculating effective coverage of health services using ecological linking requires accounting for variability in facility readiness to provide health services and patient volume by incorporating adjustments for facility type into estimates of facility readiness and weighting facility readiness estimates by service-specific caseload. The aim of this study is to compare the ideal caseload-weighted facility readiness approach to two alternative approaches: (1) facility-weighted readiness and (2) observation-weighted readiness to assess the suitability of each as a proxy for caseload-weighted facility readiness. We utilised the 2014-2015 Tanzania Service Provision Assessment along with routine health information system data to calculate facility readiness estimates using the three approaches. We then conducted equivalence testing, using the caseload-weighted estimates as the ideal approach and comparing with the facility-weighted estimates and observation-weighted estimates to test for equivalence. Comparing the facility-weighted readiness estimates to the caseload-weighted readiness estimates, we found that 58% of the estimates met the requirements for equivalence. In addition, the facility-weighted readiness estimates consistently underestimated, by a small percentage, facility readiness as compared to the caseload-weighted readiness estimates. Comparing the observation-weighted readiness estimates to the caseload-weighted readiness estimates, we found that 64% of the estimates met the requirements for equivalence. We found that, in this setting, both facility-weighted readiness and observation-weighted readiness may be reasonable proxies for caseload-weighted readiness. However, in a setting with more variability in facility readiness or larger differences in facility readiness between low caseload and high caseload facilities, the observation-weighted approach would be a better option than the facility-weighted approach. While the methods compared showed equivalence, our results suggest that selecting the best method for weighting readiness estimates will require assessing data availability alongside knowledge of the country context.

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Introduction: Foot-and-mouth disease (FMD) is a highly contagious viral disease that is endemic in East Africa. FMD virus infection incurs significant control costs and reduces animal productivity through weight loss, lowered milk yield, and potentially death but how household's respond to these losses may differentially affect household income and food consumption. Methodology: To address this, we use unique data from a FMD outbreak to assess how household production and consumption activities change from before to during the outbreak. Data came from a 2018 survey of 254 households in selected Tanzanian wards and sub-counties in Uganda. The data includes household recall of before and during an outbreak in the past year on livestock and livestock product sales, milk and beef consumption, as well as related changes in market prices. We apply both difference-in-difference and change in difference ordinary least squares regressions with fixed effects to evaluate the impact of FMD on household production and consumption. Results and discussion: We find that households reported the largest reductions in livestock and livestock product sales, followed by reduced milk consumption and animal market prices. The changes in household income from livestock sales appears to be driven by FMD virus infection within the household herd while changes in market prices of substitute protein sources are primary associated with changes in milk and beef consumption. The role of widespread market price effects across both infected and uninfected herds and countries, tends to suggest that stabilizing prices will likely have a large impact on household nutritional security and income generation. We also propose that promoting diversity in market activity may mitigate differing impacts on households in FMD endemic regions.

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The COVID-19 pandemic created a need for high-frequency employment and income data. Policy-makers and researchers of developing countries typically have not had access to such data. In India, a new private high-frequency panel dataset has recently emerged as the dataset of choice for analysis of the economic impact of COVID-19. This is the Consumer Pyramids Household Survey (CPHS) conducted by the Centre for Monitoring the Indian Economy (CMIE). But the CPHS has also been criticised for being inadequately representative nationally by missing poor and vulnerable households in its sample. We examine the comparability of monthly labour income estimates for the pre-pandemic year (2018-19) for CPHS and the official Periodic Labour Force Survey (PLFS). Across different methods and assumptions, as well as rural/urban locations, CPHS mean monthly labour earnings are anywhere between 5 percent and 50 percent higher than corresponding PLFS estimates. In addition to the sampling concerns raised in the literature, we point to differences in the way employment and income are captured in the two surveys as possible causes of these differences. While CPHS estimates are always higher, it should also be emphasised that the two surveys agree on some stylised facts regarding the Indian workforce. An individual earning ₹50,000 per month lies in the top 5 percent of the income distribution in India as per both surveys. Second, both PLFS and CPHS show that half the Indian workforce earns below the recommended National Minimum Wage. Supplementary Information: The online version contains supplementary material available at 10.1007/s41027-023-00427-8.

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This study examined how community vulnerabilities contextualized the impact of exposure to five major disasters in 2017 on individuals' disaster preparedness. We pooled two panels of the Federal Emergency Management Agency (FEMA)'s National Household Survey in 2017 (pre-disaster) and 2018 (post-disaster) and further merged the data with 15 Centers for Disease Control and Prevention Social Vulnerability Index factors to examine the moderating impact of county-level vulnerabilities. Latent class analysis was used to identify patterns of disaster preparedness based on six preparedness items defined by FEMA with a total of 10,045 individuals. Three groups were identified and named basic preparedness (BP) group, high preparedness: socially engaged (HP-SE) group, and high preparedness: advanced socially engaged (HP-ASE) group. A working sample with a smaller sample size was constructed to include 2,179 individuals from 92 counties with disaster declarations of Hurricane Harvey, Hurricane Irma, Hurricane Maria, Hurricane Nate, and California Wildfires in 2017. Multinomial logistic regression indicated that post-disaster respondents were more likely to be in the HP-SE relative to the BP group. Two-level multinomial logistic regression showed that post-disaster respondents in communities with higher percentages of single-parent households and those of no vehicles were less likely to be in the HP-SE vs. the BP group. Post-disaster respondents in communities with higher percentages of unemployment, no high school diploma, and occupied housing units with more people than rooms were less likely to be in the HP-ASE vs. the BP group. Post-disaster respondents in communities with higher percentages of older adults and mobile homes were more likely to be in the HP-SE vs. the BP group. The findings also highlighted the importance of social engagement in disaster preparedness disparities and the need for community-level intervention to promote individuals' disaster preparedness.

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