[dropcap]H[/dropcap]ealth Education is an incredibly flexible profession. It has an innate ability to deeply influence many different arenas that affect the human experience, thus creating long-lasting, positive impacts in our communities and on the people who live in them. Being a Certified Health Education Specialist (CHES), in particular, has opened many doors for me to work with groups of people who I never would have guessed I would be working with in geographical areas I never dreamed I would be working in. The good people of rural Van Zandt County, Texas, fall into this category.

The National Oceanic and Atmospheric Association estimates tornado wind speeds by examining damage to property. The Enhanced Fujita scale ensures that all tornados are rated evenly. Tornados with higher wind speeds and increased damage receive higher EF-values. (U.S. Air Force graphic/Senior Airman Thomas Trower)

On April 29, 2017, seven tornadoes ripped through Van Zandt County in Northeast Texas, leaving in its wake nine million dollars in private property damage, and four fatalities. Two of the seven tornadoes were found to have caused the most damage, and were rated an EF-3 and EF-4, respectively. The areas that were affected the most were immediately to the East and immediately to the West of the city of Canton, Texas. In the hours and days that immediately followed this disaster, many people came together in interdisciplinary teams to perform search and rescue, to provide emergency medical care, food and shelter, and to address aftercare needs (social, emotional, spiritual) that always accompany events such as this. Once the initial crisis has passed, there are many other long-term needs that needed to be addressed, and this is where Public Health in general and health education specifically can play a pivotal role in assisting communities recover from disastrous events, and, in fact, did.

Health educators are uniquely positioned to address issues in disaster planning…

Through a series of fortuitous events following the Van Zandt County disaster, Russell Hopkins and I were connected through a mutual colleague. Russell had just assumed the mammoth task of being Van Zandt County’s Long Term Recovery Group (LTRG) Chair, and juggling that new role with his ongoing responsibilities as the Director of the Northeast Texas Public Health District (NET Health). NET Health has provided Public Health Emergency Preparedness (PHEP) and Disease Surveillance services to the residents of Van Zandt County since 2002. In the last three years, the County has had four declared disasters. Severe weather has visited the area with alarming frequency. This started the PHEP department at NET Health on a mission to address the issue of Community Recovery as this has been a core capability that never seemed to offer easy solutions when creating annual work plans. On Mother’s Day 2015, an EF3 tornado struck the unincorporated areas of Van Zandt County and moved into the town of Van. The tornado killed two people and hospitalized 48 with many more people less severely injured. The immediate response after the tornado worked reasonably well with plenty of opportunities for improvement identified in After Action Reports provided through the work of the county’s Long Term Recovery Group (LTRG). Unfortunately, this group disbanded after the final financial distribution was made.  After the April 2017 tornadoes, however, the primary concern became making LTRGs a permanent feature in the county. Lacking any previous experience, the LTRG began reaching out to the former members of the Van 2015 LTRG, Texas Department of Emergency Management (TDEM) and the City of Rowlett for ideas and lessons learned from other LTRGs that had been formed in the aftermath of other disasters in Texas.

Russell was at this point in the process when we were introduced. I was the Project Manager for a grant that was being administered through the American Planning Association – Texas Chapter (APA-TX) (via the CDC) called Planners4Health, a three-year initiative whose goal was to bring planners and public health professionals back together in a symbiotic working relationship to make communities healthier. APA-TX was looking for a project on which to spend this newly awarded grant money, and Russell was looking for help. It was the perfect match.

In July 2017, the Planners4Health Team took a field trip to Canton to survey the damage and talk with members of the LTRG to determine the best way to help them. It was evident from the very beginning of this process that my Health Education skills and competencies were going to be put to the test. I had never worked in Disaster Recovery or in a rural community before and, truth be told, thought I had no idea what I was doing or how I was going to lead my team to success. I convinced myself to lean into the skills in my Health Education Tool Box, and off my team and I went to create an intervention for the folks in Van Zandt County.

The main deliverable of the grant was hosting a Round Table Event in Canton in October of 2017. The goal of that event was to bring together Emergency Management Professionals to disseminate the Tool Kit that the Planners4Health Team had created (which was the second deliverable of the grant). Unfortunately, the Tool Kit was not ready in time to disseminate at the Round Table Event. However, that turned out to be a positive turn of events in this case, because the team was able to glean some important information from the attendees at the Round Table Event that helped in the final version of the Tool Kit. We are in the process of moving into the second phase of this project, which will focus on implementing these Round Table Events in 5 different Health Service Regions in rural communities across the state of Texas. The third phase will be a research project focusing on building and measuring resiliency in rural communities to not only help them post-disaster, but leveraging and strengthening the Social Determinants of Health in each community to create better overall health outcomes regardless of whether they experience a disaster or not.

Health educators are uniquely positioned to address issues in disaster planning by viewing this type of education as an expansion of the prevention model. By taking this view, health educators can take a deeper dive into the social determinants of health that need to be addressed in rural communities to assist those communities in becoming more resilient. To that end, we recommend that health educators familiarize themselves with the National Incident Management System (NIMS) and the Incident Command System (ICS). The self-study courses ICS 100 and 200 cover both NIMS and ICS. ICS 700 and 800 are for those professionals with an interest in health and medical disciplines. Courses are available for free at fema.gov. A free training account is required.