Aunque están conscientes de los riesgos, menos de la mitad de la población está preparada para este tipo de emergencias.

Encuestas muestran que las comunidades hispanas son las menos preparadas de todas.

Sólo el 38% de los hogares latinos reportaron tener un plan en caso de desastre, el más bajo de cualquier grupo racial o étnico, de acuerdo con el del Departamento de Salud Pública (Department of Public Health) del condado de Los Angeles. En un condado de 10 millones de personas, en el que el 48% son latinas, millones podrían estar en peligro.

“Tenemos agua”, dijo Benito Salgado, cuando se le preguntó si su familia estaba preparada. Pero eso es todo. Salgado emigró de México 11 años atrás. Su esposa y sus hijos, de 6 y 8 años, no tienen un kit de primeros auxilios, ni tampoco lo tienen cerca de dos tercios de sus vecinos de los vecindarios del este de Los Angeles.

El sur y el este de Los Angeles tienen el más alto porcentaje de residentes latinos, 68% y 73,5% respectivamente. Estos dos distritos son el hogar de cerca de 2,3 millones de personas, muchos de ellos inmigrantes. También tienen altas tasas de pobreza. Las regiones centrales tienen poblaciones más diversas y mezcladas. Las áreas costeras tienen mayormente residentes blancos no-hispanos, quienes son más prósperos.

Las dos áreas más fuertemente latinas son particularmente vulnerables a los desastres. Tienen pocos servicios disponibles de manera regular, como cuidado de salud o tiendas de comidas. La geografía es otra razón: la falla de Newport Inglewood corre directamente debajo de ellos. Pero factores sociales pueden ser aún más importantes, de acuerdo con los Centros para el Control y Prevención de Enfermedades (CDC, por sus siglas en inglés).

Los CDC observan varios factores para determinar cuán bien un área podría soportar un desastre. Se halló que les iba peor a las comunidades con residentes de menor estatus socioeconómico, y a las minorías raciales y étnicas con limitado dominio del inglés.

Quién vive en el hogar también importa. Las familias con niños o adultos mayores, personas enfermas o discapacitadas, o las encabezadas por un solo padre tienen luchas más grandes. El tipo de vivienda (tales como edificios altos o construcciones más viejas), y el transporte, también pesan sobre el riesgo, dijeron los CDC.

Los angelinos en el sur y este de Los Angeles tienden a tener tasas más altas de enfermedades crónicas, menos educación e ingresos más bajos. Los hogares latinos a menudo son más grandes e incluyen parientes de todas las edades. Es fácil ver por qué el sur y este de LA están en mayor riesgo.

Tener una comunidad muy unida hace una diferencia. Las personas que comparten un sentido de pertenencia a su barrio tienen más probabilidades de sobrevivir. Y sus comunidades tienden a una recuperación más rápida después que golpea la tragedia.

Las agencias gubernamentales y las organizaciones de ayuda, como Red Cross, están trabajando para mejorar la preparación entre los angelinos, especialmente aquéllos en mayor riesgo. Ellos tienen programas para ayudar a construir conexiones con la comunidad y aumentar los recursos en los vecindarios latinos.

Por ejemplo, el Emergency Medical Services del condado de Los Angeles tiene un plan para desastres en todo el condado que incluye sistemas de comunicación en varios idiomas. También tienen insumos de emergencia almacenados en sitios seguros a lo largo del condado.

El capítulo de Los Angeles de la American Red Cross tiene un plan para desastres llamado

, que apunta a las comunidades vulnerables. “Para estar preparado, se necesitan cuatro cosas: un plan de emergencia, un kit, saber dónde conseguir información y estar involucrado en la comunidad”, dijo María Melo Bueno, gerenta de comunicaciones regional.

Prepare SoCAL trabaja con grupos de fe, escuelas, organizaciones sin fines de lucro y negocios que ya están en el vecindario. “Trabajar con grupos locales es importante porque hemos aprendido que después de una catástrofe, las personas primero buscan a alguien a quien conocen y en quien confían”, dijo Melo Bueno.

Red Cross también se comunica con los latinos a través de medios de comunicación en español, incluyendo Telemundo y Univision. Probablemente la radio sería la principal fuente de comunicación, ya que el 97% de los latinos escuchan radio cada semana.

Las escuelas son importantes para ayudar a los niños a estar preparados. “El mes pasado, completamos un en una escuela católica del este de Los Angeles”, dijo Melo Bueno. Los estudiantes recibieron lecciones sobre seguridad y fundas de almohadas para llenarlas con lo esencial, como agua, comida y una linterna.

Los hijos de Salgado aprendieron qué hacer en caso de un terremoto en la escuela. “Nos dijeron que debemos cubrirnos las cabezas”, dijo Benito, de 8 años, “… y tenemos Band-Aids”. Salgado está contento de que la escuela enseñara a sus hijos sobre terremotos; él quiere que estén seguros en caso que no esté allí.

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Though aware of the risks, less than half of the population is prepared for such emergencies.

Surveys show Hispanic communities are least prepared of all.

Only 38 percent of Latino households reported having a disaster plan, the lowest of any ethnic or racial group, according to the LA County Department of Public Health’s . In a county of 10 million people where 48 percent are Latinos, millions could be left in peril.

“We have water,” said Benito Salgado, when asked if his family was prepared. But that’s about it. Salgado immigrated from Mexico 11 years ago. His wife and their children, ages 6 and 8, do not have an emergency kit — nor do nearly two-thirds of their East LA neighbors.

South LA and East LA have the — 68 percent and 73.5 percent, respectively. Those two districts are home to nearly 2.3 million people, and many are immigrants. They also have high rates of poverty. The central regions have more diverse and co-mingled populations. have mostly white residents who are more prosperous.

The two most heavily Latino areas are particularly vulnerable to disasters. They have few regularly available services, such as health care and . Geography is another reason: the Newport-Inglewood Fault runs directly beneath them. But social factors may be even more important, according to the .

The CDC looks at several factors to determine how well an area might hold up during a disaster.

It found that communities with residents of lower social economic status, racial/ethnic minorities and limited English proficiency fare more poorly.

Who lives in the household also matters. Families with children, elderly, ill or disabled people, or ones led by a single parent, have bigger struggles. The type of housing (such as high-rises or older construction) and transportation also weigh on risk, the CDC said.

Angelenos in South and East LA tend to have higher rates of chronic illnesses, less education and lower incomes. Latino households are often large and include relatives of all ages. It’s easy to see why South and East LA are at higher risk.

Having a close-knit community makes a difference. People who share a sense of belonging to their neighborhood are more likely to survive. And, their communities tend to recovery more quickly after tragedy strikes.

Government agencies and relief organizations, such as the Red Cross, are working to improve readiness among Angelenos, especially those at highest risk. They have programs to help build community connections and increase resources in Latino neighborhoods.

For example, LA County’s Emergency Medical Services agency has a that includes communication systems in several languages. They also have emergency supplies stored in secure sites throughout the county.

The Los Angeles chapter of the American Red Cross has a disaster plan called that targets vulnerable communities. “To be prepared, four things are needed — an emergency plan, a kit, knowing where to get information and being involved in the community,” said Maria Melo Bueno, communications manager for the American Red Cross in Los Angeles.

Prepare SoCAL works with faith-based groups, schools, non-profits and businesses that are already in a neighborhood. “Working with local groups is important because we’ve learned that after a catastrophe, people first reach out to someone they know and trust,” said Melo Bueno.

The Red Cross also communicates with Latinos via Spanish-language media, including Telemundo and Univision. Radio will likely be the main source of information, since each week.

Schools are important for helping children get prepared. “Last month, we completed a in a Catholic school in East LA,” said Melo Bueno. School children are given safety lessons and pillowcases, donated by Disney. The kids can decorate the pillowcases and then fill them with essentials, such as water, food and a flashlight.

Salgado’s children learned in school what to do in case of an earthquake. “They told us to cover our head,” said 8-year-old Benito, “and we have Band-Aids.” Salgado is glad the school taught his kids about earthquakes. He wants them to be safe in case he’s not there.

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He is using a window of opportunity recently opened by the mass shooting in Orlando, Fla., to bring attention to the issue.

Wintemute, once named a “hero of medicine” by Time magazine, has led the at the University of California, Davis Medical Center for 25 years. Twenty years ago, the federal Centers for Disease Control and Prevention funding Wintemute’s program. He has since put up $1.3 million of his own money to keep it running.

Wintemute is one of the nation’s most prominent gun violence experts. He studies the problem from a public health perspective, using empirical research, and then proposes potential solutions based on his findings.

Wintemute’s projects are frequently controversial. His 1996 report on makers of “Saturday night specials” led California state legislators to ban the cheap handguns. Soon afterward, a firearms-manufacturer told him he had put a price on his head.

Wintemute also has proposed stripping the right to buy firearms from people convicted of violent misdemeanors — “a group sometimes referred to as not-so-law-abiding gun owners,” as he wrote in the 2013 book,

California has adopted this proposal, but the federal government has not. To make his case to U.S. policymakers, Wintemute cites data showing individuals with just one misdemeanor offense — a non-violent one, at that — are five times more likely than people with no criminal background to commit firearm-related or other violent crimes.

He also points out the inherent dangers in plea-bargain arrangements, which can knock a violent felony charge down to a lesser misdemeanor sentence — thereby allowing a released parolee to pass federal background checks to buy guns.

Because of Wintemute’s work and advocacy, extremists send e-mail threats. Gun show dealers circulated a photo of Wintemute, advising firearms salesmen to “forcibly” throw him out if they spotted him. At the time, Wintemute was touring 78 gun shows nationwide — a self-described “guerilla scientist” masquerading as a firearms dealer to collect material for his 2008 book,

Recently, Wintemute delivered a bold challenge to his fellow physicians. In a published in the Annals of Internal Medicine, he urged doctors to ask patients about their access to firearms, their knowledge of gun-safety, and injury prevention techniques. When posted a news story about it online, 700 comments flooded the site.

Wintemute sat down with California Healthline recently to discuss his life’s work and his reaction to the Orlando shooting.

Q: What was your first response upon learning that yet another mass shooting had occurred, this time in Orlando, killing or wounding 100 people?

My first thought is always about the pain and suffering that will forever be present for family members of those who lost their lives.

Q: Your next response?

I remind the public that deaths by mass shooting account for 1 percent of the people killed by firearms each year. Ninety people a day — day in and day out — die of gunshot wounds, suicides included.

Q: Were you surprised by the flood of opinions and comments that followed the publication last month of your research paper calling for physicians to ask their patients about guns?

I had no idea the proposal would be controversial. What I’d challenged physicians to do was to merely ask patients if they had access to firearms and if they knew how to handle them safely. After a detailed examination of federal and state government legislative language to discourage such lines of questioning, I found none actually outlawed such doctor-patient discussions. So, the paper detailed how physicians could go about structuring these conversations.

Q: Many experts consider gun violence to be a medical or criminal justice issue. Why should we view it through the lens of public health as you do?

Why wouldn’t it be a public health issue? David Satcher, head of the CDC 20 years ago, said, “If it’s not a public health issue, why are so many people dying?” There’s a war going on. Sandy Hook was a tipping point … People get angrier and angrier as this goes on. So we seek out data to identify who’s most likely to commit gun violence. I am an empiricist, a scientist driven by the evidence. This is the public health approach.

Q: What accounts for the increased frequency of mass shootings in the United States?

There are probably a half-dozen factors. There has always been hate in America. There’s alcohol and substance abuse. There’s despair, resentment over income equality. There’s more social distance among people. I’m convinced social distance is one of the reasons.

Q: Why is it important for policymakers to seriously consider the policy proposals you and your colleagues have drafted?

We are in dire need of policy overhaul in the United States. Experts, myself included, have closely studied and interpreted statistics showing alcohol abuse contributes to gun violence. In Orlando, witnesses said they saw the gunman drinking at the nightclub before leaving, only to return with his assault rifle and a revolver. Expanding policies that deny gun ownership to individuals with a record of alcohol-related offenses would likely lessen gun violence.

Q: After Orlando, the U.S. Senate again that would have tightened background checks and prohibited gun sales to people on a terrorism watch list. What do you make of that?

Some senators say the list has technical problems, is unreliable and possibly inaccurate. Fine. I say, make a better list.  The larger problem is that we’re forced in all cases to make group judgments on eligibility to purchase firearms (felons, domestic violence misdemeanants, etc.). There are members of all these high-risk groups who won’t commit future crimes. We don’t know in advance who will, and who won’t. The only option is to have a policy that applies evenly to all members of the group.

Q: California has some of the tightest gun control laws in the nation. The state Senate, in response to the San Bernardino terrorist shootings last December, recently approved 11 more such measures. What impact will these have on keeping firearms out of the hands of the wrong people?

We’ll have to see them enacted, and then see what their effects will be. Some are not directed at restricting access. (Editor’s note: This interview took place before the full California legislature Thursday and sent them to Gov. Jerry Brown).

Q: What has your research told you about which populations are most at risk of injury or death by firearms?

Who knew that gun violence is an old white guy problem? Two-thirds of gun violence deaths are suicides. Firearm suicides are going up nationwide. Ninety percent of them occur among middle-aged to older white men, especially in rural areas with lower incomes and higher opioid use.

Q: What were the circumstances surrounding your loss of funding from the Centers for Disease Control and Prevention?

From 1989 to 1996, we received CDC funding. Then, the CDC cut grants specifically for firearms violence. Our research funding, my salary, disappeared. using federal dollars for gun violence research. We turned to grants and private donors to close the gap. But there were still electric bills, gas bills and some staff salaries that research dollars would not cover. About 10 years ago, I decided the work we are doing here is really good and should be supported. I decided to keep the lights on myself and told staff, “You will be paid.” Over the years, I poured $1.3 million into the research program. I will continue.

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In an analysis presented Tuesday, the California Public Employees’ Retirement System’s staff lauded the goal of controlling prescription drug prices, but it warned of possible resistance — or even retaliation — by pharmaceutical companies.

The CalPERs staff also noted that implementation of the drug price proposition could unravel the whole purchasing and distribution network the agency has in place.

“The proponent’s intent to lower drug prices for certain Californians, such as CalPERS members, is very attractive and might possibly provide cost savings,” the staff report says. “However, passage and implementation of the Act would drastically change the current drug purchasing landscape and could result in unintended consequences.”

The CalPERS analysis echoes the findings and language of a May report by the state Legislative Analyst’s Office.

CalPERS’ interest in the ballot initiative, known as the Drug Price Relief Act, is not surprising since its members would benefit directly from any savings the proposal generates.

The agency is not only the largest public buyer of health care in California but the second largest in the nation after the federal government. Of the $8 billion CalPERS paid in health benefits last year for its 1.4 million covered members, about $1.8 billion went to buy prescription drugs, according to the agency.

CalPERS covers active and retired state, local government and school employees and their families.

In recent years, officials at the agency have blamed sharply escalating drug prices for its imposition of relatively high premium increases.

CalPERS expects rising health care expenses to remain a perennially thorny challenge well into the future. A draft of a five-year strategic plan for 2017 to 2022 already lists “increasing health and pharmacy costs” — under the heading “Threats, Obstacles and Impending Changes.”

This week, however, CalPERS unveiled its health plan rates for 2017, showing that members will face significantly lower increases than they did this year. A CalPERS spokesman attributed the moderating trend in part to the agency’s new pharmacy benefit manager, OptumRx, which he said is guaranteeing lower prices on brand name and generic drugs.

The Drug Price Relief Act, sponsored by Michael Weinstein, head of the AIDS Healthcare Foundation in Los Angeles, would curb rising drug costs by tying state agency spending on prescriptions to the lowest prices paid by the U.S. Department of Veteran Affairs. The VA uses the clout of volume purchases for millions of veterans to negotiate what are widely believed to be the best deals with drugmakers.

But here’s the rub: Those negotiations are confidential, and there is no guarantee the VA would share its price data with California state agencies. The VA does post prescription drug prices on a public website, but the CalPERS analysis casts doubt on whether those postings include all the drugs in the VA’s formulary.

The ballot initiative is intended to benefit nearly 5 million Californians, mostly Medi-Cal fee-for-service enrollees, public employees and retirees. It would not apply to the 10.3 million state residents enrolled in Medi-Cal managed care.

The debate is transpiring against a backdrop of sharply escalating prescription drug costs, which have angered consumers and become a hot button issue in a presidential election year.

Gilead, based in Northern California, grabbed headlines when it marketed Sovaldi, a hepatitis C drug, at $1,000 a pill — and $84,000 for a 12-week course of treatment.

Then, pharmaceutical entrepreneur Martin Shkreli infuriated lawmakers and the public when he bought a company called Turing Pharmaceuticals and jacked up the price of its AIDS-related drug Daraprim from $13.50 per pill to $750.

The report speculates that the initiative could provoke the ire of pharmaceutical companies, which have depicted doomsday scenarios if it passes.

One of those scenarios is the possibility that companies will raise prices on the VA, forcing California health programs to pay even more than they do now.

The report also expresses concern that pharmaceutical companies could make certain medically necessary drugs unavailable to the state.

Another route drugmakers could take, the report says, is to offset any concessions to the state by raising prices for private market health plans.

Garry South, lead strategist for the act’s proponents, said the fears highlighted in the CalPERS report are nothing more than surrender to the agenda of the drugmakers.

“Anything in life can have unintended consequences,” South said. “So all these hand-wringers are simply buying into the whole Pharma menu of threats in terms of how the industry would punish the state of California if the voters have the audacity to pass this measure.”

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