Unveiling Disparities in Pediatric Wildfire Preparedness: A Novel, Mixed-Methods Framework for Family Resilience.

Abstract

To uncover disparities and systemic barriers in pediatric wildfire preparedness across diverse households in a fire-prone community. This mixed-methods investigation employed 2 novel instruments, literacy-adapted surveys (n = 75) and semi-structured interviews (n = 9) to caregivers. Both tools were pilot tested prior to data gathering. Researchers recruited English- and Spanish-speaking adult (18 years and older) caregivers seeking care for their child in an urban pediatric emergency department. Analysis utilized multivariable regression, dual-independent interview transcript coding and thematic consensus, and convergent methodology. Three study-generated outcomes assessed household readiness, including wildfire item preparedness (WIP), wildfire action preparedness (WAP), and wildfire overall preparedness (WOP). WOP is summative and combines WIP and WAP. Half the households were not prepared for wildfires. Action preparedness (WAP: 18.6%) was less common than item (WIP: 80.6%). Caregivers with less education, younger age, and Hispanic/Latino ethnicity had significantly lower odds of completing readiness actions (WAP). Financial stressors were a major readiness barrier in both study arms. Four novel findings emerged: (1) home insurers represented an untapped opportunity for preparation; (2) renters experienced systematic barriers in home improvement; (3) diagnosis of a child chronic health condition significantly improved family readiness; and (4) caregivers believed schools lacked wildfire preparedness. This study reveals unique and urgent wildfire preparedness gaps and critical inequities that increasingly threaten children's health, safety, and resilience. These findings necessitate immediate, targeted actions that increase public access to low-cost smoke mitigation supplies, optimize renter safety, and strengthen school and community fire responses.