摘要：Children are the most prevalent vulnerable population in US society and have unique needs during the response to and recovery from public health emergencies. The physiological, behavioral, developmental, social, and mental health differences of children require specific attention in preparedness efforts. Despite often being more severely affected in disasters, children’s needs are historically underrepresented in preparedness. Since 2001, much progress has been made in addressing this disparity through better pediatric incorporation in preparedness planning from national to local levels. Innovative approaches, policies, and collaborations contribute to these advances. However, many gaps remain in the appropriate and proportional inclusion of children in planning for public health emergencies. Successful models of pediatric planning can be developed, evaluated, and widely disseminated to ensure that further progress can be achieved. Children younger than 18 years constitute approximately 25% of the US population and, as is often said, 100% of our future. In the context of disasters and public health emergencies, they are the most prevalent vulnerable population and have age-specific vulnerabilities that heighten their risks and magnify their unique needs during response and recovery. 1 These include physiological vulnerability to a variety of pathogens, toxins, radioactive isotopes, and harsh conditions. Increased skin permeability, faster metabolism, more active cell division, higher respiratory rate, and higher surface area–to–mass ratio can all contribute to greater susceptibility to physical threats. 1 Behavioral differences in children based on their stages of development, such as more hand-to-mouth contact, underdeveloped sense of self-preservation, more time spent outdoors and on the ground, and difficulty communicating symptoms, can make them more likely to be exposed to a hazard or less able to protect themselves from its effects. 2 Beyond this, children have substantially more daily person-to-person social contact than adults, making them especially vulnerable to contagious threats. 3 Children in disasters may develop mental health problems, including acute stress disorders, posttraumatic stress disorder, and depression. Children’s vulnerability can vary according to individual factors as well; some children live with disabilities or are dependent on medical technology, and more than 30% of all US children live below poverty levels. 4
