Although numerous government, nonprofit, and relief organizations have endeavored to educate and prepare the American public for disasters, adults with physical, mental, and educational disabilities remain among the most vulnerable and least prepared subgroups of the population. The lack of alignment between the literacy demands of existing disaster preparedness and recovery materials and the literacy skills of many vulnerable subgroups limits their ability to understand and effectively use potentially life-saving information. We review the literature on literacy and vulnerable populations, propose a new model for disaster literacy, and describe opportunities for incorporating best practices into planning and preparedness activities. Disaster literacy is defined here as an individual's ability to read, understand, and use information to make informed decisions and follow instructions in the context of mitigating, preparing, responding, and recovering from a disaster. Recommendations are made for developing and evaluating disaster communication materials for vulnerable populations. To meet and improve the disaster literacy of vulnerable populations we suggest pilot-testing and evaluation be routinely used to inform selection of media type, message, and point of contact.

IMPORTANCE Nursing home residents are at heightened risk for morbidity and mortality following an exposure to a disaster such as a hurricane or the COVID19 pandemic. Previous research has shown that nursing home resident mortality related to disasters is frequently underreported. There is a need to better understand the consequences of disasters on nursing home residents and to differentiate vulnerability based on patient characteristics. OBJECTIVE To evaluate mortality and morbidity associated with exposure to Hurricane Irma, a Category 4 storm that made landfall on September 10, 2017, in Cudjoe Key, Florida, among short-stay (<90-day residence) and long-stay (Ն90-day residence) residents of nursing homes. DESIGN, SETTING, AND PARTICIPANTS Cohort study of Florida nursing home residents comparing residents exposed to Hurricane Irma in September 2017 to a control group of residents residing at the same nursing homes over the same time period in calendar year 2015. Data were analyzed from

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