Skip directly to search Skip directly to A to Z list Skip directly to navigation Skip directly to site content Skip directly to page options
CDC Home

The Risk Communicator Newsletter

Risk communicator

Providing information and resources to help emergency risk communicators prepare and effectively respond in the event of a crisis.

Pan Flu Preparedness

A rural health department’s plan to communicate with the public

When the public’s health is threatened, either by an outbreak, natural disaster, or terror event, it can be difficult to predict the severity and duration of the threat. However, proper preparation at the local level can lessen its effects and help protect the public’s health.

Preparing the public for any hazard poses a tremendous challenge to health officials and risk  communicators.  This is particularly true of communicable disease threats and pandemics.  The Sierra County Health Department in California has devised a low cost, proactive, and easily-instituted way of communicating with its constituents during an emergency event.  At a subcommittee meeting of the pandemic influenza planning group, local EMS personnel suggested the idea of distributing color-coded door hangers to everyone in the county.

The hangers serve as a two-way communication tool during an outbreak.  Health officials use the hangers to distribute information regarding the outbreak to residents. Residents then hang a different color hanger on the front door to indicate the health status of those inside the home.

fireman police“The hangers serve our purpose of providing people in the county with health and safety information and meeting their needs without exposing our minimal pool of responders to a potentially contagious outbreak,” says Rhonda Grandi, Sierra County Health Department Public Health Educator and Emergency Preparedness Coordinator.

Three double-sided door hangers made of card stock are placed in a bag along with instructions on how to use the hangers and information about the potential outbreak.  Each side of the hanger is a different color, signifying the status of those inside the home for law enforcement on patrol.  In addition to the hangers, residents are provided with instructions on how to make a sanitizing agent to help prevent the spread of disease inside the home.

“The hangers come with instructions for residents.  If everyone is okay inside the home, then residents should display the green side on even days and the white side on odd days,” says Grandi.  Even and odd days are defined on the tags.

This method allows responders to know that everyone is healthy within a particular home on a day-to- day basis; because a resident has to consciously make the decision to display the correct color each day, responders can be confident that someone inside the house is well enough to do so.

“The yellow side is to say ‘I need something’ and it has an area to write what is needed.  If law enforcement sees yellow, they notify whatever agency would be responsible for fulfilling that need,” Grandi concludes. “The red side indicates that someone needs help or emergency medical assistance.”

The Sierra County Health Department collaborated with the sheriff and coroner to determine the appropriate language for the black hanger, which indicates that someone inside the home has passed away.  This was the most sensitive and difficult part of the process, but Grandi says that it was also the most crucial.  Preparing for all eventualities is a key component of any preparedness plan, and death is no exception.

One of the advantages of this system is that it costs relatively little to implement, which is a major benefit for local health departments working with a limited budget. “The cost was very minimal. It was just a matter of time, really. We made about 1,500 hangers to cover our county, and the only out-of-pocket cost was the card stock and printing,” says Grandi.

Grandi says this system might prove too labor-intensive and difficult to track if implemented in a major metro area.  However, in rural areas or areas with low density populations, the Sierra County Health Department’s door hanger system could serve as a low-cost model for local health departments looking for a low-tech way to communicate during a public health threat.

For more information on the project, please contact Rhonda Grandi.

If you have additional questions, please e-mail


Contact Us: - Prepare. Plan. Stay Informed. The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC-INFO

A-Z Index

  1. A
  2. B
  3. C
  4. D
  5. E
  6. F
  7. G
  8. H
  9. I
  10. J
  11. K
  12. L
  13. M
  14. N
  15. O
  16. P
  17. Q
  18. R
  19. S
  20. T
  21. U
  22. V
  23. W
  24. X
  25. Y
  26. Z
  27. #