Are Families Ready for Disease X? Disparities in Household Outbreak Preparedness in a High-Density State in Malaysia

Abstract

Household preparedness for outbreaks, including those caused by novel threats, is an important component of disaster risk reduction. However, evidence from Malaysia remains limited. This study aimed to assess household preparedness for Disease X and outbreaks and identify the associated factors in a selected high-density state in Malaysia. A cross-sectional survey was conducted among 566 households using a validated questionnaire. Preparedness was assessed as a continuous score and examined using a preparedness matrix incorporating cognitive preparedness and preparedness behaviour.  The mean household outbreak preparedness score was 57.4 out of 100 (SD=16.8), indicating a moderate level of preparedness. In the multivariable general linear model, Indigenous Orang Asli respondents had lower preparedness scores than Malay respondents, while respondents with secondary education had higher preparedness scores than those with no formal education. Respondents residing at their current address for 4 to 6 years had lower preparedness scores than those residing there for 3 years and below. The preparedness matrix showed clustering in the Prepared and Aware quadrants, suggesting that cognitive preparedness may not always translate into preparedness behaviour. These findings indicate the need for community-based strategies that support households in translating preparedness knowledge into practical action, particularly among vulnerable and marginalised groups.

Keywords: household preparedness, outbreak preparedness, public health, survey, Malaysia