Hurricane Katrina affected a population with significant levels of chronic disease.
The extent to which Hurricane Katrina disrupted treatments is not known but would be useful information for future disaster planning.
1,043 displaced and nondisplaced English-speaking Katrina survivors ages 18 and older who resided in affected areas before the hurricane.
DESIGN AND SETTING
A geographically representative telephone survey conducted between January 19 and March 31, 2006.
MEASUREMENTS AND MAIN RESULTS
The proportions of survivors with chronic illnesses in the 12 months before the hurricane and the extent to which those with chronic illnesses cut back or terminated treatments because of the disaster. Correlates and reasons given by survivors for disrupted treatment were identified. Most (73.9%) Katrina survivors had 1 or more chronic conditions in the year before the hurricane; of these, 20.6% cut back or terminated their treatment because of the disaster. Disruptions in treatment were significantly more common among the non-elderly, uninsured, socially isolated, those with housing needs, or for conditions remaining relatively asymptomatic but still dangerous if untreated. Frequent reasons for disrupted care included problems accessing physicians (41.1%), medications (32.5%), insurance/financial means (29.3%), transportation (23.2%), or competing demands on time (10.9%).
Many Katrina survivors burdened by chronic disease had their treatments disrupted by the disaster. Future disaster management plans should anticipate and address such chronic care needs, with timely reestablishment of primary care services, access to medications, and means to address financial and structural barriers to treatment.
This is a preview of subscription content, access via your institution.
Buy single article
Instant access to the full article PDF.
Price excludes VAT (USA)
Tax calculation will be finalised during checkout.
U.S. Department of Homeland Security. Federal Emergency Management Agency. Available at: http://www.fema.gov. Accessed April 6, 2006.
Rosenbaum S. US health policy in the aftermath of Hurricane Katrina. JAMA. 2006;295:437–40.
Ahern M, Kovats RS, Wilkinson P, Few R, Matthies F. Global health impacts of floods: epidemiologic evidence. Epidemiol Rev. 2005;27:36–46.
Shultz JM, Russell J, Espinel Z. Epidemiology of tropical cyclones: the dynamics of disaster, disease, and development. Epidemiol Rev. 2005;27:21–35.
Centers for Disease Control and Prevention. Assessment of health-related needs after Hurricanes Katrina and Rita: Orleans and Jefferson Parishes, New Orleans area, Louisiana, October 17–22, 2005. Morb Mort Wkly Rep. 2005;55:38–41.
Centers for Disease Control and Prevention. Health concerns associated with mold in water-damaged homes after Hurricanes Katrina and Rita: New Orleans area, Louisiana, October 2005. Morb Mort Wkly Rep. 2005;55:41–4.
Centers for Disease Control and Prevention. Two cases of toxigenic vibrio cholerae 01 infection after Hurricanes Katrina and Rita: Louisiana, October 2005. Morb Mort Wkly Rep. 2005;55:31–2.
Centers for Disease Control and Prevention. Injury and illness surveillance in hospitals and acute-care facilities after Hurricanes Katrina and Rita: New Orleans area, Louisiana, September 25–October 15, 2005. Morb Mort Wkly Rep. 2005;55:35–8.
Centers for Disease Control and Prevention. Public health response to Hurricanes Katrina and Rita: Louisiana, 2005. Morb Mort Wkly Rep. 2005;55:29–30.
Centers for Disease Control and Prevention. Carbon monoxide poisoning after Hurricane Katrina: Alabama, Louisiana, and Mississippi, August–September 2005. Morb Mort Wkly Rep. 2005;54:996–8.
Centers for Disease Control and Prevention. Infectious disease and dermatologic conditions in evacuees and rescue workers after Hurricane Katrina: multiple states, August–September, 2005. Morb Mort Wkly Rep. 2005;54:961–4.
Greenough PG, Kirsch TD. Hurricane Katrina. Public health response-assessing needs. N Engl J Med. 2005;353:1544–6.
Mokdad AH, Mensah GA, Posner SF, Reed E, Simoes EJ, Engelgau MM. When chronic conditions become acute: prevention and control of chronic diseases and adverse health outcomes during natural disasters. Available at: http://www.cdc.gov/pcd/issues/2005/nov/05_0201.htm. Accessed April 7, 2006.
Charatan F. US government declares emergency after Hurricane Katrina. BMJ. 2005;331:531.
Zwillich T. Health care remains basic in New Orleans. Lancet. 2006;367:637–8.
Springgate B. Day five. Health Aff (Millwood). 2006;25:482–3.
Ferdinand KC. The Hurricane Katrina disaster: focus on the hypertensive patient. J Clin Hypertens (Greenwich). 2005;7:679–80.
Cefalu WT, Smith SR, Blonde L, Fonseca V. The Hurricane Katrina aftermath and its impact on diabetes care: observations from “ground zero”: lessons in disaster preparedness of people with diabetes. Diabetes Care. 2006;29:158–60.
Twombly R. Cancer community offers unprecedented support after hurricanes slam U.S. Gulf Coast. J Natl Cancer Inst. 2005;97:1716–8.
Centers for Disease Control and Prevention. National Center for Health Statistics. National Health Interview Survey (NHIS). Available at: http://www.cdc.gov/nchs/nhis.htm. Accessed April 11, 2006.
Knight M, Stewart-Brown S, Fletcher L. Estimating health needs: the impact of a checklist of conditions and quality of life measurement on health information derived from community surveys. J Public Health Med. 2001;23:179–86.
Edwards WS, Winn DM, Kurlantzick V, et al. Evaluation of national health interview survey diagnostic reporting. Vital Health Stat Ser 2. 1994:1–116.
Wolter K. Introducation to Variance Estimation New York, NY: Springer-Verlag; 1985.
National Center for Health Statistics. (U.S. Dept. Health and Human Services). Health, United States 2004. 2005.
Berkman L, Kawachi I. Social Epidemiology Oxford, England: Oxford University Press; 2000.
Brodie M, Weltzien E, Altman D, Blendon RJ, Benson JM. Experiences of Hurricane Katrina evacuees in Houston shelters: implications for future planning. Am J Public Health. 2006;96:1402:8.
Dewan S, Connelly M, Lehren A. Evacuees’ lives still upended seven months after hurricane. New York Times. March 22, 2006; 1.
Kaskutas LA, Weisner C, Caetano R. Predictors of help seeking among a longitudinal sample of the general population, 1984–1992. J Stud Alcohol. 1997;58:155–61.
Bennet G. Bristol floods 1968. Controlled survey of effects on health of local community disaster. BMJ. 1970;3:454–8.
Lorraine NSR. Canvey Island flood disaster, February, 1953. Med Off. 1954;91:59–62.
Spiegel P, Sheik M, Gotway-Crawford C, Salama P. Health programmes and policies associated with decreased mortality in displaced people in postemergency phase camps: a retrospective study. Lancet. 2002;360:1927–34.
van Meerveld J. The continuing anguish of a lucky evacuee. Health Aff (Millwood). 2006;25:489–90.
Noji EK. Disasters: introduction and state of the art. Epidemiol Rev. 2005;27:3–8.
Burkholder BT, Toole MJ. Evolution of complex disasters. Lancet. 1995;346:1012–5.
Centers for Disease Control and Prevention. Emergency preparedness and response: strategic national stockpile. Available at: http://www.bt.cdc.gov/stockpile/index.asp. Accessed April 11, 2006.
Nieburg P, Waldman RJ, Krumm DM. Hurricane Katrina. Evacuated populations—lessons from foreign refugee crises. N Engl J Med. 2005;353:1547–9.
Lambrew JM, Shalala DE. Federal health policy response to Hurricane Katrina: what it was and what it could have been. JAMA. 2006;296:1394–7.
Haslanger K. Radical simplification: disaster relief medicaid in New York City. Health Aff (Millwood). 2003;22:252–8.
Mileti D. Disasters by design: a reassessment of natural hazards in the United States Washington, DC: Joseph Henry Press; 1999.
The Writing Committee appreciates the helpful comments of the other Advisory Group scientific collaborators on an earlier version of the manuscript. Other helpful comments on the earlier draft were provided by Farris Tuma. A complete list of scientific collaborators, publications, and respondent oral histories can be found at: www.HurricaneKatrina.med.harvard.edu.
The Hurricane Katrina Community Advisory Group is supported by the National Institute of Mental Health (R01 MH070884-01A2), with supplemental support from the Federal Emergency Management Agency.
Potential Financial Conflicts of Interest
Dr. Kessler owns stock in the company that conducted the telephone interviews for the original survey. The other authors have no conflicts of interest.
This paper was prepared by a Writing Committee on behalf of the Hurricane Katrina Community Advisory Group. The Writing Committee (Philip S. Wang, M.D., Dr.P.H., National Institute of Mental Health, Division of Services and Intervention Research; David Kendrick, M.D., M.P.H., Center for IT Leadership at Partners HealthCare, Harvard Medical School; Nicole Lurie, M.D., M.S.P.H., RAND Corporation; Benjamin Springgate, M.D., M.P.H., UCLA, Geffen School of Medicine; and Ronald C. Kessler, Ph.D., Department of Health Care Policy, Harvard Medical School) assumes responsibility for the overall content and integrity of the manuscript.
About this article
Cite this article
The Hurricane Katrina Community Advisory Group., Kessler, R.C. Hurricane Katrina’s Impact on the Care of Survivors with Chronic Medical Conditions. J GEN INTERN MED 22, 1225–1230 (2007). https://doi.org/10.1007/s11606-007-0294-1