Abstract
BACKGROUND
Hurricane Katrina affected a population with significant levels of chronic disease.
OBJECTIVE
The extent to which Hurricane Katrina disrupted treatments is not known but would be useful information for future disaster planning.
PARTICIPANTS
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%).
CONCLUSIONS
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.
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Acknowledgments
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.
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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.
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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
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DOI: https://doi.org/10.1007/s11606-007-0294-1