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Medium-Term Post-Katrina Health Sequelae

Medium-Term Post-Katrina Health Sequelae. Son Chae Kim PhD, RN Quynh Bui Gredig MSN, RN Ruth L. Plumb MSN, RN Larry Rankin PhD, RN Barbara Taylor PhD, RN. Pre-Katrina. High poverty levels: 2 nd worse state 12% unemployment rate: Twice national average 21% receive food stamps:

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Medium-Term Post-Katrina Health Sequelae

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  1. Medium-Term Post-Katrina Health Sequelae Son Chae Kim PhD, RN Quynh Bui Gredig MSN, RN Ruth L. Plumb MSN, RN Larry Rankin PhD, RN Barbara Taylor PhD, RN

  2. Pre-Katrina • High poverty levels: • 2nd worse state • 12% unemployment rate: • Twice national average • 21% receive food stamps: • Three times national average (Louisiana Department of Health and Hospitals, 2005) • 20% of Jefferson Parish eligible for Medicaid

  3. Hurricane Katrina August 29, 2005 The Christian Science Monitor, http://www.csmonitor.com/slideshows/katrina2/slide3.html

  4. Hurricane Rita September 24, 2005 Wikimedia Commons, http://commons.wikimedia.org/wiki/Image:Hurricane_Rita_200509240900-3-Day_Cone.gif Wikipedia, http://en.wikipedia.org/wiki/Hurricane_Katrina

  5. BackgroundShort-term Post-Katrina • 2 weeks post-Katrina: (Millin, et al. 2006) • >40% clinic visits for chronic illness management • 4 -8 Months Post-Katrina: (Weisler, et al., 2006) • Suicide rates ↑ X 3 • Murder rates ↑ 37% over pre-Katrina rates • 1 Year Post-Katrina: (Lambrew & Shalala, 2006) • Many hospitals remained closed, including Charity hospital

  6. Purpose • To describe medium-term effects on living environment, health status & healthcare access • To assess medium-term mental and physical health 15 months post-Katrina • To determine demographic, social & environmental factors that predict poor mental & physical health

  7. Method • Study Design: Cross sectional survey • Sampling: A convenience sample (N=222) • Inclusion Criteria: age 18yrs or older, currently living or working in the area, able to speak and understand English. • Study Duration: December 16 -18, 2006

  8. Method • Questionnaire: survey items were selected • Behavioral risk Factor Surveillance System (BRFSS) • MMWR Morbidity and Mortality Weekly Report • United States Department of Agriculture • Previous reports on disaster-related studies

  9. Method • Approved by PLNU IRB • Data collection • Data collector training • 6 teams of faculty, MSN, & BSN students • Door-to-door survey & Health Fair • Structured Interview Process • Data Analysis: • Descriptive Statistics • Multivariate Logistic Regression

  10. Participants Characteristics

  11. Descriptive Statistics • Living Environment • 27% living below poverty line • 15% difficulty accessing clean drinking water • 26% eating less than they should due to lack of money • 23% feeling unsafe from crime

  12. Descriptive Statistics • Healthcare Status • Healthcare Access

  13. Mental and Physical Health Diagnoses (N=222)

  14. Frequency of Poor Mental Health Days

  15. Multivariate Logistic Regression Model Predicting ≥ 1 Day of Poor Mental Health

  16. Frequency of Poor Physical Health Days

  17. Multivariate Logistic Regression Model Predicting ≥ 1 Day of Poor Physical Health (N=198)

  18. Conclusions • Fifteen months post-Katrina, the experience continues to affect the mental and physical health of New Orleans residents. • The rebuilding and reestablishment of basic needs and of accessible healthcare are continuing needs.

  19. Recommendations • Ongoing community assessments to identify issues with healthcare access and health related needs. • Partnering of the public health system and local communities to identify program development opportunities and interventions.

  20. References Brodie M, Weltzien E, Altman D, Blendon RJ & Benson JM (2006): Experiences of hurricane Katrina evacuees in Houston shelters: implications for future planning. American Journal of Public Health96, 1402-1408. Centers for Disease Control and Prevention (2006): Assessment of health-related needs after Hurricanes Katrina and Rita--Orleans and Jefferson Parishes, New Orleans area, Louisiana, October 17-22, 2005. MMWR Morbidity Mortality Weekly Report 55, 38-41. Lambrew JM & Shalala DE (2006): Federal health policy response to Hurricane Katrina: what it was and what it could have been. Journal of the American Medical Association 296, 1394-1397. Louisiana Department of Health and Hospitals, Office of Public Health, Policy, Planning, and Evaluation Section. (2005). 2005 Parish health profiles: A tool for community health planning. Retrieved May 14, 2007 from http://www.dhh.louisiana.gov/OPH/PHP%202005/Data/Jefferson/index.htm

  21. References Millin MG, Jenkins JL & Kirsch T (2006): A comparative analysis of two external health care disaster responses following Hurricane Katrina. Prehospital Emergency Care10, 451-456. Mills MA, Edmondson D & Park CL (2007): Trauma and stress response among Hurricane Katrina evacuees. American Journal of Public Health97 Suppl 1, S116-123. Weisler RH, Barbee JGt & Townsend MH (2006): Mental health and recovery in the Gulf Coast after Hurricanes Katrina and Rita. Journal of the American Medical Association 296, 585-588. Walker, B. & Warren, R. (2007). Katrina perspectives. Journal of Health Care for the Poor and Underserved. 18:233-240.

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