Skip to main content
Top
Published in: Journal of General Internal Medicine 9/2007

01-09-2007 | Original Article

Hurricane Katrina’s Impact on the Care of Survivors with Chronic Medical Conditions

Authors: Ronald C. Kessler, Ph. D., The Hurricane Katrina Community Advisory Group

Published in: Journal of General Internal Medicine | Issue 9/2007

Login to get access

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.
Literature
2.
3.
go back to reference Ahern M, Kovats RS, Wilkinson P, Few R, Matthies F. Global health impacts of floods: epidemiologic evidence. Epidemiol Rev. 2005;27:36–46.PubMedCrossRef Ahern M, Kovats RS, Wilkinson P, Few R, Matthies F. Global health impacts of floods: epidemiologic evidence. Epidemiol Rev. 2005;27:36–46.PubMedCrossRef
4.
go back to reference Shultz JM, Russell J, Espinel Z. Epidemiology of tropical cyclones: the dynamics of disaster, disease, and development. Epidemiol Rev. 2005;27:21–35.PubMedCrossRef Shultz JM, Russell J, Espinel Z. Epidemiology of tropical cyclones: the dynamics of disaster, disease, and development. Epidemiol Rev. 2005;27:21–35.PubMedCrossRef
5.
go back to reference 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. 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.
6.
go back to reference 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. 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.
7.
go back to reference 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. Two cases of toxigenic vibrio cholerae 01 infection after Hurricanes Katrina and Rita: Louisiana, October 2005. Morb Mort Wkly Rep. 2005;55:31–2.
8.
go back to reference 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. 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.
9.
go back to reference 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. Public health response to Hurricanes Katrina and Rita: Louisiana, 2005. Morb Mort Wkly Rep. 2005;55:29–30.
10.
go back to reference 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. Carbon monoxide poisoning after Hurricane Katrina: Alabama, Louisiana, and Mississippi, August–September 2005. Morb Mort Wkly Rep. 2005;54:996–8.
11.
go back to reference 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. 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.
12.
go back to reference Greenough PG, Kirsch TD. Hurricane Katrina. Public health response-assessing needs. N Engl J Med. 2005;353:1544–6.PubMedCrossRef Greenough PG, Kirsch TD. Hurricane Katrina. Public health response-assessing needs. N Engl J Med. 2005;353:1544–6.PubMedCrossRef
14.
16.
go back to reference Springgate B. Day five. Health Aff (Millwood). 2006;25:482–3. Springgate B. Day five. Health Aff (Millwood). 2006;25:482–3.
17.
go back to reference Ferdinand KC. The Hurricane Katrina disaster: focus on the hypertensive patient. J Clin Hypertens (Greenwich). 2005;7:679–80.CrossRef Ferdinand KC. The Hurricane Katrina disaster: focus on the hypertensive patient. J Clin Hypertens (Greenwich). 2005;7:679–80.CrossRef
18.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
19.
go back to reference Twombly R. Cancer community offers unprecedented support after hurricanes slam U.S. Gulf Coast. J Natl Cancer Inst. 2005;97:1716–8.PubMedCrossRef Twombly R. Cancer community offers unprecedented support after hurricanes slam U.S. Gulf Coast. J Natl Cancer Inst. 2005;97:1716–8.PubMedCrossRef
21.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
22.
go back to reference Edwards WS, Winn DM, Kurlantzick V, et al. Evaluation of national health interview survey diagnostic reporting. Vital Health Stat Ser 2. 1994:1–116. Edwards WS, Winn DM, Kurlantzick V, et al. Evaluation of national health interview survey diagnostic reporting. Vital Health Stat Ser 2. 1994:1–116.
23.
go back to reference Wolter K. Introducation to Variance Estimation New York, NY: Springer-Verlag; 1985. Wolter K. Introducation to Variance Estimation New York, NY: Springer-Verlag; 1985.
24.
go back to reference National Center for Health Statistics. (U.S. Dept. Health and Human Services). Health, United States 2004. 2005. National Center for Health Statistics. (U.S. Dept. Health and Human Services). Health, United States 2004. 2005.
25.
go back to reference Berkman L, Kawachi I. Social Epidemiology Oxford, England: Oxford University Press; 2000. Berkman L, Kawachi I. Social Epidemiology Oxford, England: Oxford University Press; 2000.
26.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
27.
go back to reference Dewan S, Connelly M, Lehren A. Evacuees’ lives still upended seven months after hurricane. New York Times. March 22, 2006; 1. Dewan S, Connelly M, Lehren A. Evacuees’ lives still upended seven months after hurricane. New York Times. March 22, 2006; 1.
28.
go back to reference 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.PubMed 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.PubMed
29.
go back to reference Bennet G. Bristol floods 1968. Controlled survey of effects on health of local community disaster. BMJ. 1970;3:454–8.PubMedCrossRef Bennet G. Bristol floods 1968. Controlled survey of effects on health of local community disaster. BMJ. 1970;3:454–8.PubMedCrossRef
30.
go back to reference Lorraine NSR. Canvey Island flood disaster, February, 1953. Med Off. 1954;91:59–62. Lorraine NSR. Canvey Island flood disaster, February, 1953. Med Off. 1954;91:59–62.
31.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
32.
go back to reference van Meerveld J. The continuing anguish of a lucky evacuee. Health Aff (Millwood). 2006;25:489–90. van Meerveld J. The continuing anguish of a lucky evacuee. Health Aff (Millwood). 2006;25:489–90.
36.
go back to reference Nieburg P, Waldman RJ, Krumm DM. Hurricane Katrina. Evacuated populations—lessons from foreign refugee crises. N Engl J Med. 2005;353:1547–9.PubMedCrossRef Nieburg P, Waldman RJ, Krumm DM. Hurricane Katrina. Evacuated populations—lessons from foreign refugee crises. N Engl J Med. 2005;353:1547–9.PubMedCrossRef
37.
go back to reference 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.PubMedCrossRef 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.PubMedCrossRef
38.
go back to reference Haslanger K. Radical simplification: disaster relief medicaid in New York City. Health Aff (Millwood). 2003;22:252–8.CrossRef Haslanger K. Radical simplification: disaster relief medicaid in New York City. Health Aff (Millwood). 2003;22:252–8.CrossRef
39.
go back to reference Mileti D. Disasters by design: a reassessment of natural hazards in the United States Washington, DC: Joseph Henry Press; 1999. Mileti D. Disasters by design: a reassessment of natural hazards in the United States Washington, DC: Joseph Henry Press; 1999.
Metadata
Title
Hurricane Katrina’s Impact on the Care of Survivors with Chronic Medical Conditions
Authors
Ronald C. Kessler, Ph. D.
The Hurricane Katrina Community Advisory Group
Publication date
01-09-2007
Publisher
Springer-Verlag
Published in
Journal of General Internal Medicine / Issue 9/2007
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-007-0294-1

Other articles of this Issue 9/2007

Journal of General Internal Medicine 9/2007 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.