Thousands of Gulf Coast families displaced in 2005 by Hurricanes Katrina
and Rita are the victims of an unprecedented epidemic of chronic medical
and mental health problems, yet are receiving little appropriate
care, reveals a report released 17 April 2006 from the Mailman School
of Public Health. “A year after Katrina, over half of the New
Orleans population has not returned—perhaps as many as three hundred
thousand people,” says principal investigator David Abramson, acting
director of research at the Columbia University National
Center for Disaster Preparedness. Many families still live in FEMA-subsidized
trailer parks.Even before the hurricanes hit, Louisiana and Mississippi ranked 50th and 49th
in the nation, respectively, in terms of overall health status, according
to the United Health Foundation’s America’s Health: State Health Rankings 2004. Today, post-hurricane reconstruction has hardly begun. With the loss
of hospitals, clinics, pharmacies, medical records, and (for many people) employer-subsidized
medical insurance, thousands of residents of what
was already one of the nation’s most medically underserved
regions could be facing serious long-term health consequences.Under the auspices of the Louisiana Child & Family Health Study, Abramson’s
team used multistage random sampling to select 820 households
from 14 FEMA-financed housing sites across Louisiana. More than
three-quarters of the households responded, representing 1,171 adults
and 488 children. Respondents were interviewed at their homes about
chronic medical conditions suffered by their family members, their children’s
emotional and behavioral status, their previous and current
access to health care services, medical insurance coverage, and
the family’s post-hurricane displacement history.Respondents had moved an average of 3.5 times—some as many as 9 times—with
the consequent loss of stability. Thirty-four percent
of the children had at least one diagnosed chronic medical condition, a
rate one-third higher than the general U.S. child population, with
asthma and developmental delays among the most-cited problems. Nearly
half the children who had a personal doctor before the hurricanes no
longer had one.Almost 50% of the parents said at least one of their children had
emotional or behavioral problems they did not have before they became
displaced. And the children aren’t alone: a standardized test
given at the time of the interview indicated that more than two-thirds
of the mothers interviewed may be suffering depression or anxiety
disorders.Though these families are in acute need of medical surveillance, access
to health care resources remains limited. According to a white paper
accompanying the report by the Children’s Health Fund, which lobbies
for comprehensive health care for all children, only 3 of 9 acute
care hospitals that existed in New Orleans before Katrina are now operating
at full capacity, and only 19 of 160 clinics remain open. Some 44% of
respondents had no medical insurance—about twice
as many as before Katrina. In addition, people who were earning above
the threshold for receiving Medicaid before Katrina hit were still
ineligible for that program since eligibility depends on the previous
year’s income.The white paper calls for Congress and President Bush to establish a “health
care Marshall Plan” to address the urgent needs
of displaced families. “National leaders need to be aware that
this is an unprecedented situation,” says Irwin Redlener, director
of the National Center for Disaster Preparedness and president of
the Children’s Health Fund. “There needs to be an emergency
effort to bring health care professionals to the Gulf region, to
rebuild hospitals, to get people’s medical conditions into
databases that can be used wherever they end up, to increase mental health
benefits under Medicaid, and to bring school-based health services
fully online.”Senator Susan Collins (R–Maine), chairwoman of the Senate committee
that investigated the government response to the Katrina disaster, says, “Nearly
a year after Hurricane Katrina, Gulf Coast residents
are still struggling to return to a sense of normalcy. It is extremely
important that the government do all that it can to help address
not just this immediate health crisis but all of the long-term needs
of those who survived this terrible natural disaster.”Adds Senator Mike Enzi (R–Wyoming), “We must build on the
private and public sector investments in New Orleans and the Gulf Coast, attracting
medical personnel as hospitals and health centers are
rebuilt, and give survivors the necessary and appropriate assistance
to reclaim their lives.”The authors plan to publish the full text of On the Edge: Children and Families Displaced by Hurricanes Katrina and
Rita Face a Looming Medical and Mental Health Crisis in a peer-reviewed journal. In the meantime, the report is available free
of charge by contacting Abramson at dma3@columbia.edu.