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

3. Pre-Katrina  High poverty levels:  2 nd 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

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

5. Hurricane Rita September 24, 2005 Wikimedia Commons, http://commons.wikimedia.org/wiki/Image:Hurricane_Rita_20050924090 0-3-Day_Cone.gif http://commons.wikimedia.org/wiki/Image:Hurricane_Rita_20050924090 0-3-Day_Cone.gif http://commons.wikimedia.org/wiki/Image:Hurricane_Rita_20050924090 0-3-Day_Cone.gif Wikipedia, http://en.wikipedia.org/wiki/Hurricane_Katrina http://en.wikipedia.org/wiki/Hurricane_Katrina

6. Background Short-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

7. 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

8. 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

9. 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

10. 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

11. Participants Characteristics

12. 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

13. Descriptive Statistics  Healthcare Access  Healthcare Status

14. Mental and Physical Health Diagnoses (N=222) Diagnoses Pre-Katrina n (%) Post-Katrina n (%) Total n (%) Depression18 (8)29 (13)47 (21) Hypertension88 (40)10 (5)98 (44) Arthritis55 (25)5 (2)60 (27) Diabetes Mellitus24 (11)3 (1)27 (12) Angina14 (6)12 (5)26 (12) Asthma22 (10)2 (1)24 (11)

15. Frequency of Poor Mental Health Days

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

17. Frequency of Poor Physical Health Days

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

19. 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.

20. 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.

21. 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 Health 96, 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 http://www.dhh.louisiana.gov/OPH/PHP%202005/Data/Jefferson/index.htm

22. References Millin MG, Jenkins JL & Kirsch T (2006): A comparative analysis of two external health care disaster responses following Hurricane Katrina. Prehospital Emergency Care 10, 451-456. Mills MA, Edmondson D & Park CL (2007): Trauma and stress response among Hurricane Katrina evacuees. American Journal of Public Health 97 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.