Resilience and Hurricane Katrina

Clinical Epidemiological Data from Hurricane Katrina

The National Oceanic and Atmospheric Administration (NOAA) documented a chronology, climacteric, and description of impacts, storm surge, rainfall data, and other contributing data associated with Hurricane Katrina. NOAA's report describes Hurricane Katrina as one of the most costly natural disasters ever to strike the United States and the deadliest in more than 75 years. The flooding of New Orleans and surrounding areas following Hurricane Katrina was called catastrophic. NOAA states that the results of the flooding caused the displacement of more than 250,000 people, a higher number than during the Dust Bowl years of the 1930s. By early August 2006, the death toll was reported to exceed 1,800 and total damages and related costs were estimated to be around $125 billion. Hurricane Katrina has had a long-lasting effect on the eastern and central portions of the Gulf of Mexico. The storm passed, but the damage remained, and 6 years later has not totally been mitigated.

In October 2005, to identify health-related needs among returning parish residents, the Centers for Disease Control and Prevention (CDC), along with state and local public health and mental health agencies, conducted an assessment of living conditions, access to basic services, and physical and mental health status. Approximately 7 weeks after Hurricane Katrina made landfall, 20.2% of housing units lacked water, 24.5% had no electricity, 43.2% had no telephone service, and 55.7% of households contained one or more members with a chronic health condition. In addition, 49.8% of adults exhibited levels of emotional distress, indicating a potential need for mental health services. As a result of these findings, and in an attempt to maintain resilience and mitigate further emotional suffering and psychological trauma, the Louisiana Office of Mental Health established a crisis-counseling program to provide interventions and support to hurricane survivors. Community assessments after natural disasters can identify health-related needs and guide public health interventions. In addition, the U.S. Public Health Service (PHS), Substance Abuse Mental Health Services Administration (SAMHSA), Louisiana State University, and Catholic Charities established temporary health and mental facilities.

Karen DeSalvo and colleagues conducted a web-based survey of Tulane University employees, 6 months after Hurricane Katrina struck. The researchers found a prevalence rate of posttraumatic stress disorder symptoms of 19.2%. DeSalvo noted that predictors of PTSD symptoms included being female, being non-Black race, having personal knowledge of someone who died in the storm, having a lack of property insurance, having evacuated further after the hurricane, and having a significantly longer commute to work than before Hurricane Katrina. Tulane employees had universal health coverage and the benefits of an employee assistance program. But, only 28.5% of those with PTSD symptoms, and 13.4% of those without symptoms consistent with PTSD used available mental health resources. DeSalvo also noted that there was a positive correlation between becoming symptomatic and the loss of one's pre-Katrina residence. This suggests the need to focus resources and clinical interventions on those individuals living in temporary housing. These data need to be compared with the 1-year period prevalence of PTSD in U.S. adults of 3.6% with the wide range of point prevalence being cited in the literature, which varies from 5% to 60%. DeSalvo makes an important distinction between the consequences of Hurricane Katrina and other point source exposure events. The posthurricane difficulties for those affected, especially those who lost their homes and employment, extended well beyond the acute phase of the storm's passing overhead.

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