In the year following Hurricane Katrina, the health of
survivors 65 and older declined nearly
four times that of a national sample of older adults not
affected by the disaster, according to a study
led by researchers at the
Johns Hopkins Bloomberg School of Public Health.
The August 2005 storm was one of the most powerful and
deadliest hurricanes in U.S. history.
Katrina displaced thousands and severely disrupted access
to health care. Researchers monitored
enrollees of a New Orleans-area managed care organization
and found morbidity rates increased 12.6
percent compared with 3.4 percent nationwide. The results
are published in the January issue of The
American Journal of Managed Care.
"In the year following Hurricane Katrina, morbidity
rates increased substantially," said Lynda
Burton, lead author of the study and adjunct associate
professor in the Bloomberg School's
Department of Health Policy and Management. "Morbidity
rates among nonwhite Orleans residents
were the highest when compared to [those of] other
parishes, and there was a significant increase in
the prevalence of patients with cardiac diagnoses,
congestive heart failure and sleep problems," she
said. "Survivors displaced out of state experienced higher
morbidity rates than those not displaced.
In the month following the disaster, mortality spiked but
during the remainder of the year returned
to a level consistent with the previous year's."
Researchers examined the managed care organization
claims of 20,612 white and nonwhite
residents of Orleans, Jefferson, St. Tammany and
Plaquemines parishes who were over the age of 65
and enrolled in Peoples Health, a provider-owned managed
care organization. Burton, along with
colleagues from the Bloomberg School, Health Data
Essentials and the Johns Hopkins School of
Medicine, conducted an observational study to compare
mortality, morbidity and services used for one
year before and after Hurricane Katrina.
The researchers found that emergency department visits
increased 100 percent in the month
following Katrina, and by 21 percent over the next year
compared to the pre-Katrina year.
Hospitalization rates increased 66 percent in the first
month after Katrina and maintained an increase
of 23 percent over the ensuing year. Using a telephone
survey, the study also examined the health of a
random sample of enrollees after the hurricane. Researchers
said they believe displacement played a
major role in health outcomes. Sixty-nine percent of
respondents reported moderate or severe
damage to their home, or that their home was destroyed. At
the end of the year, 28 percent reported
their residence remained unlivable, and another 28 percent
reported a worse financial situation.
"The enormous health burden experienced by older
individuals and the disruptions in service
utilization reveal the long-term effects of Hurricane
Katrina on this vulnerable population," said
Jonathan Weiner, senior author of the study and director of
the Bloomberg School's PhD Program in
Health Services Research and Policy. "Although quick
rebuilding of the provider network may have
attenuated more severe health outcomes for this managed
care population, new policies must be
introduced to deal with the health consequences of a major
The study was written by Burton, Elizabeth A. Skinner,
Lori Uscher-Pines, Richard Lieberman,
Bruce Leff, Rebecca Clark, Qilu Yu, Klaus Lemke and
The research was funded by Peoples Health.