LSUHSC public health documents unmet health needs of Katrina-displacedNew Orleans– Working with Columbia University's Mailman School of Public Health, a group of students from LSU Health Sciences Center in New Orleans' School of Public Health found a host of under or untreated medical and mental health conditions affecting adults and children living in FEMA-subsidized housing units (trailers and hotel rooms) in Louisiana. On the Edge: Children and Families Displaced by Hurricanes Katrina and Rita Face a Looming Medical and Mental Health Crisis, released this week, reported that the loss of stability, health care providers, workplace, and community, has further complicated the overall health status of displaced residents, especially children.
The students were part of the survey teams who collected data from 665 randomly selected households from February 11-20, 2006. Virtually all the respondents in the study came from one of five Louisiana parishes – Orleans (65%), St. Bernard (11%), St. Tammany (10%), Jefferson (7%), and Plaquemines (4%). Fifty-eight percent of the respondents would like to return to their former neighborhoods, 30% would like to relocate elsewhere (including a number of respondents interested in purchasing their FEMA-subsidized travel trailers and then moving them elsewhere), and 11% were still unsure about their future plans.
Study participant LSUHSC public health student Toni Marie Jones said, "I didn't expect to walk the talk so soon. I thought I'd graduate and be eased into it, but that's not going to happen. If you're in public health in New Orleans now, the city needs you."
The purpose of the study was to provide information about the health and social service needs of people living in transitional housing. Not only is such information important to health care providers, but also to preparedness planners and policymakers.
LSUHSC School of Public Health Dean Dr. Elizabeth Fontham noted, "Not only are we using this unique teaching experience, we are helping to meet critical needs that will shape the short- and long-term health of New Orleans and Southeast Louisiana."
Among the key findings were:
- 34% of children living in FEMA-subsidized community settings have at least one diagnosed chronic medical condition, a rate one-third higher than that of the general pediatric population in the United States. Parents report high rates of asthma, behavioral problems, and learning disabilities.
- Nearly half the children who had a personal medical doctor before Katrina did not have one after the hurricane.
- A number of parents reported that they had a child who was either hospitalized or required repeated visits to the emergency room for acute asthmatic episodes because they could not get their child's asthmatic medications. The reasons cited included the loss of medical records, lack of insurance coverage accepted at local pharmacies, inability to get to pharmacies, and medical providers who would not prescribe the medications because they were unfamiliar with the child's past medical history. One parent noted that her child could not receive medications for ADHD and depression until the social worker had completed a 45-day evaluation period, again a consequence of lost medical records and discontinuous medical care.
- Over half of the female care givers scored at levels consistent with clinically-diagnosed psychiatric problems, such as depression or anxiety disorders. Children whose parents scored very low on this mental health score were two and a half times as likely to have experienced emotional or behavioral problems.
- Several parents and care givers reported difficulties finding appropriate and accessible mental health services. One parent, whose 6-year old was on an 18- month waiting list for psychiatric care, was told that she still needed a referral from her primary care physician even though he had relocated to Puerto Rico after the hurricane.
- 44% of the care givers surveyed reported that they did not have health insurance, although nearly half had at least one chronic medical condition. A number indicated that they had lost their insurance when they lost their jobs subsequent to the storm. 10% of children were uninsured.
- On average, households have moved 3.5 times since the hurricane, some as many as nine times, often across state lines. Each move involved various issues of resettlement, and a number of parents described lags in re-enrolling children at a new school with each move.
- Nearly half of parents and other care givers believe that their children are either never or only sometimes safe in their community, compared to 21% of care givers answering the same question in urban Louisiana pre-Katrina. 69% of care givers believed there were people in their current neighborhood who would be a bad influence on their children, compared to 52% of care givers pre-Katrina.
Among the conclusions are that four systems are key to improved future preparedness– access to care, availability of ongoing primary, mental health, and dental care, assurance of continuity of care, and the ability of schools to reach out and engage students and their families.
LSUHSC School of Public Health Associate Dean Stephanie Tortu concluded, "I hope this study helps people across the country understand the impact that this disaster has had on the health of the people of New Orleans."
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