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January 22, 2009

Decline in Health Among Older Adults Affected by Hurricane Katrina

In the year following Hurricane Katrina, the health of survivors 65 and over declined nearly 4 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. Hurricane 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, ScD, lead author of the study and adjunct associate professor with the Bloomberg School’s Department of Health Policy and Management. “Morbidity rates among non-white Orleans residents were the highest when compared to other parishes and there was a significant increase in the prevalence of patients with cardiac diagnoses, congestive heart failure and sleep problems. 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.”

Researchers examined the managed care organization claims of 20,612 white and non-white 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, Inc. 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 believe displacement played a major role in health outcomes. Sixty-nine percent 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, DrPH, 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 disaster.”

“Health of Medicare Advantage Plan Enrollees at 1 Year After Hurricane Katrina” was written by Lynda C. Burton, Elizabeth A. Skinner, Lori Uscher-Pines, Richard Lieberman, Bruce Leff, Rebecca Clark, Qilu Yu, Klaus Lemke, and Jonathan P. Weiner.

The research was funded by Peoples Health.

Media contact for Johns Hopkins Bloomberg School of Public Health: Natalie Wood-Wright at 410-614-6029 or nwoodwri@jhsph.edu.