Public Health Imapcts of Hurricanes

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Public Health Impacts
of Hurricanes

LSU received many injured from Hurricane Katrina, and set up a field
hospital at the PMAC on the Baton Rouge campus (LSU Sept 2005)

Public Health Impacts of Hurricanes will vary depending on a number of factors. Initial threats from hurricanes which are most severe include drowning due to storm surge or rainfall flooding, with some additional risks from high winds and potential tornadoes.

Evaluating coastal areas (vs. inland areas) are an important factor in assessing risk, since this will determine extent of surge and some dampening of winds.

The exposed population, transportation/sheltering assets/success of evacuation, and access/success of emergency and rescue personnel to the affected area are also critical.

The city of New Orleans is unique in its hurricane public health risks, due mainly to its low elevation. Most coastal cities are at risk of coastal storm surge, but in New Orleans case, waters may overtop - or, as learned during Hurricane Katrina, breach the cities levees - and remain in the city for weeks.

Public Health Impacts from Hurricane Katrina have therefore been quite different from most modern hurricanes that have affected the US. These public health impacts are still being researched and studied; however, some initial information has been released. The HPHC final report will summarize hurricane public health information from Katrina and other hurricanes in Louisiana.

Public Health After Katrina's Rule
A presentation by the Louisiana State epidemiologist Dr. Raoult Ratard - Nov 2005

New Orleans residents line up to enter the Superdome to shelter-in-place for Hurricane Katrina (photo: wiki news 2005)

Louisiana DHH Emergency News
Deceased and missing victims information and health updates from Hurricane Katrina

CDC Hurricane Related Morbidity and Mortality Weekly Reports (MMWRs)
Reports discussing hurricane public health impacts

Shelter risks are higher for children under 5 years of age and for those who
are older, who may have compromised immune systems, including conditions such as diabetes, asthma, or other chronic medical conditions (e.g. heart disease) (photo: Florida DMAT 2005)

In summary, Hurricane Katrina resulted in over 1,450 deaths in Lousiana and hundreds more in Mississippi and other US states.

Many Louisiana residents are believed to have drowned, while chronic medical conditions such as heart disease or other serious medical conditions, storm injuries, or conditions such as lack of basic needs (overheating or dehydration), are also believed to have caused a significant number of deaths.

However, formal summaries on cause of death of Katrina victims have not been released.

Some cases are pending investigation, so these and other research assumptions cannot be verified or considered conclusive.

Among other illnesses and injury, hurricane victims in shelters and first responders were treated for chronic medical conditions, upper respiratory and gastrointestinal illnesses, skin rash, and mental health issues (CDC MMWRs 2005). Vibrio wound infections were rare following Hurricane Katrina, but did account for 5 deaths (CDC MMWR Sept 23 2005), while MRSA wound infections were identified in some shelter settings.

Emergency responders face serious public health risks when they go in to rescue stranded residents (photo: General Media 2004 Hurricane Jeanne)

While futher study is needed, early indications suggest that Hurricane Katrina may have disproportionately impacted residents who were older, those with lower-income, and/or potentially those with special needs or special evacuation or sheltering requirements.

More work is being done in these areas to better understand, account and plan for those at most risk during storms.

Summary statistics of Hurricane Katrina deaths in Louisiana show a positive
association between age and mortality for this event
(LA DHH deceased victims data)

According to recent reports, as of August 2007 - two years following Hurricane Katrina - only four of eight hospitals have been re-opened in the city of New Orleans. Even the four hospitals which are operating are doing so at decreased capacity (City of New Orleans, Aug 1, 2007). According to the same report, sixty percent of the staff at the New Orleans health department have been lost, with eight of thirteen clinics still closed. Meanwhile, over 75 percent of New Orleans residents are returning to the city (an estimated 300,000 people).

Other research has indicated an increase in mortality city-wide, as well as escalating problems with mental health related conditions. There is a decreased capacity to care for all the patients who need care, including the poor and uninsured who once depended on Charity Hospital (now closed), emergency care patients, and the increased number of residents who require mental health services following the disaster. Emergency responders in EMS and Police also share the burden, with much of their time and personnel resources being used to confront the problems caused by the lack of services.

For more information on hurricane public health hazards and mitigation strategies, please visit the following links:

Public Health Threats to Low-Lying Coastal Cities
HPHC Poster

Disasters & Emergencies - HHS

Health Effects of Disasters - PAHO

Public Health in the Aftermath of Disasters - E. Noji 2004

It is important to consider that fire risks are significant during floods and to plan accordingly if sheltering in place (photo: Washington Post 2005)