Evaluation of the American Red Cross Disaster-Related Mortality Surveillance System Using Hurricane Ike Data—Texas 2008

Abstract

To evaluate key attributes, strengths, and limitations of the American Red Cross (ARC) disaster-related mortality surveillance system implemented during Hurricane Ike in Texas 2008, and to provide recommendations for system improvement. We evaluated key attributes of the ARC mortality surveillance system. Evaluation included interviews with stakeholders and linking ARC data with the Texas Department of State Health Services’ (DSHS) system for comparison. During September 11 through October 6, 2008, the ARC identified 38 deaths, whereas DSHS identified 74 deaths related to Hurricane Ike (sensitivity = 47%; positive predictive value = 92%). The ARC had complete data on 61% to 92% of deaths, and an 83% to 97% concordance was observed between the 2 systems for key variables. The ARC surveillance system is simple, flexible, and stable. We recommend establishing written guidelines to improve data quality and representativeness. As an important supporting agency in disaster situations and the sole source of data regarding disaster-related mortality in multiple states, improvement of the ARC system will benefit stakeholders and promote dissemination of useful information for preventing future deaths.