Katrina Evacuees Research Articles

Long‐term effects of Hurricane Katrina on the psychological well‐being of evacuees

Hurricane Katrina of August 2005 forced more than one million people to evacuate the Gulf Coast of the United States. This study examines the psychological health and well-being of a subset of evacuees to determine the prevalence of ongoing mental health problems. Interviews were conducted with 101 adults who evacuated to Louisville, Kentucky, and were living in the state at the one-year anniversary of the event or had recently returned to the Gulf Coast. The psychological health and well-being of respondents was evaluated using several well-validated measures. More than one-half met the criteria for post-traumatic stress disorder and a majority were suffering from depression and anxiety. The mean quality of life score was 0.6 on a scale from 0-1, suggesting that adaptation and return to pre-hurricane well-being had not occurred 12 months after the storm. The potential for long-term psychological damage exists in this sample of Hurricane Katrina evacuees. Results suggest other evacuees may also be at heightened risk.

Traffic Impacts and Dispersal Patterns on Secondary Roadways during Regional Evacuations

The evacuation of southeast Louisiana in the days prior to Hurricane Katrina represented the largest concentrated movement of traffic in the history of the state. Traffic data showed that nearly a half million vehicles, carrying an estimated one million people, flowed out of the New Orleans area before the storm. Since it was well recognized that evacuation traffic would overwhelm the available network capacity, Louisiana transportation and state police officials developed a plan to achieve a maximum utilization of the state's highest capacity evacuation routes. This paper differs from prior analyses by shifting the focus of attention from the impact of evacuation traffic on freeway and primary arterials to secondary and low volume roadways that have historically been underutilized during such emergencies. Analyses were conducted to determine how traffic was dispersed on the secondary roadway network, how long the impacts lasted, and where they were the most pronounced. The results suggest that many Katrina evacuees used roads in the secondary system as their primary routes of egress to far greater degrees than previously thought. They also indicate that secondary and low volume routes were also well used as alternatives to saturated interstate freeways and by evacuees seeking destinations not directly served by the primary highway network.

Patterns of substance use among Hurricane Katrina evacuees in Houston, Texas

This paper focuses on changing patterns of substance use among low income, African American drug users evacuated from New Orleans, Louisiana, during Hurricane Katrina of August 2005. It examines the relationship between increases and decreases in alcohol and tobacco (AT) use and illicit drug (ID) use after Katrina and pre-disaster and within-disaster factors. Data from structured interviews with 200 Katrina evacuees currently living in Houston were collected 8-14 months after the disaster. Multivariate analysis revealed that rises in AT use were positively associated with education. Females and younger evacuees were more likely to have increased AT use. ID use increase was positively associated with resource loss and leaving the city before Katrina. Decreases in AT and ID use were found to be associated with disaster-related exposure. The paper discusses the specific consequences of disasters on disadvantaged minority substance users and the importance of developing public health disaster policies that target this population.

Why Don't Coastal Residents Choose to Evacuate for Hurricanes?

A multinomial choice framework was used to analyze data from hypothetical storm forecast scenarios administered via mail survey to a random sample of U.S. Gulf Coast residents. Results indicate that the issuance of a mandatory evacuation notice and the presence of higher wind speeds had the largest influence on increasing the likelihood of evacuation. Age, race, disability, distance, and education were significant in explaining one's decision to wait relative to choosing to evacuate. Blacks and disabled individuals were strictly less likely to wait and more likely to make an immediate evacuation decision. Hurricane Katrina evacuees and those with an evacuation destination identified were also more likely to decide to evacuate, but were also more likely to wait before deciding. Results indicate that residents of mobile homes were more likely to either evacuate or wait before making a decision, but strictly less likely not to evacuate. Respondents very confident in being rescued were strictly more likely not to evacuate. Results indicate that not having an evacuation destination identified was the most influential factor regarding the likelihood of not knowing what choice to make.

Working with Local, State and Federal Partners to Address Health Education Needs of Hurricane Katrina evacuees in Houston

For health educators to successfully meet the challenges of responding to public health emergencies, it is important to establish and understand the role of collaborations with local, state and federal partners in identifying potential public health issues and to develop theory-based models or strategies to address these issues before, during and after an event. This paper presents a case study examining the health education and communication response to Hurricane Katrina in Houston, Texas. CDC's Health Education and Communication Teams and the Harris County Public Health and Environmental Services Division of Health Education worked with identified populations, environmental specialists, epidemiologists and other key partners to identify health education needs and develop appropriate messages and then developed and implemented a broad comprehensive health education and promotion plan. The paper discusses lessons learned and how health educators can use the model developed for this response to plan for future disasters and public health emergencies, including pandemic influenza.

Models of Location Choice and Willingness to Pay to Avoid Hurricane Risks for Hurricane Katrina Evacuees

We report on subjects’ perceptions of the risks of hurricanes and relocation decisions. Our sample contains individuals displaced by Hurricane Katrina or Rita in Gulf-coast areas, as well as a comparison group of people, not much affected by the hurricanes. Results are presented for two choice experiments, conducted immediately after the hurricane and again roughly one year later, in which we evaluate the trade-offs between given levels of risks and income, while controlling for amenities and other location characteristics. We find that perceptions of risk and damages fade, and willingness to pay to obtain protection falls over time.

"Operation Helping Hands": Massachusetts health and medical response to Hurricane Katrina.

As Hurricane Katrina bore down on New Orleans in August 2005, the city's mandatory evacuation prompted the exodus of an estimated 80% of its 485,000 residents. According to estimates from the US Centers for Disease Control and Prevention (CDC), at least 18 states subsequently hosted more than 200,000 evacuees. In this case study, "Operation Helping Hands" (OHH), the Massachusetts health and medical response in assisting Hurricane Katrina evacuees is described. Operation Helping Hands represents the largest medical response to evacuees in recent Massachusetts history. The data describing OHH were derived from a series of structured interviews conducted with two leading public health officials directing planning efforts, and a sample of first responders with oversight of operations at the evacuation site. Also, a literature review was conducted to identify similar experiences, common challenges, and lessons learned. Activities and services were provided in the following areas: (1) administration and management; (2) medical and mental health; (3) public health; and (4) social support. This study adds to the knowledge base for future evacuation and shelter planning, and presents a conceptual framework that could be used by other researchers and practitioners to describe the process and outcomes of similar operations. This study provides a description of the planning and implementation efforts of the largest medical evacuee experience in recent Massachusetts history, an effort that involved multiple agencies and partners. The conceptual framework can inform future evacuation and shelter initiatives at the state and national levels, and promotes the overarching public health goal of the highest attainable standard of health for all.

The Association Between Disaster-Related Experiences and Mental Health Outcomes Among Drug Using African American Hurricane Katrina Evacuees

This article provides a detailed examination of the relationship between disaster-related experiences and mental health outcomes among a sample of drug using African American Hurricane Katrina evacuees. Face-to-face structured interviews were administered to Hurricane Katrina evacuees (n = 350) residing in voucher assisted apartment complexes in Houston, Texas (2006-2007). We use Ordinary Least Squares and logistic regression models to examine both the relevance of disaster-related experiences and the interactive relationships between disaster-related experiences and post-disaster mental health outcomes including psychological distress, severe depression, somatic symptoms, and posttraumatic stress disorder. Results indicate that disaster-related experiences including negative life changes, disaster exposure, post-disaster stressors, and resource loss, have unique, inverse relationships with mental health. While resource loss has the strongest inverse relationship with mental health, disaster exposure has a negative interactive effect on psychological distress and anxiety. Although highly vulnerable populations report low levels of mental health nearly 2 years following a disaster experience, there is a convergence in mental health outcomes with high levels of disaster experiences and disaster exposure that suggests mental resiliency.

Factor structure of the acute stress disorder scale in a sample of Hurricane Katrina evacuees.

Acute stress disorder (ASD) is a poorly understood and controversial diagnosis (A. G. Harvey & R. A. Bryant, 2002). The present study used confirmatory factor analysis (CFA) to test the factor structure of the most widely used self-report measure of ASD, the Acute Stress Disorder Scale (R. A. Bryant, M. L. Moulds, & R. M. Guthrie, 2000), in a sample of Hurricane Katrina evacuees relocated to a Red Cross emergency shelter in Austin, Texas. Results indicated that the proposed 4-factor structure did not fit the data well. However, an alternate 2-factor model did fit the data well. This model included a second-order Distress factor (onto which the Reexperiencing, Arousal, and Avoidance factors loaded strongly) that was positively correlated with the Dissociation factor. Implications for the ASD construct and its measurement are discussed.

A tale of two studies of two disasters: Comparing psychosocial responses to disaster among Oklahoma City bombing survivors and Hurricane Katrina evacuees.

An accumulation of disaster mental health research literature in the last few decades has contributed knowledge to direct disaster mental health interventions. However, no single set of principles can necessarily outline all anticipated mental health needs to be encountered in a particular disaster. To illustrate how different disaster scenarios may yield a divergence of mental health needs, this article compares mental health findings from two distinctly different studies of two very different populations affected by two very different disasters: directly exposed survivors the Oklahoma City bombing and sheltered evacuees from Hurricane Katrina. Research on the two disasters reviewed illustrates many facets and complexities of postdisaster mental health needs in different populations in different settings after different types of disasters. The major findings of the Oklahoma City bombing study related to posttraumatic stress disorder and the main findings of the Hurricane Katrina study involved need for treatment of preexisting chronic mental health and substance abuse problems. The disaster studies in this review diverged in type of disaster, affected populations, setting, and timing of the study, and these studies yielded a divergence of findings. One disaster mental health model clearly cannot adequately describe all postdisaster scenarios.

False News Reports, Folk Devils, and the Role of Public Officials: Notes on the Social Construction of Law and Order in the Aftermath of Hurricane Katrina

In the immediate aftermath of Hurricane Katrina, rescue and evacuation efforts were slowed by rumors of extreme violence in the flooded city of New Orleans, including reports of rampant murder, systematic rape, and gangs of armed thugs taking control. Moreover, public officials solidified these rumors by presenting them as fact to reporters. In this article, we examine the contribution of public officials to false news reports. Drawing on the sociology of rumor, we argue that, in part, their descriptions of extreme violence served as rationalizations for organizational and institutional paralysis. We illustrate this “interest group” interpretation with official statements and show how it can shed additional light on the role of class and racial stereotypes, the stigma experienced by Katrina evacuees, and the evolution of the New Orleans chaos narrative. Implications for rumor control and disaster management are discussed.

The State and Civil Society Response to Disaster: The Challenge of Coordination

This article presents a case study of the reception of low-income Hurricane Katrina evacuees in Austin, Texas, to reveal the multiple barriers and problems faced by families and individuals dislodged by Katrina, as well as the difficulties faced by the service providers. The authors surveyed evacuees who had used the emergency shelter system and received housing assistance at least 10 weeks after the disaster. These survey data are supplemented with focus group and individual interviews with the city staff who conducted the survey, as well as interviews and participant observation with a range of service providers who assisted evacuees in the months following Katrina. Austin’s case managers were able to quickly organize and respond to evacuee families with an array of emergency services, including food and household goods. They also introduced new coordination efforts among agencies to distribute newly available Katrina funding. These efforts were aimed at both targeting emergency services and enhancing the capacity of case managers to help evacuees negotiate the complex maze of emergency and human services, particularly Federal Emergency Management Agency. Nevertheless, these coordination efforts were insufficient to address the problem of low-income urban evacuees living in indefinitely prolonged but possibly temporary circumstances.

Lessons Learned From the Deadly Sisters: Drug and Alcohol Treatment Disruption, and Consequences from Hurricanes Katrina and Rita

This paper reports on the effects of Hurricanes Katrina and Rita on drug and alcohol treatment in Texas in 2005–2006. Findings are based on a secondary analysis of administrative data on 567 hurricane-related admissions and on interview data from a sample of 20 staff in 11 treatment programs. Katrina evacuees differed from Rita clients in terms of demographics and primary problem substances and treatment needs, while the experiences of program staff and needed changes to improve disaster readiness were more similar. Additional systematic research is needed to document the intermediate and long-term impacts of the storms in these and other affected areas.

The Other Side of the Diaspora: Race, Threat, and the Social Psychology of Evacuee Reception in Predominantly White Communities

This article provides a social psychological framework for understanding the reception of Hurricane Katrina evacuees in predominantly White relocation communities. According to this framework, racial prejudice and perceptions of economic and social threat are likely to have an important influence on residents’ reactions to the evacuees. In the “Katrina in my Community Study,” the authors surveyed 532 residents from Colorado Springs, CO, Salt Lake City, UT, and San Antonio, TX—three cities that had African American populations well below the national average and that received large numbers of Katrina evacuees. The respondent’s evaluations of and judgments about the evacuees, including overall attitudes and support for continued assistance, were explained to a greater extent by perceived threat and prejudice than by their actual experiences with the evacuees. Thus, at least in predominantly White communities, race and subjective feelings of threat may frame decisions about helping newcomers to a community, even when need is salient.

Risk Perceptions, Race, and Hurricane Katrina

This study examined differences across race and income in responses to warning messages associated with Hurricane Katrina. Surveys were administered to Katrina evacuees who had been relocated throughout the country, investigating perceptions of the seriousness of the crisis, motivation to evacuate, and preparations for the storm. Results suggest differences between Whites and non-Whites along these lines. The findings are discussed in terms of their implications for considering race and poverty in audience responses to crisis messages, and the need to consider marginalized subpopulations in future crisis communication research.

After the Storm: How Race, Class, and Immigration Concerns Influenced Beliefs About the Katrina Evacuees*

Objective. In September 2005, approximately 150,000 Gulf Coast residents fled to Houston, Texas, seeking shelter following Hurricane Katrina. Since the majority of evacuees were poor African Americans, the political and social consequences of the storm inspired a national dialogue on race and class. However, in Houston, the discourse on Katrina evacuees also involved immigration concerns. The city's distinction as a gateway to new arrivals influenced the dialogue on the evacuees' impact on the local area. This article assesses the extent to which race, class, and immigration concerns influenced Houstonians' beliefs about the Katrina evacuees.Methods. We analyze data from the 2006 and 2008 Houston Area Survey in order to assess attitudes toward these newcomers at two distinct time periods: within six months of their arrival and then again more than two years later.Results. Our findings show that both national and local factors influenced beliefs about the Katrina evacuees.Conclusions. The dynamics of race/ethnicity and apprehension toward immigrants drove largely antagonistic beliefs about the mostly poor, mostly black new arrivals.

Exposure, avoidance, and PTSD among Hurricane Katrina evacuees.

This article describes an investigation into the relationship between exposure, avoidant coping, and posttraumatic stress disorder (PTSD) in Hurricane Katrina evacuees. Specifically, this study examines the unique contribution of the dose of exposure to variance in PTSD and provides a mediational analysis to deter mine the degree to which avoidant coping affects the relationship between exposure and PTSD. Findings reveal that the dose of exposure is a strong predictor of threshold-level PTSD at 1 year postdisaster and identifies avoidant coping strategies as a partial mediator between exposure and the development of PTSD. Identification of avoidant coping as a significant factor in the causal pathway between exposure and PTSD provides a clearly definable and specific target for clinical intervention.

Emerging Disease Syndromic Surveillance for Hurricane Katrina Evacuees Seeking Shelter in Houston's Astrodome and Reliant Park Complex

Transmission of infectious diseases became an immediate public health concern when approximately 27,000 New Orleans-area residents evacuated to Houston's Astrodome and Reliant Park Complex following Hurricane Katrina. This article presents a surveillance system that was rapidly developed and implemented for daily tracking of various symptoms in the evacuee population in the Astrodome "megashelter." This system successfully confirmed an outbreak of acute gastroenteritis and became a critical tool in monitoring the course of this outbreak.

Physical and Mental Health Status of Hurricane Katrina Evacuees in Houston in 2005 and 2006

Hurricane Katrina necessitated the evacuation of over 200,000 individuals into Houston. This study compared characteristics of three samples of evacuees with those of the U.S. population and examined how evacuees' experiences have changed over time. Sub-populations of evacuees in Houston were surveyed immediately following the hurricane, two months afterwards, and one year later. Demographic characteristics, socioeconomic status, physical and mental health status, and access to care of the most disadvantaged evacuees in Houston were analyzed. Predominantly, evacuees surveyed were Black, low-income, unemployed, and facing challenges accessing health care. Twenty-eight percent felt their health was worse than it was before Katrina. Almost 60% of evacuees reported nervousness, restlessness, worthlessness, hopelessness, and spells of terror or panic at least a few times a week. The evacuees displaced by the storm experienced loss of full-time employment, income, and deteriorating health, as well as struggles accessing necessary physical and mental health care.

Lessons Learned From Chicago's Emergency Response to Mass Evacuations Caused by Hurricane Katrina

We analyzed the response of the Chicago Department of Public Health with respect to its effectiveness in providing health care to Hurricane Katrina evacuees arriving in the city. Between September 12 and October 21, 2005, we conducted a real-time qualitative assessment of a medical unit in Chicago's Hurricane Victim Welcome and Relief Center. A semistructured guide was used to interview 33 emergency responders in an effort to identify key operational successes and failures. The medical unit functioned at a relatively high level, primarily as a result of the flexibility, creativity, and dedication of its staff and the presence of strong leadership. Chronic health care services and prescription refills were the most commonly mentioned services provided, and collaboration with a national pharmacy proved instrumental in reconstructing medication histories. The lack of a comprehensive and well-communicated emergency response plan resulted in several preventable inefficiencies. Our findings highlight the need for improved planning for care of evacuee populations after a major emergency event and the importance of ensuring continuity of care for the most vulnerable. We provide an emergency response preparedness checklist for local public health departments.