Population Of New Orleans Research Articles

A Review of Mental Health Issues as a Result of Hurricane Katrina

<p>Hurricane Katrina was an unprecedented disaster in the United States, whose effects and consequences are ongoing. What is well known to those of us practicing psychiatry in this region is that Hurricane Katrina created diverse and serious mental health issues that have been among the greatest personal and professional challenges of our lives. This article is intended to review and explore these issues since Katrina’s landfall on August 29, 2005. We hope that our experiences can inform mental health professionals planning for or facing regional or national emergencies.</p> <H4>ABOUT THE AUTHORS</H4> <p>Mordecai N. Potash, MD, is Associate Professor of Clinical Psychiatry, Department of Psychiatry and Neurology, Tulane University School of Medicine. Daniel K. Winstead, MD, is Heath Professor and Chairman, Department of Psychiatry and Neurology, Tulane University School of Medicine.</p> <p>Address correspondence to: Mordecai N. Potash, MD, Tulane SOM Dept. of Psychiatry and Neurology, TB 48, 1440 Canal Street, 10th Floor, New Orleans, LA 70112-2715; or e-mail <a href="mailto:mpotash@tulane.edu">mpotash@tulane.edu</a>.</p> <p>Dr. Potash and Dr. Winstead have disclosed no relevant financial relationships.</p> <h4>EDUCATIONAL OBJECTIVES</H4> <ol><li>Review issues in mental health care arising in New Orleans since Hurricane Katrina’s landfall and how these issues can help mental health professionals plan for future regional or national emergencies.</li> <li>Discuss psychological stressors affecting first-responders during the first weeks and months after Hurricane Katrina and review findings of researchers studying mental health consequences in affected residents in New Orleans.</li> <li>Explain the consequences of the loss of mental health practitioners and facilities on the returning population of New Orleans and discuss responses of government officials to the loss of mental health services in New Orleans since Hurricane Katrina.</li></ol>

Constructing New Orleans, Constructing Race: A Population History of New Orleans

How do we understand the racial and ethnic recomposition of New Orleans's diminished population in the year following Hurricane Katrina? Optimists viewing the influx of Latino migrants see in it a revival of the multicultural past of New Orleans, while skeptics suspect that delays in government assistance for residents to return to the city are an attempt to keep out low-income blacks and make the city whiter and wealthier. The shifts in the population of New Orleans are familiar to sociologists and economists who study labor-market demand for low-skill, inexpensive, and flexible workers. The low-prestige jobs they do are reserved for those at the bottom of the social hierarchy, most often immigrants or members of stigmatized minorities.1 The sociodemographic characteristics of workers building and rebuilding the city shift only when social and market forces combine to make one group less expensive and more flexible than the other. I use this sociological insight to analyze New Orleans's population history and the way race has been socially constructed and reconstructed there.

Data Collection and Communications in the Public Health Response to a Disaster

Hurricanes Katrina and Rita crippled the ability of the local public health community to provide healthcare services to the population of New Orleans. Lack of information about the city's population size and health needs and the absence of an adequate communications system posed considerable obstacles to the coordination of local, state, and federal public health assets. Acting to relieve the information crisis, personnel from the Health and Human Services Branch of the city of New Orleans Emergency Operations Center designed a project to collect population-based data through field surveys. With technical assistance from the Centers for Disease Control and Prevention, the Health Branch conducted surveys between October 2005 and January 2006, the results of which were widely used throughout the recovery process. INFORMATION REPORTING: The Dashboard began as an internal reporting mechanism of the Centers for Disease Control and Prevention. The Health Branch assumed responsibility for the Dashboard and made it the key communication tool for the local healthcare community. The NOLA Dashboard Readership Survey identified the continued relevance and usefulness of the Dashboard almost 1 year after Katrina. Communicating the population-based data collected from the rapid population estimate surveys to disseminate results to the local healthcare community proved to be a vital link for informing the public health response to Hurricane Katrina.

Survival and Death in New Orleans: An Empirical Look at the Human Impact of Katrina

Hurricane Katrina has been interpreted as both a “metaphor” for the racial inequality that characterizes urban America and as a purely “natural” disaster that happened to strike a predominantly Black city. To resolve these conflicting interpretations, the author analyzes data on New Orleans residents who died during Katrina in an effort to provide an empirical look at the groups most directly affected by the hurricane. Contrary to prior reports in the popular press, the author finds that the impact of the storm was felt most acutely by the elderly population in New Orleans and by Blacks, who were much more likely to die than would be expected given their presence in the population. Data on the locations of recovered bodies also show that Katrina took its largest toll in New Orleans’s Black community. These findings confirm the impression that race was deeply implicated in the tragedy of Katrina.

Terri and Katrina: A Population-Based Perspective on the Constitutional Right to Reject Treatment

In 2005, two events garnered great national attention: the controversy over the death of Terri Schiavo and the destruction of New Orleans by Hurricane Katrina. Although each event was compelling and even tragic, only the former, which focused on whether a single individual would be removed from life support, was widely understood as implicating constitutional questions. Using a population-based perspective that is influenced by the discipline of epidemiology and focuses attention on both the interests of and the impact of law on populations, this Article analyzes why a controversy concerning the life and death of one woman was understood as raising questions of constitutional law while the failure to protect thousands was not viewed as such. The Article begins reviewing the courts' embrace of an individualistic right-to-reject treatment in cases such as Cruzan v. Director, Missouri Department of Health and contrasting that embrace with the Supreme Court's rejection, in cases such as DeShaney v. Winnebago County Department of Social Services, of any broad right to care and protection. Taken together, these cases demonstrate that contemporary constitutional law fails to appreciate the interdependency of risk and the social and population context in which health threats, and treatment decisions, arise. As a result, the rights vindicated in cases such as Cruzan and Schiavo are particularly shallow as they cannot provide either individuals or populations (such as that in New Orleans) with the opportunity to make meaningful risk-reducing choices. In addition, because of the influence of constitutional discourse in our society, the shallowness of constitutional rights spills over to influence political and legislative priorities. Hence, the fact that the population of New Orleans had no legally recognizable constitutional right to protection against hurricanes may have abetted the government's failure to protect the city's residents. Likewise, a constitutional discourse that focuses on the plight of a single woman while overlooking the multitude of problems faced by large populations may reinforce the political system's failure to protect populations from other potential natural disasters, such as a potential influenza pandemic.

Lead Prevention Knowledge Among Low-Income Urban Residents: The Chicago Lead Knowledge Test Revisited

ABSTRACTEfforts aimed at enhancing the knowledge of target populations constitute a widely used public health intervention strategy with the ultimate goal of improving health. However, integral to planning, implementing, and evaluating educational programs is identifying the knowledge base of the intended recipient. Improving health through educational interventions is a strategy commonly utilized in efforts to prevent childhood lead poisoning. However, few instruments have been validated for measuring lead knowledge, particularly among high-risk populations. We used factor analysis to evaluate the applicability of a previously developed lead knowledge assessment tool, the Chicago Lead Knowledge Test (CLKT), to a high-risk minority population in New Orleans and found that the structure of the CLKT did not accurately measure the knowledge of this population.

Irish Catholics and French Creoles: Ethnic Struggles within the Catholic Church in New Orleans, 1835–1920

At the funeral service for Archbishop James Hubert Blenk of New Orleans in 1917, Bishop John Edward Gunn of Natchez painted a grim picture of the state of Catholicism in this Latin city of the South: If anyone imagines the position of Archbishop of New Orleans to be a sinecure, let him explain why it is a proverb here that no Archbishop can survive ten years work .... Is it the worry? Is it the want of responsiveness? Is it the consciousness that in spite of a devoted clergy, of efficient educational advantages, the old Voltairianism still lingers...? Blenk, a native of Bavaria, Germany, had been Archbishop of New Orleans since 1905. In his funeral speech, Gunn had undoubtedly referred to Blenk's frustrated attempts to improve the standing of the Catholic Church in his diocese. These efforts had been beset by opposition and outright antagonism from both clergy and laity alike. Much to Blenk's humiliation, the Catholic population failed to respond to his appeals for a major seminary for New Orleans. His campaign to restore the crumbling St. Louis Cathedral also came to nothing. These constant setbacks may well have contributed to Blenk's untimely death from a heart attack in 1917 at the age of 61.1 Gunn was not the only contemporary observer who noted the widespread religious indifference of so much of the Catholic population of New Orleans. In 1916, in an unpublished manuscript entitled, Our Native Clergy, the Reverend Leo Gassler, the Swiss vicar general of the diocese, posed the question,Is Catholic Louisiana backwards in matters religious? Gassler argued that the Church in Louisiana was somehow less American than the Catholic Church elsewhere. Writing in 1916, two years after World War I had cut off the European supply of priests to the city, he lamented the inability of the diocese to produce its own native clergy. Gassler also noted that his clerical colleagues in the North often spoke disparagingly about Louisiana Catholicism. The Swiss prelate fully accepted their criticism and by way of explanation referred to the grim legacy of the French colonial heritage that still manifested itself. Under French rule the colonists had never provided for the Church, which had always relied on state and aristocratic philanthropy. In the Northern cities Gassler noted that persecution from without had stimulated the Church.' Interestingly, Gassler pointed to the lack of immigrants as a major reason for the backward state of Catholicism in his diocese. However, this view of New Orleans history needs to be questioned. New Orleans was hardly devoid of Catholic immigrants in its history. Indeed, during the four decades before the Civil War, it had drawn more immigrants through its port than any North American city except for New York. True, this immigration flow slowed dramatically from 1860 to 1880, but thereafter significant new immigration from Sicily, South America, and the Philippines added to the ranks of foreign-born Catholics in New Orleans. Clearly, what preoccupied Gassler was not so much the number of immigrants in New Orleans but their failure to have any great impact on the character of Catholicism in the city. This view of immigrant church relations seems paradoxical. One might assume that immigrants would hinder rather than enhance the development of an American Catholic Church. Yet, when one studies the history of American Catholicism on a national level, one cannot ignore the vital role played by immigrants, above all Irish immigrants, in transforming the Catholic Church in the United States into an American institution. But Gassler was correct: New Orleans was an anomaly. Somehow its nineteenth-century immigrants failed to seize control and transform the Catholic Church in New Orleans. Despite a heavy influx of Irish into the city in the mid-nineteenth century, they proved unable to push aside the French and Creole leaders of New Orleans Catholicism, in marked contrast to their victories elsewhere in the United States. …

Coronary heart disease in young black and white males in New Orleans: Community Pathology Study

The biracial population of New Orleans has a high overall mortality rate, high coronary heart disease (CHD) mortality rate, and high autopsy rate. In the New Orleans Community Pathology Study we investigated atherosclerosis and CHD in all deceased males aged 25 to 44 years, with major focus on the 52% of subjects from whom heart and arterial specimens were collected and evaluated according to standardized procedures. Morphologic correlates of CHD are the same in young black and white males. CHD mortality and mortality from cerebral hemorrhage, hypertensive heart disease, chronic renal disease, and diabetes are greater in young black males than young white males. Age, serum cholesterol, and hypertension were identified as important associated factors in the atherosclerotic process, as well as in CHD. The extent of coronary lesions seems to have decreased between 1960–1964 and 1969–1978 in young white males but not in blacks. Racial differences in coronary lesion involvement in non-CHD deaths are smaller than in our earlier studies.

Multiple sclerosis in New Orleans, Louisiana, and Winnipeg, Manitoba, Canada: Follow-up of a previous survey in New Orleans, and comparison between the patient populations in the two communities

A follow-up and re-evaluation of the 1951 epidemiologic survey of multiple sclerosis in New Orleans was conducted during 1964 and 1965. The purpose of this study was to reappraise all case reports of the previous survey in order to evaluate the degree of accuracy of the 1951 survey. Additional objectives of this investigation were to provide information on survivorship patterns and the natural history of multiple sclerosis in New Orleans and to establish a comparison with the corresponding aspects of the disease in Winnipeg, Manitoba, Canada where a similar study had been completed 2 yr before. All but one of the 69 patients examined in the previous survey were successfully traced in the follow-up study and their latest medical status was determined. Twenty-four of the 29 patients included in the 1951 survey as being in the group with “probable” multiple sclerosis were accepted as such in our follow-up study, and four in the “possible” and “unlikely” groups of the previous survey were reclassified to the “probable” group on the basis of our re-evaluation. An additional 31 patients, who in retrospect should have been eligible for the original study in 1951 but had not been examined then, usually because their condition had not yet been diagnosed, were also classified in the “probable” group in our study. Our revised total of patients in the “probable” group as of 1 Jan. 1951 was therefore 59, with a prevalence rate of 8.6 per 100,000 population. On the basis of our re-evaluation studies the ratio of prevalence rates in the two communities, which in the previous study had been computed at 6.6:1 (Winnipeg vs. New Orleans), is now estimated as about 4:1. For the “probable” group in our re-evaluation study in New Orleans, the female: male ratio was 1.2: 1, as compared to 2: 1 in Winnipeg. The estimated mean age at onset for all patients was 30 yr in New Orleans and 28 yr in Winnipeg. The rate of progression of the disease was similar in New Orleans and in Winnipeg, with the average duration of the disease estimated to be not less than 22 yr in New Orleans and 21 yr in Winnipeg. The average annual mortality rate in New Orleans was estimated as 0.23 per 100,000 population, and the Winnipeg: New Orleans ratio of mortality rates was estimated as 4: 1, which is the same as the ratio of prevalence in the two communities. The average annual incidence rate per 100,000 population in New Orleans was 0.45 for the 1940 through 1949 decade, and 0.39 for the 1950 through 1959 decade, the difference not being significant; the incidence rates for the same periods in Winnipeg were 1.6 and 1.5, respectively, with the Winnipeg: New Orleans ratio of incidence rates also close to 4: 1 for each decade. The prevalence of multiple sclerosis for metropolitan New Orleans was also determined as of 1 Jan. 1962. The number of patients in the “probable” group was estimated to be 83, with a prevalence rate of 9.6 per 100,000 population. The prevalence rate per 100,000 population in Winnipeg was 35.4 in 1960, and the Winnipeg: New Orleans ratio of prevalence rates remains close to the 4: 1 observed for 1951. In conclusion, our study reinforces the previous notion of a north-south difference in the frequency of multiple sclerosis, while it lends support to the impression that the natural history of multiple sclerosis in a southern community is essentially similar to that in a northern one. Although the explanation for the geographic variation in the distribution of multiple sclerosis is still not clear, the formulation of future etiologic hypotheses would be facilitated by a more exact determination of the distribution pattern of the disease throughout the United States. Further studies would therefore be needed. These could be less complex and still comparable for statistical purposes, by limiting the surveys to a critical review of hospital records only, in a large number of communities in the United States.

Intestinal Parasite Infections of the Ambulatory White Clinic Population of New Orleans 1

Summary 1. Data are presented on the intestinal parasites of a sampling of the ambulatory white clinic population resident in the metropolitan area of New Orleans, comprising 4,270 individuals over a period of five years (1929–1935). 2. The rates for all of the parasites found have been analyzed by age groups, by geographical subdivisions and by year periods. These rates are presented in tabular form (table 1) and have been considered briefly ad seriatim in the body of the communication. 3. Statistically Endamoeba histolytica, E. coli, Endolimax nana and Giardia lamblia are important protozoan infections while Ascaris lumbricoides and Trichocephalus trichiurus constitute large blocs of the helminthic infections. Clinically E. histolytica, Ascaris lumbricoides and possibly Giardia lamblia are important. 4. Especial analysis is presented of the rate of intestinal parasite infections in childhood (1 to 10 years) in the New Orleans area. 5. Because of the differences in technics, the varied types of populations surveyed by different investigators and different personal equations involved, it has not seemed advisable to compare our data with those elsewhere. Our data are believed to be fairly representative of a relatively homogeneous population which constitutes approximately the lower two–fifths of the economic strata of the white population of the city and its immediate environs. 6. The weighted averages for the infections encountered in our survey have been compared with theoretical standardized rates, computed by using the 1930 age distribution of the Louisiana population. In infections which accumulate with age the standardized averages are much higher; in those which are particularly heavy in childhood the standardized averages are appreciably lower.