This is an interesting study by the folks at Columbia University:
Families displaced by Hurricane Katrina are suffering from mental disorders and chronic conditions like asthma and from a lack of prescription medication and health insurance at rates that are much higher than average, a new study has found.
The study, conducted by the Mailman School of Public Health at Columbia University and the Children’s Health Fund, is the first to examine the health issues of those living in housing provided by the Federal Emergency Management Agency. Based on face-to-face interviews with more than 650 families living in trailers or hotels, it provides a grim portrait of the hurricane’s effects on some of the poorest victims, showing gaps in the tattered safety net pieced together from government and private efforts.
Among the study’s findings: 34 percent of displaced children suffer from conditions like asthma, anxiety and behavioral problems, compared with 25 percent of children in urban Louisiana before the storm. Fourteen percent of them went without prescribed medication at some point during the three months before the survey, which was conducted in February, compared with 2 percent before the hurricane.
While I can understand the missing prescribed medication at some point (I could not figure out whether they just had to miss one dose of medicine to qualify as going without- if they missed once during the hurricane, that could count as going without, so the numbers may be inflated), but what is intriguing is the higher incidence of asthma. My gut instinct is that the Hurricane and the displacement did not cause the asthma, etc., but rather these were chronically poor who were simply never diagnosed, and during the course of the Hurricane and the rescue operations and aftermath, were finally given basic health care and diagnosed for the first time. Therefore, I am unsure if this is more of a commentary on the status of health care for the urban poor than it is the on the rescue efforts and the aftermath.
Your thoughts?
Mac Buckets
Bush’s fault.
Mr Furious
I think your athsma hypothesis is right on. This is likely a case of poor kids going undiagnosed and getting some health care.
Anxiety and behavioral problems seem more likely to be connected to the upheaval of essentially being refugees.
Mr Furious
No, not Bush’s fault. But it is indicitive of the crock of shit that poses as “the world’s best health care system” as he likes to call it…
Aaron Adams
FEMA travel trailers are constructed with materials which give off formaldehyde fumes. Because FEMA travel trailers are located in a region which has since the storm been experiencing record heat and because many FEMA travel trailer occupants can be expected to close all the doors and windows and run the air conditioner it can be expected noxious fumes may be concentrated.
Add to the above this fact: once one steps out of their FEMA travel trailer one is likely subject to considerable particulate laden air (dust created by a mix of drive Katrina muck, dry weather and constant traffic from heavy equipment and trucks hauling debris) – it is not hard to imagine the elements described above being as sort of recipe for respiratory complaints of all types being a significant part of post-Katrina life in the disaster areas.
PS: I live in a FEMA travel trailer in Pass Christian, MS.
Joel
“I am unsure if this is more of a commentary on the status of health care for the urban poor than it is the on the rescue efforts and the aftermath.”
The Columbia study gave no comparison between the plight of the refugees now versus what their health was like before Katrina. Undoubtedly because we have no data on what their health was like before. They weren’t getting health care before.
I agree, this isn’t Bush’s fault, though it is certainly fair to blame him for pretending that our health care system is great.
stickler
Keep in mind, too, that the incidence of asthma among poor urban kids has skyrocketed in the last couple of decades, for reasons that still remain unclear. It’s not like air pollution is uniformly worse today than it was in 1970.
Better diagnosis might be part of the problem (especially with these kids), but something else is also going on.
Faux News
The poor of New Orleans were getting health care before Katrina. It was at Charity Hospital, which was badly damaged by the flood and will probably never re-open.
Safety net
“Charity Hospital is such a critical component of New Orleans’ health care because it serves one of the nation’s largest metropolitan concentrations of the poor and uninsured. Louisiana ranks fifth in the country in the percentage of its population without health insurance; its poverty rate is the fourth worst in the nation. In New Orleans, 22% of the residents have no insurance and just over half of the city’s adults get health insurance through their work. (Many of the city’s jobs are in the relatively low-paying tourism and service industries.)
Add the fact that there is no effective system for delivering primary care throughout the neighborhoods, and it is not surprising that the “underlying health status indicators here are terrible,” said Kenneth Thorpe, PhD, of Tulane University’s Institute for Health Services Research. A 1998 report published by the state identified Louisiana as 48th in the country based on various health indicators, including higher-than-expected rates of cancer, diabetes and infant mortality.
Health care officials are quick to point out that without Big Charity, those numbers would be worse. “We need to maintain a public hospital system because we have such a large number of indigent patients in Louisiana,” explained Dwayne A. Thomas, FACP, Charity Hospital’s medical director.”
Safety net
Charity Hospital is such a critical component of New Orleans’ health care because it serves one of the nation’s largest metropolitan concentrations of the poor and uninsured. Louisiana ranks fifth in the country in the percentage of its population without health insurance; its poverty rate is the fourth worst in the nation. In New Orleans, 22% of the residents have no insurance and just over half of the city’s adults get health insurance through their work. (Many of the city’s jobs are in the relatively low-paying tourism and service industries.)
Add the fact that there is no effective system for delivering primary care throughout the neighborhoods, and it is not surprising that the “underlying health status indicators here are terrible,” said Kenneth Thorpe, PhD, of Tulane University’s Institute for Health Services Research. A 1998 report published by the state identified Louisiana as 48th in the country based on various health indicators, including higher-than-expected rates of cancer, diabetes and infant mortality.
Health care officials are quick to point out that without Big Charity, those numbers would be worse. “We need to maintain a public hospital system because we have such a large number of indigent patients in Louisiana,” explained Dwayne A. Thomas, FACP, Charity Hospital’s medical director.
Safety net
Charity Hospital is such a critical component of New Orleans’ health care because it serves one of the nation’s largest metropolitan concentrations of the poor and uninsured. Louisiana ranks fifth in the country in the percentage of its population without health insurance; its poverty rate is the fourth worst in the nation. In New Orleans, 22% of the residents have no insurance and just over half of the city’s adults get health insurance through their work. (Many of the city’s jobs are in the relatively low-paying tourism and service industries.)
Add the fact that there is no effective system for delivering primary care throughout the neighborhoods, and it is not surprising that the “underlying health status indicators here are terrible,” said Kenneth Thorpe, PhD, of Tulane University’s Institute for Health Services Research. A 1998 report published by the state identified Louisiana as 48th in the country based on various health indicators, including higher-than-expected rates of cancer, diabetes and infant mortality.
Health care officials are quick to point out that without Big Charity, those numbers would be worse. “We need to maintain a public hospital system because we have such a large number of indigent patients in Louisiana,” explained Dwayne A. Thomas, FACP, Charity Hospital’s medical director.
Faux News
Sorry for the repeat in my last post. Not enough coffee today :-(
Ryan S
We’ll I can tell you never had asthma. My two biggest triggers for my asthma were, a new environment (like a hotel room or worse spending the night at a friends house), and stress.
So I can see how a person, under normal circumstances, might not even be diagnosed, but after a disaster, could start show symptoms.
Dantheman
In addition, asthma is frequently made worse by exposure to mold. Living for days in conditions ideal for the growth of mold could easily have created such an outbreak.
DougJ
Well, the important thing is that that they’re going to be getting to use that terrific Ignite! software from Neil Bush’s company. Cough or no cough, they’ll all be acing their exams in no time.
Mr Furious
Yeah, I wondered about the hotel room/FEMA trailer environment factor… I don’t really know much about asthma…
Is a new environment a potential trigger just because it’s different? Even if condiditions at home might be worse?
EL
The PDF of the original study is here. I’m skimming it, but some relevant quotes:
I’d take from this that these children had been diagnosed, had ongoing medical care, and have lost access to ongoing medical care. (I recognize the care may be available, but too many barriers of cost, transportation, etc., and it might as well not be there.)
They definitely do not mean one skipped dose. Especially for asthma, where most of the “controllers” are fairly long acting, one dose wouldn’t be significant. I don’t have a reference handy, but many studies don’t expect 100% compliance with everyday meds. I recall one study that defined “compliance” as patients taking 90% of their meds in a long term (6 month) study.
Ryan S
For me at least it would take at least a year sometimes longer to adjust to a new living environment. Every house has a differing kinds and amount of dust, mold spores, and various allergen ‘cocktails’. For instance I used to be horribly alergic to book mold, more than anything else, and if i walked into a a house with a lot of old books I would be miserable within a matter of seconds. Luckily, I grew out of most of my allergies, still very alergic to book mold and certain pine trees.
And if I were them I wouldn’t go back. That nasty black mold would prolly kill me, without a inhaler even now.
Ryan S
Man, I can’t type today. Too many a’s.
The Other Steve
25% of children in urban Louisiana have Asthma before the storm?
I can count on my fingers the number of kids I knew who had Asthma and had to use an inhaler while I was growing up.
I don’t understand that statistic. That just seems incredibly high.
Krista
The Other Steve – asthma rates in kids have skyrocketed since we were little, however, as stickler said upthread. It does seem awfully high, but hey, so do the obesity rates amongst children, and they’re real enough.
KC
I think John’s probably got it right, but we’ll see.
LITBMueller
Your analysis does seem logical, John, and perhaps correct. Assuming it is, though, when you take your sentence:
…and combine it with this:
…that’s still a pretty big indictment of how we treat our citizens. Too bad it took a natural disaster for people to notice.
SeesThroughIt
ZING!
Also, I agree with LITBMueller above.
jg
How very Rush Limbaugh of you. Thanks for cutting through the bullshit and pointing out the ‘there’s no story here’ conclusion for us. Any thoughts on Vince Foster?
jg
In case you couldn’t tell I was just messing with you John. Your post just made me think of the way some of my wingnut friends summarize shit they hear on non-FOX news channels. They never believe they are hearing the truth, they always feel they’re being told something, an exageration, they don’t need to hear. Something that is designed to make them feel a certain way rather than just data to be digested. Its the whole liberal media agenda thing that controls them. They think there’s always an angle and they pride themselves on pointing it out. Your post is dripping with ‘they just want me to think this all could have been avoided if Bush had stopped the hurricane’. Laughable, right? But thats our country now.
Pooh
jg, that’s massively unfair.
Pooh
oops. cross-post, retracted, sorry jg.
Lee
A bit off topic:
Have a Katrina refugee in my daughter’s class at school. Met the parents a couple of times thru school functions.
From what I could deduce from conversations with them, they were part of the ‘working poor’ in NO.
They are not going back. Ever.
Here in North Texas they have more opportunities to work at a higher wage. Combined with the charity they recieved right after, they can now live in a booming suburb of Dallas with a top notch school system.
This to me demonstrates the power of private/public assistance when it works.
It also makes me wonder how many other ‘success’ stories are out there (success in quotes because it is tough to think of losing your home as a success).
ET
Always hard to judge these things. There are stories in papers and when I was back in NOLA for Christmas, on the increase of deaths. The funeral home operators and health professionals in state and local groups, were sure Katrina had an affect but it was hard to quantify in any reliable manner. Sure people dying during Katrina (however that may have happend) can be attributed to Katrina. Suicides where the note says can’t take the Katrina related pressure anymore are quantifible, but heart attacks is what ends up on a death certificate not heart attack due to natural disaster.
I would suspect that many of these asthma, anxiety and behavioral problems were present before but many/most/some may have a direct relationship with Katrina but it may never be easy to tell the difference.
ppGaz
Asthma sufferer for six decades weighs in:
You are exactly right.
Just add “air pollution” to the equation, and it’s complete.
Ryan S
Of course, I’ve never lived in or near a ‘city’ larger than 30,000 people.
Jess
Re: Asthma, pollution and poverty
Okay, I admit I don’t have the specific details at hand, but while some forms of air pollution have decreased, many, sometimes more toxic forms, have increased, such as industrial pollutions, synthetic fragrances, pesticides, and so forth (I may be wrong on some of these, but not all). Many poorer areas are located closer to or downwind from dumping grounds for industrial waste, and low income housing tends to be made of cheaper and/or older building materials that are more likely to trigger health problems. Added to that is the difficulty and expense involved in getting good medical treatment if one is poor. Some also argue that diets higher in sugar and refined carbs can exacerbate allergies, and that can be a problem for the urban poor in particular.
Bill Tyler
having left the NOLA area because of Katrina–I found the medical care at shelters very good and the concern for well being great but the not knowing the conditions of home the wait again the wait the lack of informed information about the very basics anxiety is triggered by the reation of adults around the kids normalicy is now where to be found many left with only what clothes they could wear and pitful litle to carry many walked or waided for blocks
I packed medication for only a week in that week I recieved additional medication at no cost for an additional month I was fortunate to have the pill bottles with me I met a lot of great people in the shelter, all just wanted it to be over. We had no real problems but boredom for the most part.
The children did have things the roughest, no place to play and little to play with after the first week school stated for those of school age It was the not knowing where friends and family were and in some cases mom and dad
I was home in the end of the frist month, no damage to house, but after 7 and one half months nothing is quite the same
I must close with a thanks for everyone that aided me Thanks
I'm blue in a red state world
My parents lived in a small community in West Virginia devastated by the flood of 1985. The households of the elderly and the sick died off within 12 months of the flood in a piecemeal fashion. The exposure to biohazards, raw sewage, smoke from burning fires and constant stress is a toxic cocktail.
Although we were able to clean my parents’ home up and get them back in after flood waters reached up to two and one-half feet on the first floor, I don’t think we did them any favors. I believe the molds and bateria left behind the walls and invisible in the basement eventually ruined their health and might have been the primary factor in my mother’s death. She died 12 years later from an undiagnosed lung infection. For the last two years of her life she coughed constantly.
These types of toxic agents always affect the weakest among us. While I have no data or objective evidence other than anecdotal, I think your theory that the poor NOLA children must have just gotten diagnosed and its their first opportunity to have real health care reminiscent of the Barbara Bush “Marie Antoinette” theory. You know her theory that the survivors were poor and would be making out very well from all of this.
scs
Aren’t we all forgetting about Medicaid (or is it Medicare?) the program providing free health insurance to pretty much all poor children? I know we love to bash Bush and our health care system, but I don’t think this is one of those times. Those children probably had better healthcare than I do.
Plus I don’t get the problem with flooding and mold. The back half of my house was moldy when I moved in, due to, I theorize, a washing machine overflowing. That’s why I got it for cheap I think. Anyway, I took up the carpet and flooring, down to the floorboards (which were still damp) and sprayed bleach on everything, let it air out and everything is fine now. Although spores may remain, any mold growth will eventually go away with the cessation of a moisture source, and practically everything dries eventually. I don’t get why they have to destroy whole houses for that.
scs
Also, I have heard other theories on increased asthma. The trick to avoid mold is to stop a moisture source. Houses today are built with synthetic materials, such as vinyl siding, that trap in moisture and don’t let moist air out like wood and brick did. Add to that all the weather sealing that is done nowadays and the constant keeping of windows closed for air conditioning. It’s a mold cocktail. We might need to trade a little energy efficiency to try and keep down asthma rates.