Internet-based morbidity and mortality surveillance among Hurricane Katrina evacuees in Georgia.
INTRODUCTION: The Internet has revolutionized the way public health surveillance is conducted. Georgia has used it for notifiable disease reporting, electronic outbreak management, and early event detection. We used it in our public health response to the 125,000 Hurricane Katrina evacuees who came to Georgia. METHODS: We developed Internet-based surveillance forms for evacuation shelters and an Internet-based death registry. District epidemiologists, hospital-based physicians, and medical examiners/coroners electronically completed the forms. We analyzed these data and data from emergency departments used by the evacuees. RESULTS: Shelter residents and patients who visited emergency departments reported primarily chronic diseases. Among 33 evacuee deaths, only 2 were from infectious diseases, and 1 was indirectly related to the hurricane. CONCLUSION: The Internet was essential to collect health data from multiple locations, by many different people, and for multiple types of health encounters during Georgia's Hurricane Katrina public health response. (+info)
RGS2 and generalized anxiety disorder in an epidemiologic sample of hurricane-exposed adults.
Hurricane Katrina: impact on cardiac surgery case volume and outcomes.
Hurricane Katrina produced a surge of patient referrals to our facility for cardiac surgery. We sought to determine the impact of this abrupt volume change on operative outcomes. Using our cardiac surgery database, which is part of the Department of Veterans Affairs' Continuous Improvement in Cardiac Surgery Program, we compared procedural outcomes for all cardiac operations that were performed in the year before the hurricane (Year A, 29 August 2004-28 August 2005) and the year after (Year B, 30 August 2005-29 August 2006). Mortality was examined as unadjusted rates and as risk-adjusted observed-to-expected ratios. We identified 433 cardiac surgery cases: 143 (33%) from Year A and 290 (67%) from Year B. The operative mortality rate was 2.8% during Year A (observed-to-expected ratio, 0.4) and 2.8% during Year B (observed-to-expected ratio, 0.6) (P = 0.9). We identified several factors that enabled our institution to accommodate the increase in surgical volume during the study period. We conclude that, although Hurricane Katrina caused a sudden, dramatic increase in the number of cardiac operations that were performed at our facility, good surgical outcomes were maintained. (+info)
Spatial patterns of natural hazards mortality in the United States.
Health of Medicare Advantage plan enrollees at 1 year after Hurricane Katrina.
OBJECTIVE: To assess the effects of Hurricane Katrina on mortality, morbidity, disease prevalence, and service utilization during 1 year in a cohort of 20,612 older adults who were living in New Orleans, Louisiana, before the disaster and who were enrolled in a managed care organization (MCO). STUDY DESIGN: Observational study comparing mortality, morbidity, and service use for 1 year before and after Hurricane Katrina, augmented by a stratified random sample of 303 enrollees who participated in a telephone survey after Hurricane Katrina. METHODS: Sources of data for health and service use were MCO claims. Mortality was based on reports to the MCO from the Centers for Medicare & Medicaid Services; morbidity was measured using adjusted clinical groups case-mix methods derived from diagnoses in ambulatory and hospital claims data. RESULTS: Mortality in the year following Hurricane Katrina was not significantly elevated (4.3% before vs 4.9% after the hurricane). However, overall morbidity increased by 12.6% (P <.001) compared with a 3.4% increase among a national sample of Medicare managed care enrollees. Nonwhite subjects from Orleans Parish experienced a morbidity increase of 15.9% (P <.001). The prevalence of numerous treated medical conditions increased, and emergency department visits and hospitalizations remained significantly elevated during the year. CONCLUSIONS: The enormous health burden experienced by older individuals and the disruptions in service utilization reveal the long-term effects of Hurricane Katrina on this vulnerable population. Although quick rebuilding of the provider network may have attenuated more severe health outcomes for this managed care population, new policies must be introduced to deal with the health consequences of a major disaster. (+info)
Katrina and the Thai Tsunami - water quality and public health aspects mitigation and research needs.
The South East Asian Tsunami in Thailand and Hurricane Katrina in the United States were natural disasters of different origin but of similar destruction and response. Both disasters exhibited synonymous health outcomes and similar structural damage from large surges of water, waves, and flooding. A systematic discussion and comparison of the disasters in Thailand and the Gulf Coast considers both calamities to be similar types of disaster in different coastal locations. Thus valuable comparisons can be made for improvements in response, preparedness and mitigation. Research needs are discussed and recommendations made regarding potential methologies. Recommendations are made to: (1) improve disaster response time in terms of needs assessments for public health and environmental data collection; (2) develop an access-oriented data sharing policy; and (3) prioritize natural geomorphic structures such as barrier islands, mangroves, and wetlands to help reduce the scale of future natural disasters. Based on the experiences gained opportunities to enhance disaster preparedness through research are presented. (+info)