Mental health problems appear to be worse than those suffered after Sept. 11

Half the residents of New Orleans were suffering from poor mental and physical health more than a year after their homes and community were devastated by Hurricane Katrina in August 2005, according to research published in the September issue of the UK-based Journal of Clinical Nursing.

Researchers from Point Loma Nazarene University, San Diego, California, spoke to 222 local residents 15 months after they survived one of the worst natural disasters to hit the USA.

They discovered that some health problems tripled in the post-Katrina period, compared to a survey of Louisiana residents carried out before the hurricane.

"Our results add to the growing body of evidence that disaster survivors continue to suffer from poor mental and physical health for prolonged periods of time after the initial impact" says lead researcher Professor Son Chae Kim.

"The health problem rates we recorded were considerably higher than those reported by Louisiana residents to the Behavioral Risk Factor Surveillance System (BRFSS) in 2003. The BRFSS is the world's largest, on-going telephone health survey system and has been tracking health conditions and risk behaviors in the United States every year since 1984."

Key findings of the survey include:

52 per cent of the respondents reported a day or more of poor mental health in the past month, with 18 per cent reporting daily mental health problems. These figures were two to three times higher than the pre-Katrina levels recorded in 2003 among Louisiana residents. Then, 26 per cent reported a day or more of mental health, with six per cent reporting daily mental health problems.

The mental health problems appear to be worse than those reported five to 15 months after the September 11 terrorist attacks, in which 33 per cent of survivors reported having a day or more of poor mental health.

People were more likely to suffer from poor mental health if they were female or had experienced poor physical health in the past month. Respondents diagnosed with depression before the incident were 19 times more likely to experience poor mental health and people who felt unsafe from crime were four times more likely.

Just under half of the residents (48 per cent) reported a day or more of poor physical health, with 11 per cent reporting daily physical health problems. These are approximately one and half times the pre-Katrina levels recorded in 2003 among Louisiana residents. Then, 33 per cent reported a day or more of poor physical health, with seven per cent reporting daily physical health problems.

Poor mental health during the past month, lack of money for food and pre-Katrina arthritis were significant predictors of poor physical health during the past month.

"Some of the findings did surprise us" says Professor Kim. "Being unemployed and having missing family members were not correlated with poor mental health, but they did correlate with poor physical health.

"Also, difficult access to clean drinking water did not correlate with poor physical health, but it did correlate with poor mental health."

The aims of the study were to assess the medium-term post-Katrina mental and physical health of New Orleans residents and to determine the demographic, social and environmental factors that predict these problems.

The 222 residents were interviewed by University nursing students and faculty members, in partnership with the non-profit organisation Heart to Heart International. They were carried out during door-to-door visits and a community health fair in December 2006, 15 months after Katrina.

Just under two-thirds of the respondents (64 per cent) were aged between 35 and 64 years of age and 47 per cent had some college education. Sixty per cent were female, 77 per cent were black and 47 per cent were unemployed.

More than a quarter had no healthcare insurance, ate less than they should because of lack of money, lived below the poverty line and said their current house was unsafe due to major damage. Almost a quarter (23 per cent) felt unsafe from crime.

"Our findings indicate that the Katrina survivors are likely to suffer from persistent poor mental and physical health for the foreseeable future unless concerted interventions are put in place" says Professor Kim.

"The study suggests that post-Katrina efforts should focus on protecting the residents from crime, improving mental health services to those who are depressed and improving food supplies to the poor.

"We also hope that our findings will provide valuable guidance for healthcare professionals and policy makers involved in future disasters, by helping them to anticipate and deal with the mental and physical health problems that are left behind once the initial crisis has been dealt with."

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Notes to editors

Medium-term post-Katrina health sequelae among New Orleans residents: predictors of poor mental and physical health. Kim et al. Journal of Clinical Nursing. 17, pp 2335 2342 (September 2008).

Founded in 1992, Journal of Clinical Nursing is a highly regarded peer reviewed Journal that has a truly international readership. The Journal embraces experienced clinical nurses, student nurses and health professionals, who support, inform and investigate nursing practice. It enlightens, educates, explores, debates and challenges the foundations of clinical health care knowledge and practice worldwide. Edited by Professor Roger Watson, it is published 10 times a year by Blackwell Publishing Ltd, part of the international Blackwell Publishing group. www.blackwellpublishing.com/jcn