Impact of Katrina on Health Disparities

1
Impact of Katrina on Health Disparities

• George C. Hill, PhD
• Levi Watkins Jr. Professor and Associate Dean for
  Medical Education
  
• Professor, Department of Microbiology and
  Immunology
  
• Vanderbilt University School of Medicine
• Nashville, TN 37208

2
Health Status

• In both Mississippi and Louisiana, infant
  mortality is worse (for every 1,000 babies born,
  10 die in their first year of life) than in Costa
  Rica (8 die per 1,000).
• For black babies in either state, the picture is
  still more horrifying 15 die per 1,000. In poor,
  war-torn Sri Lanka, where per capita medical
  spending is only 131, babies have better odds,
  with 13 dying per 1,000.

3

• Darlene Humphrey, foreground center, a nurse with
  the Alexandria Veterans Affairs Medical Center,
  tends to one of the patients evacuated in the
  aftermath of Hurricane Katrina from a hospital in
  New Orleans by the Missouri Air National Guard to
  Alexandria, La., on Sept. 1.

4

• Health officials expect many of the storm-related
  deaths to result not from trauma or drowning, but
  from lack of medicine and treatment for people
  with chronic illnesses such as diabetes, asthma,
  heart disease and hypertension.

5

• New Orleans homes and buildings that are flooded
  with water will soon become infested with mold,
  medical experts

6

• Cancer patient Tam Tran, 73, receives treatment
  from Dr. Robert Rankin near the Convention Center
  in New Orleans on Sept. 8. Many cancer patients
  who were forced to evacuate in the hurricanes
  have lost access to life-saving medication,
  specialized treatment and participation in
  clinical trials

7
New Orleans health care system destroyedNo
hospitals operating normally many doctors and
nurses likely to leave

• Members of a cleaning crew gather at a back
  entrance to Tulane University Hospital and Clinic
  in New Orleans Sunday.

8
David Satcher, MD

• "The same things that lead to disparities in
  health in this country on a day-to-day basis led
  to disparities in the impact of Hurricane
  Katrina," said former U.S. surgeon general David
  Satcher, interim president of the Morehouse
  School of Medicine in Atlanta.
• "What worries me is that in a country where there
  are so many people who don't have a personal
  physician, who don't have access to health care,
  if somebody wants to attack us using that kind of
  weapon," a virus or other bioterrorism agent "is
  going to spread rapidly because people there are
  not going to have ready access to health care."
  

9
David Satcher, MD

• "I'm sure that many of the deaths that have
  occurred after the hurricane have resulted from
  people with chronic diseases either suffering
  from dehydration or the inability to access
  their medications," said Satcher. "All of these
  risks of suffering from chronic diseases and
  dying from them were greatest for the poor and
  the other people who could not get out of there."

10

• New Orleans resident Kay Kelly-Brown, right,
  discusses her diabetes with physician Deborah
  Nortan at a North Carolina shelter.
  
• Such facilities report treating many patients
  with chronic medical conditions -- a gap that,
  some experts say, is large due to preexisting
  health disparities. A Louisiana shelter last week
  reported that 500 of the 2,000 to 3,000 people
  housed there had diabetes.

11
Health Disparities

• A Louisiana health department report paints a
  detailed picture of the state's disparities.
  About 11.9 percent of African Americans have
  diabetes, compared with 7.2 percent of whites,
  according to the 2004 Louisiana Health Report
  Card.
• About 15.8 percent of those who lived in
  households with income of less than 15,000 per
  year had diabetes. And "this prevalence steadily
  decreases as the yearly income rises with the
  lowest prevalence for those with annual incomes
  of more than 50,000 (4.8 percent)," according to
  the report.

12
Health Disparities

• Diabetes rates among evacuees seem to reflect --
  and even intensify -- those statistics.
  
• At a shelter in Lafayette, La., last week, 500 of
  the 2,000 to 3,000 people housed there had
  diabetes, according to Steven R. Smith, an
  endocrinologist at Louisiana State University's
  Pennington Biomedical Research Center.

13
Diabetes

• People with diabetes also face crucial risks when
  they are left without drinking water, food or
  medication. Because many are dependent on
  injected insulin, which must be refrigerated,
  even those who had their medications with them
  had to worry about spoilage. (How long the
  medication remains effective largely depends on
  how well it is kept cool.)

14
Diabetes

• Low blood sugar -- which can cause headaches,
  sweating, weakness, fatigue, hunger and
  neurological difficulties -- is a risk,
  particularly for those who were able to take
  their medications but couldn't eat afterwards.
• Not taking diabetes medications, on the other
  hand, can lead to high blood sugar -- which can
  result in frequent urination, dehydration,
  weakness, nausea, confusion, convulsions,
  fatigue, increased thirst and dry mouth.
  Unstabilized blood sugar levels, either high or
  low, can lead to a coma.

15
Health System Needs Repair

• In the richest country in the world, a man named
  Eugene Johnson is going blind in a homeless
  shelter, because his eye medicine washed away in
  Hurricane Katrina and he can't afford to buy
  more.
• Yet at a deeper level, Mr. Johnson's plight is a
  window into our broken health care system. Sure,
  we need to think about how to rebuild New
  Orleans, but we also need to reconstruct a
  sensible health care system.
• And that task is urgent, for one study suggests
  that more than 18,000 Americans will die this
  year as a consequence of not having health
  insurance.

16
Future

• So let's rebuild the levees, but let's also
  construct a health care system that works. A
  dozen years after the last, failed attempt to
  reform health care, the system is more broken
  than ever. For the sake of Mr. Johnson, and for
  our children, it's time to try again.

17
Katrina and Health Disparities
18
(No Transcript)
19
Katrina and Health Disparities
20
Katrina and Health Disparities
21
Katrina and Health Disparities
22

• A young patient at Charity Hospital in New
  Orleans is carried to a waiting bus after being
  evacuated by airboat on Sept. 2.