摘要：Objectives. To shed light on how the public health community can promote the recovery of Hurricane Katrina victims and protect people in future disasters, we examined the experiences of evacuees housed in Houston area shelters 2 weeks after the hurricane. Methods. A survey was conducted September 10 through 12, 2005, with 680 randomly selected respondents who were evacuated to Houston from the Gulf Coast as a result of Hurricane Katrina. Interviews were conducted in Red Cross shelters in the greater Houston area. Results. Many evacuees suffered physical and emotional stress during the storm and its aftermath, including going without adequate food and water. In comparison with New Orleans and Louisiana residents overall, disproportionate numbers of this group were African American, had low incomes, and had no health insurance coverage. Many had chronic health conditions and relied heavily on the New Orleans public hospital system, which was destroyed in the storm. Conclusions. Our results highlight the need for better plans for emergency communication and evacuation of low-income and disabled citizens in future disasters and shed light on choices facing policymakers in planning for the long-term health care needs of vulnerable populations. Hurricane Katrina made landfall on August 29, 2005, as a category 4 hurricane, causing widespread damage throughout the Gulf Coast region and virtually destroying the city of New Orleans, La. As thousands fled the region, the nation watched painful images of fellow Americans suffering in conditions that more resembled our expectations of disasters in developing countries than what we would expect to see in our own wealthy nation. According to one survey, more than 9 in 10 Americans said they were closely following these media stories during and after the catastrophe. 1 Across the nation, Americans asked ourselves how this could happen and what we could do to help. The public health community also asked what it could do to protect victims’ health and promote their recovery and what lessons it could learn to better plan for a future storm or other disaster. We sought to shed light on these issues by describing the results of a survey of evacuees conducted in Houston area shelters 2 weeks after Hurricane Katrina struck, providing a unique view of the experiences of the victims most affected. Hurricane Katrina was not the first powerful hurricane to strike the United States, nor is it the first time that researchers have asked what lessons can be learned from tragedy. Between 1900 and 2004, the United States mainland has been hit by 3 category 5, 13 category 4, 49 category 3, 41 category 2, and 70 category 1 hurricanes. 2 Studies focusing on these previous events suggest that, in the case of any given storm, a portion of the population will not evacuate and will require rescue and aid afterward. 3 – 5 Households are much more likely to evacuate if they trust the source of evacuation information and have clear instructions and options. 5 Residents of an evacuation area who have family in nearby cities are more likely to evacuate than those who do not, 6 as are higher income families that have the means to evacuate to hotels. 4 Conversely, low-income households, minority households (which tend to have lower incomes than White households), and households with elderly or disabled people are less likely to evacuate than other households. 5 Previous studies have shown that, even when reliable information about probable danger is available, it is difficult to effectively warn large populations that cannot directly perceive the danger associated with a disaster. If a storm warning is at all vague, people will underestimate the threat and be less likely to heed evacuation orders. 3 , 7 Also, research has revealed that people who have lived in an area for a short time and may lack experience with hurricanes tend to underestimate the associated danger. 6 , 7 In contrast, the longer people have lived in an area, the less likely it is that they will evacuate, in part because they have successfully ridden out past hurricanes. 5 Some residents may be unwilling to abandon property or possessions. We asked whether the evacuees of Hurricane Katrina shared these propensities, and we sought to describe the health status and health care needs of these individuals. In addition, we explored their experiences during the storm and evacuation, looking closely at who did and did not evacuate before the storm, how they perceived the circumstances surrounding their rescue and evacuation, and their plans for the future. The data uncovered raise questions about how to best go forward with policies designed to care for the health needs of these evacuees and offer lessons on how to protect vulnerable populations in future disasters.
