摘要：Objectives. We examined whether there were high levels of mental illness among displaced New Orleans, LA, residents in the fall of 2006, 1 year after Hurricane Katrina. Methods. We used data from the Displaced New Orleans Residents Pilot Study, which measured the prevalence of probable mild or moderate and serious mental illness among a representative sample of people who resided in New Orleans at the time of the hurricane, including people who evacuated the city and did not return. We also analyzed disparities in mental illness by race, education, and income. Results. We found high rates of mental illness in our sample and major disparities in mental illness by race, education, and income. Severe damage to or destruction of an individual's home was a major covariate of mental illness. Conclusions. The prevalence of mental illness remained high in the year following Hurricane Katrina, in contrast to the pattern found after other disasters. Economic losses and displacement may account for this finding as well as the disparity in mental illness between Blacks and Whites. Hurricane Katrina struck New Orleans, Louisiana, on the morning of August 29, 2005. The city's population of 455 000 1 was displaced by the storm and flooding that followed. The devastation, disruption, chaos, and despair caused by the hurricane were expected to have a significant effect on the mental health of the survivors, and results to date suggest that this was indeed the case. 2 , 3 Early studies of the mental health effects of Hurricane Katrina suggested that displaced New Orleans residents experienced high rates of distress in the initial period following the hurricane, 4 – 6 although not all of these studies collected reliable measures of mental illness or included representative samples. Little is known about the intermediate and long-term mental health effects of Hurricane Katrina. This is largely attributable to the difficulty of collecting current information from a representative sample of the prehurricane population of New Orleans, which has hampered research on many Katrina-related topics of high scientific and policy relevance. 7 , 8 Following other natural, human-made, and technological disasters, initially elevated rates of mental illness—most commonly assessed by rates of posttraumatic stress disorder—have generally fallen during the first year after the event and then declined more slowly. This has been found, for example, in studies of survivors of a Turkish earthquake 9 ; the September 11, 2001, attacks in New York City 10 ; and the 2000 tsunami in Southeast Asia. 11 However, in other cases, the prevalence of mental illness remained stable or increased over time, often when exposure to stress continued. 12 , 13 These latter findings are consistent with results from New Orleans 1 year after Hurricane Katrina, results that have identified substantially elevated rates of mental illness among, for example, the local Vietnamese American population 14 and community college students (C. Paxson, PhD, et al, unpublished manuscript, 2008). We used data from the Displaced New Orleans Residents Pilot Study (DNORPS) to examine mental illness among hurricane survivors, both those who had returned to New Orleans and those who were still living elsewhere, who were assessed during the fall of 2006, approximately 1 year after Hurricane Katrina. In addition, we described and analyzed disparities in mental illness by race, education, and income. We focused on the population of the City of New Orleans and on disparities because of the widespread devastation that occurred there and the likelihood of major disparities existing in the city's diverse population. 5 , 15 Previous research has found a significantly higher prevalence of mental illness among socially and economically disadvantaged populations, 16 although the prevalence of mental illness among racial and ethnic minorities has not been as high as would be expected from their disadvantaged socioeconomic status. 17 Research on disparities in postdisaster mental health by socioeconomic status and race has been scarce. 18 – 20 Our analysis also builds on previous research on the mental health effects of Hurricane Katrina that considered the population of the entire affected region. 2 , 3
