摘要：Objectives. We examined the psychosocial and personal factors that influenced African Americans’ decision not to evacuate New Orleans, La, before Hurricane Katrina’s landfall. Methods. We conducted 6 focus groups with 53 African Americans from New Orleans who were evacuated to Columbia, SC, within 2 months of Hurricane Katrina. Results. The major themes identified related to participants’ decision to not evacuate were as follows: (1) perceived susceptability, including optimism about the outcome because of riding out past hurricanes at home and religious faith; (2) perceived severity of the hurricane because of inconsistent evacuation orders; (3) barriers because of financial constraints and neighborhood crime; and (4) perceived racism and inequities. Conclusions. Federal, state, and local government disaster preparedness plans should specify criteria for timely evacuation orders, needed resources, and their allocation (including a decentralized distribution system for cash or vouchers for gas and incidentals during evacuation) and culturally sensitive logistic planning for the evacuation of minority, low-income, and underserved communities. Perceptions of racism and inequities warrant further investigation. Public health’s success critically depends on the public’s willingness to cooperate and comply with evacuation and other mandates during emergencies. When individuals or groups fail to cooperate, they could face disproportionate mortality and morbidity. 1 Hurricane-related flooding causes risks of water-borne infectious illnesses 2 because of contamination with sewage, agricultural and industrial waste, and septic tank waste. Natural disasters often disrupt electricity and water supply systems, aggravating public hygiene and disinfection measures and facilitating infectious disease outbreaks. Within a month of Hurricane Katrina, the Centers for Disease Control and Prevention reported 22 cases (18 wound-related) and 5 deaths from Vibrio illness. In addition, upper respiratory infections, pneumonia, and gastrointestinal illnesses were widely reported. 3 Heavy rains and flooding caused an increase in the mosquito population, leading to fears of West Nile virus and dengue epidemics. Despite these hazards, the mandatory evacuation requests of the government in the wake of Hurricane Katrina failed to result in complete evacuation of New Orleans, La, residents. Disproportionately large numbers of those seeking refuge at the designated shelters in New Orleans were African American, and three fourths of the 2300 reported missing and the majority of the 668 reported dead from Louisiana were African American. 4 Several authors have examined the factors that impact evacuation patterns in the United States. 5 – 9 Dow and Cutter 5 , 6 conducted a telephone survey of South Carolina residents who were given mandatory evacuation directions by the governor in 1999 when Hurricane Floyd was poised for landfall. The factors that influenced evacuation response were magnitude of the storm, proximity of the storm to respondent, elected official decrees, and past hurricane encounters. Other authors have shown that a response to emergency warnings is impacted by the family’s preparation for emergencies, having children, consistency and clarity of the warning message, and (female) gender of the respondent. 9 Predictors for non-compliance with evacuation requests are surviving past hurricane encounters, work responsibilities, optimism concerning outcome, 6 being a racial/ethnic minority, crime and fear of property loss, and lack of credible information on a storm or disaster. 9 The purpose of our study was to determine what factors influenced some African Americans’ decisions not to evacuate before Hurricane Katrina.
