|
|
|||||||
|
|||||||
|
International Health Division Researcher Releases Study on Health Care Needs of Persons Displaced by Hurricane Katrina: Exclusive Q&A Dr. Lynn Lawry, Senior Health Stability and Humanitarian Assistance Specialist in the International Health Division of the Assistant Secretary of Defense Health Affairs, is the senior author of a manuscript titled, "Health Assessment and Health Care Access Among Internally Displaced Persons in Mississippi Travel Trailer Parks Two Years after The 2005 Gulf Coast Hurricane Season" published in the Journal of Health Affairs, Aug. 29, as a health affairs Web exclusive. Visit http://content.healthaffairs.org/cgi/content/abstract/hlthaff.27.5.w416 for the abstract. The health care needs of persons displaced by Hurricane Katrina remaining in travel trailer parks had not been previously evaluated. Dr. Lawry and other researchers conducted a population-based assessment of health care access of travel trailer park residents in Mississippi. The findings indicate a worsening of chronic disease, mental illness, and barriers to health care access since displacement. Meeting both the chronic disease and mental health needs of persons displaced by this disaster is essential for ensuring recovery. Dr. Lawry also co-authored an editorial titled, "Measuring the True Human Cost of Natural Disasters." The editorial is available ahead of print at http://www.dmphp.org/pap.dtl and will be published in the October issue of Disaster Medicine and Public Health Preparedness. We sat down with Dr. Lawry to discuss her research on this topic. FHP&R: You've just recently had an article published in JAMA about the psychosocial health of people living in post-civil war Liberia. Your recent article in the Journal of Health Affairs focuses on the psychosocial health of victims of Hurricanes Katrina and Rita. What drew you to focus on populations within the United States? Dr. Lawry: My work focuses on disasters, whether they're natural or manmade. Disasters do not only strike the vulnerable parts of the world, they also strike us here in the United States. Given my long-term experience with disasters, I wanted to take a look at the impact of Hurricanes Katrina and Rita in the hopes of bringing a more global view to our own disasters here. FHP&R: Going into the study, were there certain things you expected to find based on previous research? Dr. Lawry: Based on the article I co-authored with Larrance et al., I expected mental health issues to remain the same; to see more problems with access to healthcare and mental health services, given how protracted this disaster was for those living in travel trailers, and to find significant issues regarding chronic disease management. ("Health Status Among Internally Displaced Persons in Louisiana and Mississippi Travel Trailer Parks: A Global Perspective." Annals Emer Med. 2007; 49(5): 590-601.) FHP&R: What were your major findings? Dr. Lawry: We primarily found that as a result of the hurricanes, chronic and mental health care needs had increased, but the resources to provide the needed care had decreased. Specifically regarding mental health, we found that the rates of suicide and suicide attempts among that population were nearly four times higher than the baseline rates in that region, but that more than two-thirds of those with major depressive disorder or suicidal ideation did not receive mental health services since their displacement. FHP&R: Were there any particular surprising or unexpected findings? Dr. Lawry: I was surprised by the rates of chronic disease, among both children and adults, and the reasons they were not accessing care 2 years out from when the hurricanes occurred. The rates of mental health symptoms were also surprising. Primarily because the rates we found suggest that mental health trauma, which is a well understood consequence of disaster, has not been addressed in this population. Finally, the crude mortality rate in this region 2 years out from the disaster was not yet at baseline. This is particularly surprising because these rates are comparable to non-crisis sub-Saharan crude death rates; rates at a level one would not expect in the U.S. FHP&R: What, if anything, do you hope to accomplish as a result of your findings? Dr. Lawry: I'd like to create an understanding among the U.S. disaster preparedness groups that are looking at disasters in the U.S. with a global lens that will inherently make response and recovery better. Disasters have known consequences that are predictable and preventable, which I discuss in an editorial for "Disaster Med." ("Measuring the True Human Cost of Natural Disasters." Disaster Med Public Health Preparedness 2008:DMP.0b013e31818adaa2v1). 'd also like this research to remind policymakers that more than 30,000 individuals are still living in temporary housing (travel trailers), and the probability that they will recover without significant health and social support, is progressively waning. FHP&R: What can your findings tell us about how to help those who are internally displaced? Dr. Lawry: This research tells us that chronic illness and mental health are challenges that must be dealt with on a more rapid basis to decrease the rate of indirect deaths. FHP&R: Are there broader implications of this study for other populations who are internally displaced as result of a natural disaster? Dr. Lawry: Again, I think it's important to understand that direct deaths do not measure the full human costs of disasters. Indirect deaths, as a part of public health infrastructure loss, cause the largest mortality rates which continue to tally as the years go on without improvement to infrastructure losses. We can train, plan, recognize, provision and prevent these losses. FHP&R: Is there anything you'd like to add that I didn't ask you about? Dr. Lawry: In another study we hope to soon publish, we took a look at gender based violence for this displaced population in the gulf coast region and found that this is also a significant issue that leads to health and mental health problems. This is important because by not recognizing and addressing this one particular issue, displaced women remain invisible and suffering. For additional media coverage on the publication of this article please visit: http://abcnews.go.com/Travel/story?id=5686408&page=1 |
|||||||