Functional Status Post-Disaster: A Study of the Older Victims of Hurricane Katrina

Background: Older adults are disproportionately vulnerable to the immediate effects of disaster; however, long-term impacts are rarely studied. Aims: To assess the impacts of Hurricane Katrina on the physical health and functional status of older adults. Methods: Sixteen months post-Katrina, we had completed 233 of 300 telephone surveys with older adult victims who were enrolled in People's Health, a New Orleans Medicare-Advantage Plan. They were randomly sampled from a cohort of 20,612 enrollees stratified by morbidity burden. Results: The 40% response rate to date is indicative of the problems of finding vulnerable populations dispersed by disaster. 17% could not participate because they were un-locatable or physically incapable. 70 (31%) respondents reported physical health decline since Katrina (with 71% attributing some decline to the storm). Although claims data show no large changes in chronic disease prevalence, half of people who needed help with IADLs at interview had not required assistance before Katrina. Of people needing help with ADLs at interview, 43% had not required assistance before Katrina. There were no significant differences in requiring assistance at the time of the survey across morbidity burden categories. Conclusions: The experience of post-disaster health decline may take years to manifest clinically. In the shorter term, older adults may be prone to experience increasing difficulties with ADLs/IADLs. Emergency planners should anticipate needs of older adults with respect to ADLs/IADLs in the period of recovery and track longer-term outcomes in vulnerable populations.