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Abstract: Children with chronic conditions may be at risk of increased disruptions in health care following natural disasters such as Hurricane Katrina. The objective of this cross-sectional study was to evaluate differences between children and adolescents with and without chronic conditions immediately following Katrina. Of 531 participants, there were 79.8% younger than 13 years old, 50.5% male, 42.8% African American. Participants with pre-existing conditions (39.4% of the total sample) were more likely than those without to be at the clinic for a non-chronic health condition rather than another problem (43.5 vs. 16.2%), to take asthma medication (37.4 vs. 3.9%), to have asthma worsen (16.3 vs. 1.9%), to miss a visit (49.2 vs. 39.8%), to run out of medications (33.9 vs. 7.9%), to live with flood damage (19.7 vs. 11.3%) or mold (23.6 vs. 15.8%), and to experience disruption in care (58.4 vs. 38.3%) or negative psychological consequences (ranging from 2.5% to 12.9%). While the medical differences are unsurprising, given the groups being compared, the other differences between the groups merit attention from policymakers and health care providers. Children and adolescents with chronic conditions are at increased risk of adverse outcomes following a natural disaster. Providers may be able to reduce negative effects on this population by developing condition-specific preparedness care mechanisms.
Key words: Children, adolescents, chronic conditions, Hurricane Katrina, disaster, outcomes, preparedness.
Hurricane Katrina made landfall on the Gulf Coast of the United States on August 29, 2005, causing one of the country's most expensive natural disasters in terms of both financial and human losses.1,2 In New Orleans, the combination of wind, storm surge, and rainfall resulted in an undermining of the levee system and flooding of over 80% of the city by neighboring Lake Pontchartrain.1 The impact of the hurricane on New Orleans, both immediate and over the subsequent year has been extensively chronicled.1-12
Even in the absence of a natural disaster, children and adolescents-especially those with chronic health conditions-have specific needs and vulnerabilities at each developmental stage. Of the 469,032 residents of New Orleans at the time of Hurricane Katrina, an estimated 27% were under 18 years old.13 While children and adolescents will react differently to a disaster and its aftermath depending on age, developmen- tal level, and prior experiences, much child...