Sunday, June 24, 2007

New Orleans deaths up 47% ...

By Steve Sternberg, USA TODAY

Hurricane Katrina's tragic aftermath lingered for at least a year after the storm abated, boosting New Orleans' death rate last year by 47% compared with two years before the levees broke, researchers reported Thursday.

Doctors say the dramatic surge in deaths comes as no surprise in a city of 250,000 mostly poor and middle-class people who lost seven of 22 hospitals and half of the city's hospital beds. More than 4,486 doctors were displaced from three New Orleans parishes, creating a shortage that still hampers many hospitals, says a companion study released Thursday.

The indigent suffered the brunt of the health toll from the 2005 storm. The Medical Center of Louisiana at New Orleans, two hospitals that made up the city's safety net for the uninsured, were severely damaged. Charity Hospital, oldest and best known of the two, remains closed.

"We're facing a lot of health care challenges. I'm sure that has a significant impact on mortality," says Kevin Stephens, director of the New Orleans Health Department and lead author of the study, in the journal Disaster Medicine and Public Health Preparedness. The study on doctor relocation, led by Kusuma Madamala of the American Medical Association, is in the same journal.

Stephens' study contrasts with one carried out by the Louisiana Department of Health and Hospitals, which found "only slight excesses" in deaths in New Orleans Parish.

That study, released in May, found a death rate of 14.3 per 1,000 people during the first three months of 2006, compared with 11.3 per 1,000 for three-month spans in 2002 and 2004.

But Stephens says the state's figure still tops the U.S. rate of 8.1 per 1,000. "We don't think that's a slight increase, we've think it's a tremendous increase in mortality," he says. He called the state's numbers "inaccurate and incomplete" because they don't count deaths of evacuees who left Louisiana.

Frederick Cerise, Secretary of the Department of Health and Hospitals, said it's "hard to track deaths that occurred out of state." He adds, "We saw a spike in the first quarter of 2006 that has not been sustained since then."

Stephens says that poor people who left the city had trouble getting health care wherever they landed.

"We can get hung up on the numbers, but the bottom line is that people are dying at a faster rate here post-Katrina," says Jullette Saussy, director of New Orleans EMS.

"The lack of primary care, of mental health care and of long waits in emergency rooms all have (worsened) people's normally controllable chronic diseases," she says. "Diabetes, respiratory disease and hypertension all are killers, especially when they're not dealt with."

The storm's impact on the state office that tracks vital statistics made those deaths difficult to measure. To get information, Stephens' team tracked death notices in the New Orleans Times-Picayune and compared the findings with the state's vital statistics. He said the study wasn't designed to determine what caused the excess deaths.

From January to June 2006, they found on average 1,317 death notices a month, for a mortality rate of about 91 per 100,000 people. In 2002 and 2004, the average was 924 notices a month, for a death rate of 62 per 100,000, 47% fewer than after the storm.

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