Management of Hypertension Following Hurricane Katrina: A Review of Issues in Management of Chronic Health Conditions Fo
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Management of Hypertension Following Hurricane Katrina: A Review of Issues in Management of Chronic Health Conditions Following a Disaster Errol D. Crook & Martha I. Arrieta & Rachel D. Foreman
Published online: 12 March 2010 # Springer Science+Business Media, LLC 2010
Abstract Following Hurricane Katrina many residents of the Gulf Coast had difficulties managing their cardiovascular risk factors especially hypertension. Care for patients with chronic diseases can be an enormous challenge after any disaster. The difficulties are compounded if the population prior to the disaster was already experiencing major health disparities. Focusing on hypertension we review the issues confronted by residents of the Gulf Coast following Hurricane Katrina in managing their health care. In addition, we address possible solutions to these problems. Pre-disaster preparedness is essential and requires multidisciplinary efforts including patient education. Being certain that patients with chronic diseases have enough medical supplies to last through the immediate disaster period and for portability of medical records are essential interventions in maintaining control of blood pressure in the post-disaster period. Keywords Hypertension . Disaster preparedness . Chronic disease . Health disparity . Hurricane Katrina
Introduction Disaster preparedness and response models prior to Hurricane Katrina were grounded in the belief that (bio)terrorism E. D. Crook : M. I. Arrieta : R. D. Foreman Center for Healthy Communities and Department of Internal Medicine, University of South Alabama, Mobile, AL, USA E. D. Crook (*) Mastin 400-A, 2451 Fillingim St, Mobile, AL 36617, USA e-mail: [email protected]
was the major potential threat to public safety and these programs stressed preparation for mass casualties. Tertiary health care (emergency departments and hospitals) is the critical piece in the response to such threats [1]. Hurricane Katrina landed on the Gulf Coast on August 29, 2005 and hopefully forever changed the way disaster preparedness and response will be addressed. It was the deadliest storm in the history of the United States, impacting an enormous geographic area both directly and indirectly. It caused at least 1.5 million Gulf Coast inhabitants to become displaced and destroyed or seriously damaged infrastructure for health care and other services for those remaining in the area [2, 3]. Providing continuity of care for chronic diseases to affected and displaced persons became an extraordinary challenge post-storm [4–6]. Up to 75% of persons affected by Katrina had one or more chronic illnesses [6, 7]. A large proportion of these affected persons were from health disparate populations, something that was vividly depicted in news reports from New Orleans and other parts of the Gulf Coast. Against such a scenario, primary, rather than tertiary, care is proposed as the most effective health care model to the many health care needs of these patients [1, 6–8]. Hypertension, which affects up to 70 million Americans and 1.5 billion pe
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