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DISPARITIES IN HURRICANE KATRINA
EVACUATION: FACTORS IMPACTING AFRICAN AMERICANS'
EVACUATION RESPONSE
Research by Dr. Keith Elder
Department of Health Services Policy and Management
Hurricane Katrina made landfall in Louisiana
with sustained winds of 140 miles per hour, leaving
death and property destruction in its wake. Inability or
refusal to heed government-recommended evacuations were
reasons for many of those deaths. Disproportionately
large numbers of those seeking refuge at the designated
shelters in New Orleans were African American, as were
the majority of the 1,300 people who died.
 The
United States’ public health system is a key line of
defense in emergencies such as infectious disease
outbreaks and natural disasters. The system’s success,
however, critically depends on the public’s willingness
to cooperate and comply with emergency mandates. For
example, the public might be called upon to engage in
difficult tasks such as evacuation and separation from
family and friends until a crisis has subsided. When
individuals or groups fail to cooperate, history
demonstrates they face disproportionate mortality and
morbidity.
University of South Carolina researchers sought to
identify the factors driving African Americans’
decisions not to evacuate despite government requests.
Researchers used a theory-driven framework called the
“Health Belief Model and Brody et al model” linking
contextual processes to self-management of disease as
their general framework in the development of the
discussion guide. In particular, these models are the
foundation for examining the impact of sociodemographic,
community, societal, and personal factors on
African-American evacuation response. Researchers also
conducted “Methods Six” focus groups within two months
of Hurricane Katrina to identify the psychosocial,
financial, community network, civic, and communication
factors influencing African Americans’ decision not to
evacuate before Hurricane Katrina.
The target population was African-Americans from New
Orleans who did not evacuate before Hurricane Katrina.
The majority of the participants were low-income,
unmarried men with high school or less education levels.
Other participants tended to be older (mean age 49.9),
without children in the household (69%), and home
renters (66%). All these factors have shown to be
predictors of social vulnerability to natural disasters.
Psychosocial functioning (riding out previous
hurricanes, optimism of outcome, confidence, religious
beliefs, and hurricane impact perceptions) were the most
common reasons for not evacuating. Financial factors
(liquid resources/ready cash for travel) and community
network factors (racism experienced in accessing
publicly provided transportation for evacuation,
neighborhood crime/looting concerns) were also recurrent
reasons for not evacuating. Implications of extended
families (disabled and chronically ill older persons
inhibiting evacuation, opinions of older adults) and
historic government-citizen relationships (perceived
racism, racial concordance of government officials and
citizens, and communication skills) were also
significant factors in not evacuating. Alternatively,
other community network factors (neighbors’ support,
church leader support) were not predictors for not
evacuating. Inadequate hazard information or public
health warnings were not cited as reasons for not
evacuating by any participant.
 The
United States has some of the best warning system
technology and researchers on evacuation responses.
However, USC researchers discovered that the poor and
disadvantaged are still more likely to be impacted by
natural disasters compared to the non-poor. The
researchers concluded that this discovery needs to be
addressed through policy and programmatic improvements.
This study also provides an information portal for
community leaders, researchers, and policy-makers to
access information that could potentially lessen the
public health impacts of disasters.
For example, USC researchers recommend federal, state
and local governments emphasize (in all disaster
preparedness plans) the incorporation of culturally
sensitive communication, resource allocation, and
logistic planning for facilitating the evacuation of
minority, low income, and underserved communities.
What’s more, they recommend that state and local
disaster preparedness plans be based on findings from
locally relevant, participatory research involving these
groups. They conclude that such involvement is critical
to prevent disproportionate mortality and impact among
minority and disadvantaged Americans in future. A final
report has been presented to governmental officials in
New Orleans.Biography
Dr. Keith Elder is an assistant professor in Health
Services Policy and Management at the University of
South Carolina Arnold School of Public Health. Dr.
Elder’s fields of interest include minority men’s
health, health disparities, managed care’s contractual
practices with minority providers, and health policies
that reduce or eliminate health disparities. He has a
Ph.D. in Health Policy from the University of Maryland,
a Master’s degree in Public Health, and Master’s degree
in Public Administration from the University of Alabama
at Birmingham. He is also a recipient of a National
Institutes of Health Minority Pre-doctoral Fellowship.
Research Team/Collaborators:
Sudha Xirasagar (co-principal investigator), MBBS,
Ph.D., research assistant professor, Arnold School of
Public Health, Health Services Policy and Management.
Whiejong Han (co-investigator), Ph.D., M.A., research
assistant professor, Arnold School of Public Health,
Health Services Policy and Management. Shelly Ann Bowen,
Dr.PH. (c), doctoral candidate, Health Promotion
Education and Behavior. Debeshi Maitra, M.HA, doctoral
student, Health Services Policy and Management. |
