The response to Hurricane Katrina: A government failure

Dr. Joseph Costa, D.H.Sc., PA-C

Health Policy and Management

MPH 525

Katie Schlattmann

April 2014

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Table of Contents

Chapter Page

1. Introduction .................................................................................................................................3

Background and Significance ..............................................................................................3

Nature of the Problem ..........................................................................................................4

2. Role of Public Health and Law Enforcement .............................................................................6

Public Health ........................................................................................................................6

Law Enforcement .................................................................................................................8

Volunteer Role .....................................................................................................................9

3. Disaster Management................................................................................................................11

Federal Management ..........................................................................................................11

State and Local Management .............................................................................................12

4. Discussion and Summary ..........................................................................................................15

Discussion ..........................................................................................................................15

Summary ............................................................................................................................16

4. Recommendations .....................................................................................................................18

References ......................................................................................................................................22

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Chapter 1

Introduction

Background and Significance

Hurricane Katrina made landfall in late August 2005 and was one of the strongest storms

to hit the Gulf Coast of the United States in the past 100 years. On August 25, 2005, the then

Category 1 hurricane hit the southeast coast of Florida. As the storm system moved into the Gulf

of Mexico, it continued to gain strength to Category 5 force winds. Later, on August 29, 2005,

Hurricane Katrina made landfall for the second time on the Gulf Coast of the United States near

Buras, Louisiana (FEMA.gov, 2006). This horrendous storm came ashore with average wind

speeds of 115 – 130 mph and gusts upwards of 150 mph indicative of a Category 3 hurricane

(Teitelbaum & Wilensky, 2013 and FEMA.gov, 2006). This storm made landfall again near

Pearlington, Mississippi as a Category 3 storm with wind speeds of 120 mph with 145 mph gust

speeds (FEMA.gov, 2006). In addition, the hurricane-force winds reached up to 190 miles away

from the eye of the storm while tropical storm-force winds were felt up to 440 miles away

(FEMA.gov, 2013). The wind speeds of Hurricane Katrina alone brought about great destruction

and devastation to the people that were affected by the storm.

Furthermore, in conjunction with the high speed wind, flooding became a severe issue.

The high speed winds resulted in storm surges of up to 30 feet and intense wave action that

destroyed buildings and roads. Likewise, New Orleans was under at least 20 feet of water due to

the city’s levees and floodwalls failing. As a result, approximately 80 percent of the city was

under a measurable amount of water (FEMA.gov, 2013 & History.com, 2009). Therefore, the

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winds and flooding associated with Hurricane Katrina caused the Federal government to declare

the affected areas as major disaster zones.

Nature of the Problem

Hurricane Katrina caused widespread destruction throughout Mississippi, Alabama, and

Louisiana due to flooding and the Category 3 hurricane-force winds. As a result of the imminent

threat of Hurricane Katrina, Ray Nagin, New Orleans mayor at the time, issued a mandatory

evacuation of the city before the storm hit (History.com, 2009). Approximately 80 percent of the

city’s residents evacuated the city. However, over 10,000 citizens took refuge at the Superdome

and the rest chose to ride the storm out at home (Treaster & Zernike, 2005, & History.com,

2009). The high percentage of people that chose to ride out the storm greatly increased the

overall death toll. In the city of New Orleans alone, over a thousand people lost their lives due to

Hurricane Katrina (Fox News, 2005). The total deaths in the state of Louisiana as a result of the

hurricane was 1,577 with approximately 40 percent of these fatalities due to drowning. In

Mississippi, the death toll was much lower with only 238 deaths (CNN Library, 2013). As a

result of the mandatory evacuation of New Orleans, thousands of lives were saved. However,

nearly all of the deaths could have been prevented if the authorities enforced the evacuation

mandate enacted by New Orleans mayor.

The loss of life due to Hurricane Katrina was not the only problem the residents of the

affected areas encountered. Overall, the storm affected approximately 93,000 square miles across

138 parishes and counties throughout the Gulf Coast (Fox News, 2006). According to Burton and

Hicks, in a study to estimate the financial cost of Katrina, the storm caused at most $156 billion

in damages in Louisiana, Alabama, and Mississippi (2005). However, the damages due to the

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storm resulted in only $108 billion (CNN Library, 2013). Thus, making Hurricane Katrina the

most costly hurricane in the history of the U.S.

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Chapter 2

Role of Public Health and Law Enforcement Agencies

Public Health

Public health workers are necessary to ensure the safety of survivors after minor and

major disasters. The response to natural disasters in the U.S. is a result of the Department of

Homeland Security’s (DHS) National Response Plan (NRP). The NRP is responsible for

coordinating the response of not only public health but also the medical sector in disaster areas

(Lister, 2005). Moreover, public health agencies were in charge of a wide variety of issues

including providing sanitation and hygiene, issuing clean water, controlling infections,

administering immunizations, ensuring access to health care, and prevent exposure to

environmental toxins (Greenough & Kirsch, 2005). Also, the Department of Health and Human

Services (HHS) under the NPR is responsible for food, water, and environment safety, treating

the ill and injured, and identifying the deceased (Lister, 2005). Without the efforts of public

health and the medical sector, the death toll after natural disasters would increase exponentially.

Hurricane Katrina presented several public health challenges throughout the affected

areas. For example, due to extreme flooding the safety of water supplies and the reliability of the

sewage system was compromised which led to threats of food and water-borne illnesses.

Similarly, the loss of power due to line damage greatly increased the chances of electrocutions

and foodborne illness. Automobile crashes, drowning, carbon monoxide poisoning, and lack of

access to the health care system continued to increase the overall death toll. Over-crowding and

water scarcity in evacuation shelters ultimately led to several deaths due to dehydration and heat

stress (Lister, 2005). The serious health threats as a result of Hurricane Katrina, resulted in a

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public health effort that would attempt to provide shelter, food, water, and medical treatment to

all survivors.

Public health agencies were critical in cleaning up the destruction of Hurricane Katrina

and providing basic necessities to the storm victims. The American Red Cross operated 470

shelters and evacuation centers across the U.S. to accommodate Hurricane Katrina survivors.

Over 386,000 Katrina refugees received medical and/or mental health treatment from the Red

Cross shelters (Mills, Edmondson, & Park, 2007). Without this shelters, thousands of Katrina

victims would not have been able to receive the medical treatment needed in order to survive as

well as food, water, and shelter.

The federal government under direction of HHS brought in a number of organizations to

aid in the public health crisis due to Hurricane Katrina. The Agency for Toxic Substances and

Disease Registry (ATSDR) focused on preventing exposures to hazardous substances via health

assessments, consultations, surveillance, and education and training on hazardous substances.

The National Institutes of Health (NIH) was able to provide phone-based medical consultations

for physicians treating survivors and evacuees. Similarly, the Food and Drug Administration

(FDA) aided in the recovery effort by supplying recommendations for handling drugs, biologics,

and medical devices that may have been exposed to flood waters or harmed due to lack of

refrigeration (Lister, 2005).

Moreover, the Centers for Disease Control and Prevention (CDC) provided three key

elements to Hurricane Katrina’s public health effort. First, the CDC provided important public

health information to health professionals, clean-up workers, evacuation center staff, and the

general public by launching a website. Second, approximately 150 staff members were sent to

the affected areas along the Gulf Coast to provide expertise in areas such as epidemiology,

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medicine, environmental health, sanitation, and disease surveillance. Last, the Strategic National

Stockpile of drugs and medicine was deployed to the affected areas. Included in the stockpile

was vaccinations for tetanus, diphtheria, and hepatitis A and B, vials of insulin, ventilator kits,

and prescription pain medicines (Lister, 2005). The efforts of the various public health agencies

throughout the Gulf Coast provided immediate medical treatment to storm victims as well as the

means to prevent the spread of disease via vaccinations and education of relief workers.

Law Enforcement

Without the effort of law enforcement officials including the U.S. military, national

disaster clean-up relief would be problematic. The New Orleans Police Department (NOPD) was

responsible for maintaining order and controlling crime throughout the city during and after the

storm. However, the most central role for police officers during a time of disaster is to help those

in need of assistance (Deflem & Sutphin, 2009). Due to the lack of communication between

officers and lack of transportation, the NOPD struggled greatly with providing safety and first

aid to storm victims. Therefore, the National Guard was deployed to the disaster areas since

local, state, or other federal resources were extremely overwhelmed. The National Guard

functioned as a means to maintain civil order, provide logistical support, and coordinate rescue

and relief efforts (Bowman, Kapp, & Belasco, 2005).

Other law enforcement agencies beside the NOPD and the National Guard provided

assistance during Hurricane Katrina relief. The Federal Bureau of Investigation, Immigration and

Customs Enforcement, the Bureau of Alcohol, Tobacco, Firearms and Explosives, the Drug

Enforcement Agency, and the U.S. Marshals Service were able to provide personnel, equipment,

and assistance in security to the affected areas. Furthermore, inter-agency cooperation during the

relief effort allowed for law enforcement agencies to work in conjunction with rescue workers,

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volunteers, and local businesses in order to maintain civil order and provide aid to Hurricane

Katrina victims (Deflem, & Sutphin, 2009). Maintaining civil order was critical to the clean-up

efforts of Hurricane Katrina. Without proper policing, citizens of the affected area would have

been subjected to higher rates of crime and inadequate rescue and relief efforts.

Volunteer Role

Volunteers played a critical role in Hurricane Katrina clean-up efforts. For example,

many large corporations such as Wal-Mart, Home Depot, and State Farm Insurance were able to

make preparations for the storm weeks before it made landfall. These companies brought in

resources to the disaster areas before many government agencies were able to do so (Sobel, &

Leeson, 2006). Wal-Mart sent large amounts of free merchandise including prescription drugs to

the worse-hit areas and shipped an estimated 2,500 truckloads of merchandise during a three-

week period following Hurricane Katrina (Horwitz, 2009). In addition, several non-profits and

private foundations were able to respond to the needs of storm victims immediately after the

storm. Operation USA, a disaster relief and post-disaster redevelopment organization, provided

aid to community health centers that were overwhelmed with storm victims throughout the

affected region. The organization was able to supply large quantities of medical supplies and

medicines to various clinics throughout the Gulf Coast as well as generators, sleeping bags,

water purification systems, and portable lights (National Association of Community Health

Centers, 2006).

Throughout the clean-up and rebuilding process of Hurricane Katrina, volunteer groups

were instrumental to saving lives and restoring hope in the affected communities. In many cases

the volunteer organization were able to respond to the disaster before the government. These

groups were able to provide medical care, medical supplies, food, water, and other necessities to

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the affected areas days before the government relief effort began. Without the generosity of large

corporations, non-profit organizations, and private donors, the evacuees and other storm victims

would have suffered more due to lack of basic necessities.

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Chapter 3

Disaster Management

Federal Management

During times of disaster, human-made and natural disasters alike, the federal government

provides recovery and relief services via the Stafford Act. In this act Congress aims to provide

assistance to the state and local governments via the federal government during times of

catastrophe. Moreover, the federal government can provide assistance to the state and local

government in one of four ways: encourage the development of planning by the state and local

governments, encourage the States, local governments, and individuals to protect themselves,

encourage mitigation efforts, and encourage coordination (Birkland & Waterman, 2008). The

federal government under the Stafford Act worked to help the regions of the Gulf Coast affected

by Hurricane Katrina. As a result, the National Guard was mobilized almost immediately after

the storm slammed the Gulf Coast to coordinate rescue missions and promote social order. Aside

from mobilizing the National Guard to the affected areas, the U.S. federal government relief

effort was inefficient and lacking.

Much of the federal government breakdown can be attributed to the restructuring of the

Federal Emergency Management Agency (FEMA) in 2003. During reorganization, FEMA

became a part of the DHS instead of an independent, cabinet-level agency. Moreover, nearly 75

percent of FEMA grants were directed toward counter-terrorism activities instead of natural

disaster preparedness and relief programs (Schneider, 2005). The change in program activities

greatly affected the response to Hurricane Katrina at all levels of government.

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The federal government was not at all prepared for a natural disaster of this magnitude.

The National Response Plan Catastrophic Incident Annex (NRP-CIA) was never enacted by the

federal government (Gheytanchi et al., 2007). As mentioned above, the NRP is responsible for

coordinating the response of the public health and medical sectors to disaster stricken areas.

Without enacting this disaster response plan, the state and local governments were devastatingly

overwhelmed by the demands of the storm victims and left to fend for themselves. It is evident

that the lack of coordination between and within the federal government departments during

Hurricane Katrina led to social disorder and confusion throughout the Gulf Coast.

The U.S. federal government encountered three major flaws in response to Hurricane

Katrina and health policy. First, the Medicaid eligibility waivers designed after the storm were

available to only the individuals who previously met the eligibility requirement, and not low-

income individuals lacking health insurance or persons who used the public hospital system.

Second, the lack of securing federal funding decreased the states’ desire to help the storm

victims. Without federal funding the Gulf Coast states could not properly attend to citizens and

organizations such as community health centers in need of assistance. Third and most

importantly, President Bush’s administration desire for control over the policy making process

slowed the response of the government greatly (Lambrew, & Shalala, 2006). Instead of taking

immediate action, the Bush administration chose to lengthen the policy making process by

following step-by-step procedures and waiting for funding to be ratified by Congress before

delivering aid to those in need. The inconsistent response of the federal government led to

unstable conditions in affected areas and ultimately lack of relief to storm victims.

State and Local Management

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The state governments of the affected areas also encountered various management issues.

In Louisiana, Governor Kathleen Blanco requested assistance from at the federal level; however,

she refused to declare martial law in the affected areas of the state (Schneider, 2005). Similarly,

according to Luo, Governor Blanco declined to place the National Guard troops under direct

control of the federal government (2005). As a result of her actions, state agencies were unable to

coordinate efforts to get relief to storm victims, stabilize local conditions, and restore social

order. The collapse at the state level can also be attributed to the lack of response from the

federal government and lack of enacting the NRP-CIA.

Local governments were responsible for maintaining social order and preparing residents

for the impending hurricane. New Orleans mayor issued mandatory evacuation decrees the day

before the storm system slammed the Gulf Coast. However, the evacuation mandate went

unheeded, as thousands of citizens chose to stay in the city and wait out the storm. Local

governments of the affected areas faced three major management issues. First, the local

governments did not have the means to evacuate citizens without vehicles. Second, government

officials and other relief workers had limited means of communicating after the storm. Last, the

NRP calls on the National Guard as the first military responders which were lacking in the

immediate aftermath of Katrina. When the levees failed in New Orleans these soldiers were

preoccupied with saving their headquarters and other soldiers. The same is true for local police,

fire crews, and medical staff. Due to the nature of the disaster these groups were unable to

respond adequately (Chua, Kaynak, & Foo, 2007). Thousands of lives could have been saved had

local governments strictly enforced mandatory evacuation decrees by using all available

resources including school buses and government vehicles. The delayed response before, during,

and after Hurricane Katrina by the federal government produced a chain reaction delaying the

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response of both the state and local governments. Ultimately, the government systems of the U.S.

failed to protect and provide necessary supplies to the storm stricken areas of the Gulf Coast.

Table 1 – Causes of governmental delays in response to Hurricane Katrina. Data retrieved from

Chua et al., 2007.

Time Period Delay Cause Local State Federal

Pre-Katrina Levee fortifaction delayed X

Between

First and

Second

Landfall

Inadequate pre-deployed

resources

X

Delayed Declaration of the

Incident of National

Significance

X

Federal troops not requested X

No forethought to evacuate

residents without vehicles

X

Post-

Katrina

Collapse of first responders X X

Breakdown in

communication network

X X X

FEMA bureaucracy X

Aids from local agencies

blocked

X

Ignorance of ground

situation

X

Tussle over lines of

authority

X X

FEMA overwhelmed X

Delayed military

deployment

X

Delayed acceptance of

foreign aid

X

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Chapter 4

Discussion and Summary

Discussion

It is clear based on how the federal government responded to Hurricane Katrina that the

emergency preparedness plans of all levels of government were lacking. Since the storm, many

steps have been taken to correct these flaws. After the storm, the Bush Administration began to

work on modifying national preparedness plans. In order to do so, the federal government must

begin to collaborate with homeland security departments to create an accountable process for all

national preparedness efforts. Likewise, the Executive Branch and its agencies must be properly

organized, trained, and equipped to perform their emergency response roles (Townsend, 2006).

By implementing national preparedness objectives, the various branches of government at

federal, state, and local levels will have the resources needed to effectively respond to a natural

disaster of any magnitude.

As a result of poor planning, communication networks were all but eliminated. As a

means to prevent a collapse in chain of command and maintain social order, open lines of

communication are required. After Hurricane Katrina, the federal government began to improve

communication strategies at all levels of government. According to Townsend, many

communicate plans and assets were in place during the Hurricane Katrina relief effort; however,

no national, state-wide, or regional communications plan was utilized in order to integrate these

assets into the relief effort (2006). In order to be responsive to national emergencies the federal,

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state, and local governments need to incorporate a comprehensive, nationwide communications

plan.

Thus, by establishing a clear and concise preparedness plan and improving

communication networks, all levels of government would be more capable in responding to

catastrophes such a Hurricane Katrina. At the time disaster struck, the Gulf Coast governments

and the federal government were not equipped nor prepared to handle the aftermath of Katrina.

With more thorough planning, agency coordination, and integration of new policies the federal

government will be able to efficiently respond to disaster areas. The improvement of these two

main areas has allowed for post-Katrina disaster relief efforts to be more effective.

Summary

Hurricane Katrina wreaked havoc on the Gulf Coast. Thousands of people ended up

losing their lives while thousands more were displaced from their homes. The death toll would

have increased exponentially without the superior efforts of public health and medical workers.

These agencies responded to the needs of the affected areas with great efficiency and skill.

Several federal public health agencies were deployed to the Gulf Coast as a means to ensure

quality medical care, prevent disease outbreaks, and limit exposures to environmental hazardous.

However, the federal government’s non-public health respond was delayed and poorly

coordinated. Their delayed response to Hurricane Katrina significantly impacted the majority of

Gulf Coast citizens. Many were left for days without basic necessities such as food, water,

shelter, and medical supplies. Their local and state governments were not equipped to handle a

disaster of this magnitude; therefore, social order all but collapsed throughout the Gulf Coast.

Hurricane Katrina forced all levels of United States government to modify and/or create new

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emergency preparedness plans. By taking initiative by planning, coordinating agency activities,

and improving communication networks after the failed response to Hurricane Katrina the

citizens and government officials will be better prepared for another natural or man-made

catastrophe.

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Chapter 5

Recommendations

In situations such a hurricanes, where advanced notice is critical to the survival of

citizens, it is important to enforce evacuations when necessary. Although the mayor of New

Orleans mandated that all residents were to leave the city, thousands chose to stay behind or

were forced to stay behind due to lack of transportation. In order to decrease the number of

persons that remain in the danger zone, this author thinks that the federal government should

provide funding to state and local governments in order to evacuate as many citizens as possible.

Although this may cost the government millions of dollars, it would ultimately save billions in

medical care that would be needed to treat potential victims and dispose of the deceased.

Moreover, state and local agencies would be able to start on the relief effort immediately instead

of treating and saving those who chose to stay behind and wait out the storm. This author

proposes that when mandatory evacuation decrees are made by government officials, citizen

without transportation should be notified and encouraged to use publicly owned transportation

such a school buses and government vehicles. By using public transportation a larger percentage

of the population would be able to effectively evacuate before the storm hit. When the number of

evacuees surpasses the capacity of the state and local government, the federal government should

supply transportation to the area in need.

Similarly, evacuation plans need to be in place for individuals in nursing homes,

hospitals, etc. Only the patients that cannot be temporarily relocated to different homes and/or

hospitals should be left behind. The patients that are left behind should be condensed into the

most structurally sound facilities in the area thereby, decreasing the number of staff members

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needed to stay behind. Having evacuation plans for hurricanes and other natural disasters will

save the lives of many.

In circumstances such as this one, the local government should and need to be able to

work with the state and/or multiple state government(s) to provide shelter for the evacuees. Once

storm relief shelters are designated in safe zones, people from the affected areas will be required

to seek shelter via publicly operating center or find shelter on their own terms. Those without

vehicles that are transported by bus or government vehicles will be taken to these relief centers.

In addition, each state that is subjected to hurricanes should stockpile non-perishable goods:

food, flashlights, batteries, sleeping bags, bottled water, and medical supplies. Once an

evacuation mandate is made, then these supplies can be delivered to the designated evacuation

centers for use. Only if the local and/or state supplies are nearly depleted, then the federal

government should deliver supplies to the area in need.

One of the biggest problems with disaster management during Hurricane Katrina was the

lack of communication and chain of command. Therefore, this author proposes that every state

along the Gulf Coast and other areas susceptible to hurricanes should have a hurricane – natural

disaster plan. In this plan the chain of command should be pre-designated in accordance with the

severity of the hurricane. For example, Category 1 storms should be primarily dealt with by local

and state officials. Only when overwhelmed with relief efforts, then should the federal

government be called in to help. In these plans it should be clearly designated what the

responsibilities are for each individual government agency. Once the federal government is

called in, then they would assume top in the command chain. By creating such plans, there

would be less confusion about who is in charge and the duties of each government department.

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When a state of emergency is declared by the federal government due to a natural disaster

such as a hurricane or a tornado, this author believes that martial law should automatically go

into effect. Louisiana Governor Blanco adamantly refused to declare martial law after Hurricane

Katrina made landfall on the Gulf Coast. Had she chosen to proclaim martial law in New Orleans

and other affected areas of Louisiana, then a clear chain of command would have been

established throughout the region. Once martial law has been enacted the previously proposed

natural disaster plans would be carried out by the National Guard and the other military forces

under the reign of the federal government.

In a like manner, this author believes that by creating national, state, and local emergency

preparedness plans for natural disasters would greatly decrease the lack of social order and chaos

of the affected region. These plans not only need to be made, but also understood at all levels of

the government. Each agency would thereby clearly understand their responsibilities and how to

effectively carry out these specified duties. By having a clear emergency response plan, there

would be an increase in the efficiency of disaster management. The above recommendations are

critical to ensuring that all disasters nationwide, natural or man-made, are countered promptly

and competently by all levels of government.

Citizens living in regions vulnerable to hurricanes should be encouraged to create disaster

preparedness plans of their own. In order to effectively persuade all citizens to develop said

plans, the state government should offer tax credit incentives. Therefore, this author proposes

that every individual or family that sends in a copy of their preparedness plans to the state

government should receive a $50 - $100 tax credit annually. In these plans the individual or

family must include their evacuation plans with transportation method and at least three pre-

designated safe places. To increase the tax credit, the individual (or family) may submit receipts

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of items purchased for hurricane emergency kits. These kits should be checked and evaluated by

local law enforcement before submitting to state government for tax credit. Eligible items for tax

credit would include: batteries, flashlights, first aid kits, sleeping bags, non-perishable food,

bottled water, and weather radios. The government cannot supply basic necessities and/or aid to

all citizens living in areas susceptible to hurricanes. Thus, this author believes that it is important

for Americans to take action and ready themselves for natural disasters.

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References

Birkland, T., & Waterman, S. (2008). Is federalism the reason for policy failure in Hurricane

Katrina?. Publius: The Journal of Federalism, 38(4), 692-714.

Bowman, S., Kapp, L., & Belasco, A. (2005, September). Hurricane Katrina: DOD Disaster

Response. CRS Report for Congress. Library of Congress Washington DC Congressional

Research Service.

Burton, M. L., & Hicks, M. J. (2005). Hurricane Katrina: Preliminary estimates of commercial

and public sector damages. Marshall University: Center for Business and Economic

Research.

Chua, A. Y., Kaynak, S., & Foo, S. S. (2007). An analysis of the delayed response to Hurricane

Katrina through the lens of knowledge management. Journal of the American Society for

Information Science and Technology, 58(3), 391-403.

CNN Library. (2013). Hurricane Katrina statistics fast facts. Retrieved from:

http://www.cnn.com/2013/08/23/us/hurricane-katrina-statistics-fast-facts/.

Deflem, M., & Sutphin, S. (2009). Policing Katrina: Managing law enforcement in New

Orleans. Policing, 3(1), 41-49.

FEMA.gov. (2006). Hurricane Katrina in the Gulf Coast. Retrieved from:

http://www.fema.gov/media-library-data/20130726-1520-20490-4067/549_cvr_toc.pdf.

FEMA.gov. (2013). About Hurricane Katrina. Retrieved from: http://www.fema.gov/response

recovery/about-hurricane-katrina.

Fox News. (2005). Fast facts: Hurricane Katrina. Retrieved from:

http://www.foxnews.com/story/2005/09/06/fast-facts-hurricane-katrina/.

Gheytanchi, A., Joseph, L., Gierlach, E., Kimpara, S., Housley, J., Franco, Z. E., & Beutler, L. E.

(2007). The dirty dozen: twelve failures of the hurricane katrina response and how

psychology can help. American psychologist, 62(2), 118.

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References (Cont.)

Greenough, P. G., & Kirsch, T. D. (2005). Public health response—assessing needs. New

England Journal of Medicine, 353(15), 1544-1546.

History.com. (2009). Hurricane Katrina. Retrieved from;

http://www.history.com/topics/hurricane-katrina.

Horwitz, S. (2009). Wal-Mart to the rescue: private enterprise’s response to Hurricane

Katrina. The Independent Review, 13(4), 511-528.

Lambrew, J. M., & Shalala, D. E. (2006). Federal health policy response to Hurricane Katrina:

what it was and what it could have been. JAMA, 296(11), 1394-1397.

Lister, S. A. (2005). Hurricane Katrina: The public health and medical response. Congressional

Research Service, 21.

Luo, M. (2005). The Embattled Leader of a State Immersed in Crisis. New York Times.

Mills, M. A., Edmondson, D., & Park, C. L. (2007). Trauma and stress response among

Hurricane Katrina evacuees. American Journal of Public Health, 97.

National Association of Community Health Centers. (2006). Legacy of a disaster: Health centers

and Hurricane Katrina one year later. Retrieved from:

http://www.nachc.com/client//CHCKatrinaReport.pdf.

Schneider, S. K. (2005). Administrative breakdowns in the governmental response to Hurricane

Katrina. Public Administration Review, 65(5), 515-516.

Sobel, R. S., & Leeson, P. T. (2006). Government's response to Hurricane Katrina: A public

choice analysis. Public Choice, 127(1-2), 55-73.

Teitelbaum, J. B., & Wilensky, S. E. (2013). Essentials of health policy and law. Jones &

Bartlett Publishers.

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References (Cont.)

Townsend, F. F. (2006). The federal response to Hurricane Katrina: Lessons

learned. Washington, DC: The White House.

Treaster, J. B., & Zernike, K. (2005). Hurricane Katrina slams into Gulf Coast; dozens dead. The

New York Times. Retrieved from:

http://www.nytimes.com/2005/08/30/national/30storm.html?ref=hurricanekatrina.