Disabilities and Disaster Health Service Use after

Hurricane Katrina

Laura M. Stough, Ph.DCenter on Disability and Development

Texas A&M University

Amy N. Sharp, Ph.DElizabeth McAdams Ducy, Ph.DAaron Resch, Ph.DCenter on Disability and DevelopmentTexas A&M University 

Judith Holt, Ph.DJeff Sheen, MACenter on DisabilityUtah State University

Richard PettyIndependent Living Research Utilization at The Institute for Rehabilitation Research, Houston

Collaborators

First Study: Face-to-face Interviews

39 interviews with individuals with disabilities regarding their:1) Daily life

and supports pre-disaster

2) Disaster narrative

3) Daily life and supports 3 years post-disaster

Second Study: Telephone surveys

Telephone surveys with59 individuals that included1. 65 items

based on findings from the interviews

2. 12 demographic items

Third Study: Focus Group

Focus group with participants in both Texas (n=6) and Louisiana (n=5) which we followed up on the emergent categories from our qualitative analysis

Challenges in Design and Data Collection

Identification of participants with disabilities Determining disability status Low incidence of samples Verbal and cognitive ability to participate in data collection

procedures Physical access issues Sensory access issues Consent procedure issues Proxy and guardianship issues High mobility in post-disaster living situations Access to transportation Access to computers and other technologies

Potential participants called into a 800 number and were screened by a licensed psychologist or the PI

A brief screener was used to ascertain if they qualified for participation: 23 or older Living in southern Louisiana at the time of the storm Displaced for at least three months following the storm Were currently living in either Texas or Louisiana Had a disability or diabetes that affected at least one activity

of daily living (ADL) before the storm An appointment was made to conduct a face-to-face

interview at a locale and time of convenience for the participant or

An appointment was made to conduct a telephone survey

Procedures

After 30 face-to-face interviews were completed, transcribed, and coded, grounded theory analysis was used to identify primary emerging categories. Some of these categories included: Housing Employment Transportation Recreation Spiritual Activities Health & Well-being Social Relationships Accessing Services

Survey Item Categories

Texas Louisiana TOTAL

Intellectual Disabilities 2 2 4

Diabetes 13 13 26

Other Disabilities 16 13 29

TOTAL 31 28 59

Survey Participants

42%

58%

Gender

MaleFemale

78%

18%

2%2%

Ethnicity

African AmericanWhite HispanicNative American

Health & Well-Being

Before After Same See doctor more 27% 50% 21% See dentist more (6% reported Not Applicable)

37% 24% 31%

Physical health better 73% 5% 21% Mental health better 57% 8% 34%

Social Relationships

Before After Same Saw friends and neighbors more

88% 4% 6%

Saw family members more

72% 11% 16%

Knew more neighbors

80% 14% 4%

Had more friends 78% 11% 9%

Accessing Services

Before After Same

More time on paperwork 15% 63% 21% More time contacting agencies

3% 78% 18%

No 22%Yes 78%

If yes, how?

I can't get around and do the things I need to do by myself. I can't pay my bills, do my shopping. I have to depend on someone else and it is very upsetting.

…my health has gotten worse. …still depressed to the point that I can't fully function.

Can't do what I used to do. I have flashbacks about water coming in. I can't keep house up and organized.

It seems like if I was up and walking I would have been able to get home sooner. Being in the wheelchair I haven't been able to get back home. A lot of things were not wheel chair accessible for me. Like they were not modifying regular homes so that I could move back. They were only helping people that were on section 8 before Katrina.

Do you think that having [a disability or diabetes] has affected your long-term recovery from Hurricane Katrina?

In-depth, post-disaster data obtained directly from individuals with disabilities

Data on the health and well being status of individuals with disabilities during the long-term recovery phase

Quantitative data on pre- versus post-disaster functioning of individuals with disabilities

Description of how disability intersects with the recovery process following disaster

Contributions to Extant Literature

Contact information

Laura M. Stough, Ph.DDepartment of Educational PsychologyCenter on Disability and Development

Texas A&M Universitylstough@tamu.edu

979-845-8257