Post-Katrina death rate in New Orleans shows significant increase; demonstrates need for intervention and improved reporting

CHICAGO — The death rate between January and June 2006 in the greater New Orleans area was nearly 50 percent higher than pre-Hurricane Katrina rates, due in part to a compromised public health infrastructure after Hurricane Katrina, which hit the Gulf Coast on August 29, 2005, according to a study in the inaugural issue of the AMA journal, Disaster Medicine and Public Health Preparedness.

Reports that death notices in the New Orleans Times-Picayune newspaper increased dramatically in 2006 prompted local health officials to determine whether death notice surveillance could serve as a valid alternative means to confirm suspicions of excess mortality requiring immediate preventive actions and intervention.  Under normal circumstance, death rates are derived from death certificates registered at a state's office of vital records.  But for several reasons – including relocation and a reduced workforce after Hurricane Katrina, the data was not available for a timely review and analysis.

Kevin U. Stephens Sr., MD, JD, Director of the New Orleans Health Department, and colleagues used monthly totals from the New Orleans Times-Picayune to obtain the frequency and proportion of deaths from January to June 2006.  They compared these figures with deaths notices from 2002 to 2003.  They also compared death notice figures with data from the state Health Statistics Center on the top ten causes of death in the greater New Orleans area from 2002 to 2003.

"The post-Katrina mortality rate for the first six months of 2006 was approximately 91.37 deaths per 100,000 population. Compared to the pre-Katrina population mortality rate of 62.17 deaths per 100,000 population, this represents an average 47 percent increase from the baseline mortality, suggesting a marked increase in indirect (excess) deaths post-disaster, the authors report. 

"This disaster severely compromised the public health infrastructure, they continue.  "It is suggested that a destroyed or poorly recovered public health infrastructure, which normally would be able to identify health problems and protect the health of a population, has in fact contributed to excess mortality.

Death notices published in the daily Times-Picayune were found to correlate highly with mortality data from the conventional state health information system in the pre-Katrina population.  The authors believe their study validates this alternative source of information, and reveals an urgent need for states to adopt electronic reporting systems.

"Furthermore, death notice monitoring provides real-time mortality information well ahead of official state health information mortality data, giving impetus to the Louisiana health departments to adopt an interoperable statewide EDRS [electronic death registration system] to rapidly assess and monitor mortality," the authors write.  More specifically, there is no accurate or well coordinated methodology to track out of state deaths.  Currently, it is estimated that more than 150,000 residents have not returned to their homes in New Orleans. 

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