HSD SGER: Assessing the Public Health Impacts of Hurricane Katrina

卡特里娜飓风带来的公共卫生问题，特别是可能引发传染病的问题非常严重。卡特里娜飓风过后在休斯顿避难所进行的监测表明，有相当数量的人患有呼吸道和腹泻疾病，包括由诺沃克病毒和可能的志贺氏菌引起的疾病。虽然有大量研究记录了自然灾害对公众健康的影响，但很少有研究审查这些健康影响与衡量灾害及其对建筑和自然环境造成的损害的相关性。这项研究的目的是检查受影响地区的人们的健康结果与他们可能接触的危险条件之间的相关性，包括：1)可能造成身体伤害的结构性损害；2)暴露在水和空气中的环境污染物，包括有毒物质和传染病；3)疏散前暴露在环境中的时间长度；4)获得食物和/或水的机会有限；以及5)无法获得医疗服务的时间长度，包括获得必要药物的时间。初步数据收集将侧重于与人口暴露在潜在危险条件下有关的数据。有关洪水水位、风速和污染性质的信息将从二次来源以及一名联合调查员进行的同期环境研究中获得。HAZUS软件将被用来估计有关县的人口普查区域水平(飓风)或人口普查区块水平(洪水)的建筑损坏情况。面谈将于2006年1月/2月在四个选定的受影响社区进行，包括密苏里州的比洛克西、密苏里州的格尔夫波特、洛杉矶的斯利德尔，如果可能的话，还有洛杉矶的新奥尔良。将开发一个预测性风险模型，以阐明各种自变量和因变量(健康结果)之间的关系。由于变量是相互关联的，将利用多变量分析来操作该模型。将使用适当的分析软件来考虑抽样方法，并将对差异的影响降至最低。由此产生的模型将提供基本信息，可用于改进关于减轻、准备和应对活动的决策，这些活动可以减少飓风造成的短期和长期健康负担的可能性，它还可能允许对其他类型的灾害进行推断。

Public health concerns from Katrina, especially the potential for infectious disease, are significant. Surveillance conducted in the shelters in Houston following Katrina indicated significant numbers of individuals with respiratory and diarrheal disease, including those caused by Norovirus and possibly Shigella. While a significant amount of research exists documenting the public health impacts of natural disasters, very little research exists that examines the correlation of those health impacts with measures of the hazard and resultant damage to the built and natural environment. The purpose of this study is to examine the correlation between health outcomes for people in the impacted areas and hazardous conditions to which they may have been exposed including: 1) structural damage which presents a potential for physical injuries; 2) exposure to environmental contaminants in the water and air, including toxic substances and infectious agents; 3) length of time exposed to the elements prior to evacuation; 4) time with limited access to food and/or water; and 5) length of time without access to medical care, including access to necessary medications.Primary data collection will focus on data related to the population's exposure to potentially hazardous conditions. Information on the flood levels, wind speed, and the nature of contamination will be obtained from secondary sources as well as a contemporaneous environmental study by one of the co-investigators. HAZUS software will be used to estimate building damage on a census tract level (hurricane) or a census block level (flood) for the counties of interest. In-person interviews will be conducted in four selected impacted communities in January/February 2006 including Biloxi, MS; Gulfport, MS; Slidell, LA; and if possible New Orleans, LA. A predictive risk model will be developed to elucidate relationships between the various independent variables and the dependent variables (health outcomes). As the variables are interrelated, multivariate analyses will be utilized to operationalize the model. Appropriate analytic software will be used to take the sampling methodology into consideration and minimize the effect on the variance. The resulting model will provide essential information which can be used to improve decision-making regarding mitigation, preparedness, and response activities that can reduce the potential for short and long-term health burdens as a result of hurricanes, and it may allow for extrapolation to other types of disaster as well.