[Congressional Record (Bound Edition), Volume 152 (2006), Part 5]
[Extensions of Remarks]
[Pages 6746-6747]
[From the U.S. Government Publishing Office, www.gpo.gov]




                  EVACUEE STUDY FINDS DECLINING HEALTH

                                 ______
                                 

                         HON. CHARLES B. RANGEL

                              of new york

                    in the house of representatives

                          Tuesday, May 2, 2006

  Mr. RANGEL. Mr. Speaker, I rise today in acknowledgment of a recent 
article in the New York Times which detailed the declining health of 
Hurricane Katrina survivors. The piece reiterated that we must act now 
to aid the many sufferers in Louisiana. Eight months since the disaster 
and many are still without prescription drugs, adequate housing, food, 
and security. This is not the type of problem that will heal itself in 
the matter of a few weeks or months, but of a timetable unknown to us.
  It is a glaring contradiction to say that we as members of the 
federal government have served the people of New Orleans to the best of 
our ability. Not when the rates of mental disorders, and many chronic 
conditions such as asthma are on a steady rise as the Mailman School of 
Public Health at Columbia University and the Children's Health Fund 
concluded in their study of the health impacts upon the Katrina 
survivors. Because of the lack of prescription medications and health 
insurance, people are not able to get the medical treatment that they 
need.
  Among the findings in the study, 34 percent of displaced children 
suffer from disorders such as asthma, anxiety and behavioral problems, 
compared with 25 percent in urban areas of Louisiana before the storm. 
14 percent of those children have gone without prescription medication 
at least 3 months before this study which was conducted in February, 
compared to 2 percent before the storm and the numbers do not lie.
  We have children in Louisiana who have missed huge blocks of class 
time because families are moving so much to provide better lives for 
them, with an average of 3.5 times since the storm. There is no reason 
why a woman caring for seven school-age grandchildren, none who were in 
school during the time of the survey, was battling high blood pressure, 
diabetes and leukemia without any medical treatment. She was later 
admitted to the hospital for pains that she has had since January. She 
said that it had become ``unbearable'', and nothing is making it easier 
for people just like her.
  We must make it easier for people to receive the necessary care that 
they need. The study highlighted the fact that both Congress and the 
State of Louisiana eased eligibility requirements for Medicaid after 
the storm, and because each state sets its own guidelines, some 
families who got food stamps and assistance in other states were no 
longer eligible when they returned home and that is just unacceptable
  Trauma related disorders caused by Hurricane Katrina will have 
lasting impact on the lives of these children. Future American 
generations will have to shoulder the burden left behind from the 
previous. Dr. Irwin Redlener, the director of the National Center for 
Disaster Preparedness at Mailman and co-founder of the Children's 
Health Fund made it clear that ``children do not have the ability to 
absorb six or nine months of high levels of stress and undiagnosed or 
untreated medical problems'' without long-term consequences. Our mental 
health system is not prepared to handle the amount of care it now faces 
unless more treatment dollars are funneled into the system.
  I enter into the Record this article from the New York Times 
published on April 18, 2006 for its insightful look at the real 
problems in the aftermath of Hurricane Katrina. The longer we wait to 
enforce legislation the more suffering these Americans will have to 
endure. I think it is safe to say that the study told us in conclusive 
numerical evidence what we already knew in story form according to Erin 
Brewer, the medical director of the Office of Public Health at the 
Louisiana Department of Health. The facts are clearly laid out and we 
no longer can afford to ignore them.

                [From the New York Times, Apr. 18, 2006]

                  Evacuee Study Finds Declining Health

                           (By Shaila Dewan)

       Families displaced by Hurricane Katrina are suffering from 
     mental disorders and chronic conditions like asthma and from 
     a lack of prescription medication and health insurance at 
     rates that are much higher than average, a new study has 
     found.
       The study, conducted by the Mailman School of Public Health 
     at Columbia University and the Children's Health Fund, is the 
     first to examine the health issues of those living in housing 
     provided by the Federal Emergency Management Agency. Based on 
     face-to-face interviews with more than 650 families living in 
     trailers or hotels, it provides a grim portrait of the 
     hurricane's effects on some of the poorest victims, showing 
     gaps in the tattered safety net pieced together from 
     government and private efforts.
       Among the study's findings: 34 percent of displaced 
     children suffer from conditions like asthma, anxiety and 
     behavioral problems, compared with 25 percent of children in 
     urban Louisiana before the storm. Fourteen percent of them 
     went without prescribed medication at some point during the 
     three months before the survey, which was conducted in 
     February, compared with 2 percent before the hurricane.
       Nearly a quarter of school-age children were either not 
     enrolled in school at the time of the survey or had missed at 
     least 10 days of school in the previous month. Their families 
     had moved an average of 3.5 times since the storm.
       Their parents and guardians were doing no better. Forty-
     four percent said they had no health insurance, many because 
     they lost their jobs after the storm, and nearly half were 
     managing at least one chronic condition like diabetes, high 
     blood pressure or cancer. Thirty-seven percent described 
     their health as ``fair'' or ``poor,'' compared with 10 
     percent before the hurricane.
       More than half of the mothers and other female caregivers 
     scored ``very low'' on a commonly used mental health 
     screening exam, which is consistent with clinical disorders 
     like depression or anxiety. Those women were more than twice 
     as likely to report that at least one of their children had 
     developed an emotional or behavioral problem since the storm.
       Instead of being given a chance to recover, the study says, 
     ``Children and families who have been displaced by the 
     hurricanes are being pushed further toward the edge.''
       Officials at the Louisiana Department of Health and 
     Hospitals said the study's findings were consistent with what 
     they had seen in the field.
       ``I think it told us in number form what we knew in story 
     form,'' said Erin Brewer, the medical director of the Office 
     of Public Health at the department. ``We're talking about a 
     state that had the lowest access to primary care in the 
     country before the storm. And a population within that 
     context who were really, really medically underserved and 
     terribly socially vulnerable.''
       Ms. Brewer said that some of the trailer sites were 
     regularly visited by mobile health clinics, but acknowledged 
     that such programs were not universally available. Neither 
     Congress nor the State of Louisiana eased eligibility 
     requirements for Medicaid after the storm, and because each 
     state sets its own guidelines, some families who received 
     insurance and food stamps in other

[[Page 6747]]

     states were no longer eligible when they returned home.
       While state officials said $100 million in federal block 
     grants was in the pipeline for primary care and mental health 
     treatment, the study's authors said the need was urgent.
       ``Children do not have the ability to absorb six or nine 
     months of high levels of stress and undiagnosed or untreated 
     medical problems'' without long-term consequences, said Dr. 
     Irwin Redlener, the director of the National Center for 
     Disaster Preparedness at Mailman and co-founder of the 
     Children's Health Fund.
       The households included in the study were randomly selected 
     from lists provided by FEMA. They included families living in 
     Louisiana in hotels, trailer parks managed by the disaster 
     agency and regular trailer parks with some FEMA units. A 
     random sample of children in the surveyed households was 
     selected for more in-depth questioning.
       For comparison, the study used a 2003 survey of urban 
     Louisiana families conducted by the National Survey of 
     Children's Health.
       David Abramson, the study's principal investigator, said it 
     was designed to measure the social and environmental factors 
     that help children stay healthy: consistent access to health 
     care and mental health treatment, engagement in school, and 
     strong family support.
       In the Gulf Coast region, where child health indicators 
     like infant mortality and poverty rates were already among 
     the highest in the country, Dr. Abramson said, ``all of their 
     safety net systems seem to have either been stretched or 
     completely dissipated.''
       The study's authors raise the prospect of irreversible 
     damage if children miss out now on normal development 
     fostered by stable schools and neighborhoods.
       One couple told interviewers their three children had been 
     enrolled in five schools since the hurricane, in which one 
     child's nebulizer and breathing machine were lost. The 
     equipment has not been replaced because the family lost its 
     insurance when the mother lost her job, they said, and the 
     child has since been hospitalized with asthma.
       In another household, a woman caring for seven school-age 
     grandchildren, none of whom were enrolled in school at the 
     time of the survey, said she was battling high blood 
     pressure, diabetes and leukemia.
       That woman, Elouise Kensey, agreed to be interviewed by a 
     reporter, but at the appointed hour was on her way to the 
     hospital, where she was later admitted, ``I've been in pain 
     since January, and I'm going to see what's wrong,'' she said. 
     ``It's become unbearable.''
       One woman who participated in the survey, Danielle Taylor, 
     said in an interview that she had not been able to find 
     psychiatric care for herself--she is bipolar--or her 6-year-
     old daughter, who not only went through the hurricane but had 
     also, two years before, been alone with Ms. Taylor's fiance 
     when he died.
       The public clinic Ms. Taylor used to visit has closed since 
     the storm, she said, and the last person to prescribe her 
     medication was a psychiatrist who visited the shelter she was 
     in four months ago. No doctors visit the trailer park in 
     Slidell, La., where she has been staying, she said.
       Ms. Taylor said that her daughter, Ariana Rose, needed a 
     referral to see a psychiatrist, but that her primary care 
     physician had moved to Puerto Rico. ``She has horrible rages 
     over nothing,'' Ms. Taylor said. ``She needs help, she needs 
     to talk to somebody.''
       The survey found that of the children who had primary 
     doctors before the storm, about half no longer did, the 
     parents reported. Of those who said their children still had 
     doctors, many said they had not yet tried to contact them.
       The study's authors recommended expanding Medicaid to 
     provide universal disaster relief and emergency mental health 
     services, as well as sending doctors and counselors from the 
     federal Public Health Service to the region.
       The Children's Health Fund, a health care provider and 
     advocacy group, is not the only organization to raise the 
     alarm about mental health care for traumatized children after 
     Hurricane Katrina. A report issued earlier this month by the 
     Children's Defense Fund said youngsters were being ``denied 
     the chance to share their bad memories and clear their 
     psyches battered by loss of family members, friends, homes, 
     schools and neighborhoods.''
       Anthony Speier, the director of disaster mental health for 
     Louisiana, said that while there were 500 crisis counselors 
     in the field, the federal money that paid for them could not 
     be used for treatment of mental or behavioral disorders like 
     depression or substance abuse. Instead, he said, much of 
     their effort goes into short one-on-one sessions and teaching 
     self-help strategies in group settings.
       ``The struggle for our mental health system is that our 
     resources are designed for people with serious mental 
     illnesses and behavior disorders,'' Dr. Speier said. ``But 
     now the vast population needs these forms of assistance.''
       Dr. Speier continued, ``What we really, from my vantage 
     point, could benefit from is a source of treatment dollars.''
       According to the study's authors, the post-storm 
     environment differs significantly from other crises because 
     of its uncertain resolution.
       ``This circumstance is being widely misinterpreted as an 
     acute crisis, somehow implying that it will be over in the 
     near term, which is categorically wrong,'' Dr. Redlener said. 
     ``This is an acute crisis on top of a pre-existing condition. 
     It's now a persistent crisis with an uncertain outcome, over 
     an uncertain timetable.''

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