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Why Are Deaths Up in New Orleans?

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On March 13, 2007, New Orleans Health Department Director Kevin Stephens testified about the state of post-Katrina health care before the U.S. House of Representatives Committee on Energy and Commerce. Buried in Stephens' testimony was a shocking statistic. Research he conducted found that nearly one and a half times more New Orleans residents died in the first six months of 2006 as compared to the first six months of 2003. The findings are all the more surprising given that in early 2006 the city's population had plummeted.

The full details of the study are expected to be released in June in the inaugural issue of a new journal, Disaster Medicine and Public Health Preparedness. If a trend of increased deaths is borne out by further research, there could be many reasons for it. For example, stress alone is known to exacerbate numerous health conditions.

However some doctors worry that disrupted healthcare services and a hobbled public health infrastructure are making major contributions to sickness and death in Southeast Louisiana. Only fifteen out of twenty-two New Orleans area hospitals are back open, accounting for half of pre-storm beds. The city has a critical shortage of certain specialty services, including mental health care. Moreover, the main provider of indigent healthcare services in New Orleans, Charity Hospital, remains largely shuttered. A proposed new hospital could take seven years to build. While many doctors and nurses are working tirelessly and heroically to fill the gaps, a survey study released in early May found that more than a third of New Orleans area residents said that their access to healthcare has worsened since the storm. This is troubling, given that pre-storm Louisiana consistently ranked at the bottom of all U.S. States in healthcare indicators.

Also unsettling is the back story of Stephens' research. Having the creepy feeling that he and others were "going to more funerals than ever," Stephens tried to track down current, verified mortality statistics from the State. He could not get them. Instead, to assess whether the rumors of increased deaths were real, Stephens and his colleagues were reduced to counting death notices in the pages of the local newspaper, the Times-Picayune. The Louisiana Department of Health and Hospitals, which processes death certificates and is responsible for generating statistical reports in an annual health report card, has yet to make mortality data available beyond 2003 (the latest report card, released in 2006 but bearing death statistics from 2003, can be found here).

Stephens and others are calling for immediate follow-up studies and health interventions as well as a nationwide electronic death registration system. The latter would provide health officials and researchers with a more rigorous and efficient way to follow mortality trends, including across state lines. The need to revamp America's vital records system has been recognized by the National Association for Public Health Statistics and Information systems. The widespread displacement caused by Hurricane Katrina and the real threat of future disasters highlight the urgency of devoting more resources to these priorities.