CHICAGO -- About one fourth of the physicians who left the Gulf Coast in the aftermath of Hurricane Katrina were still gone six months later, and some displaced physicians had no plans to return, according to a study in the inaugural issue of the AMA journal, Disaster Medicine and Public Health Preparedness.

Hurricane Katrina hit the Gulf Coast on August 29, 2005. The storm and subsequent flooding in Louisiana and Mississippi were blamed for at least 1,808 deaths and over $100 billion in damage. More than 1.5 million people were evacuated. By autumn 2005, nearly 6,000 physicians had been displaced from the Gulf region, including 4,486 from three New Orleans parishes. Only three of nine hospitals in Orleans parish had reopened by February 2006, according to background information in the article.

Kusuma Madamala, PhD, MPH of the American Medical Association's Center for Public Health Preparedness and Disaster Response, and colleagues conducted a descriptive Internet-based survey during the spring of 2006 to investigate physician demographics and relocation patterns following Hurricane Katrina. Survey participants were selected from an AMA master file of all licensed physicians reporting addresses within Federal Emergency Management Agency-designated disaster zones in Louisiana and Mississippi before August 2005.

A total of 312 eligible responses were collected, yielding a 32 percent response rate from the physicians who were contacted. Among the disaster zone respondents, 85.6 percent lived in Louisiana and 14.4 percent lived in Mississippi before the hurricane.

By spring 2006, 75.6 percent (236) of the respondents had returned to their original homes, whereas 24.4 percent (76) reported a different place of residence, the authors report.

Nearly ten percent remained out of state, with the preponderance of this group indicating that they were either unlikely to or uncertain about returning their original practice, they continue.

At the time of the survey, 40.7 percent of physicians reported that the hospitals with which they were primarily associated were closed. Virtually all the physicians surveyed also reported some level of damage to their homes.

"As expected, physicians whose homes were significantly damaged or destroyed were far more likely to be displaced at the time of the survey," the authors write. "Approximately 24 percent of those still relocated six months after the disaster reported complete destruction of their homes, and nearly 40 percent of this same group reported personal losses greater than $50,000.

One of the highest priorities identified by the respondents was financial assistance to rebuild their practices.

"Although the plans elicited from respondents are subject to change based on many factors as the Gulf Coast recovery progresses, programs to address identified physician needs in the aftermath of the storm may give confidence to displaced physicians to return. Additional follow-up assessments may be useful in determining whether the identified patterns of physician relocation persist or change over time, the authors conclude.

Post-Katrina Death Rate Soars

The journal also reports that the post-Katrina death rate in New Orleans shows significant increase, demonstrating the need for intervention and improved reporting. 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 that also appears in Disaster Medicine and Public Health Preparedness.

The inaugural issue of the journal covers many vital topics from recent disasters including Hurricane Katrina, the tsunami in Indonesia and the Oklahoma City bombing. Highlighted studies include, "Excess Mortality in the Aftermath of Hurricane Katrina: A Preliminary Report" and "Characteristics of Physician Relocation Following Hurricane Katrina."

Disaster Medicine and Public Health Preparedness was created by the AMA to promote public health preparedness and the science of disaster medicine. The journal will serve as a unifying resource for all health care and public health professionals, the emergency management community and others in the public and private sector who are essential to emergency planning and response.

"The events this decade -- September 11 and subsequent anthrax attacks, the tsunami in Indonesia, the earthquake in Pakistan, Hurricane Katrina, SARS and the fear of pandemic influenza -- remind us that health care and public health professionals must be coordinated and prepared to respond to emergency situations," said Dr. James.

The journal, scheduled to be published twice in 2007 and quarterly beginning in 2008, will showcase research and analysis relevant to disaster medicine and public health preparedness from global experts in all specialties of clinical medicine, epidemiology, public health and disaster management. The journal also will feature best practices, guest commentary from global leaders, and special updates on key topics including public health law and ethics, advocacy, policy and education.

Disaster Medicine and Public Health Preparedness is published for the American Medical Association by leading healthcare publisher Lippincott Williams & Wilkins, an international provider of quality information in all media for physicians and other health care professionals in training and in practice.

An online version of Disaster Medicine and Public Health Preparedness can be found on the Web at www.ama-assn.org/go/DMPHP. The journal also is available on the Journals@Ovid platform.