Katrina's Lessons Endure for Disaster Recovery Experts

GPH's Alexis Merdjanoff reflects on two decades of data about long-term resilience and how we can better support health and safety in the aftermath of the next storm

Hurricane Katrina-which made landfall in Louisiana in August 2005-is among the worst natural disasters to ever hit the United States, devastating communities across the Gulf Coast and forcing more than 1.5 million residents to evacuate their homes.

It's well established that the destruction and grief caused by hurricanes and other natural disasters can harm mental health in the short -term. A new analysis co-authored by NYU School of Global Public Health's Jonathan Purtle found that suicides and drug overdoses spiked among local residents right after the Maui wildfires, and other studies have shown an uptick in psychiatric medications prescribed to Californians in the six weeks after nearby wildfires.

But what happens after the cameras leave and federal assistance and recovery programs end? And why is it that some people can recover quickly after a disaster, while others struggle for years?

Alexis Merdjanoff

Alexis Merdnjanoff

These questions are central to research led by Alexis Merdjanoff, the director of the environmental public health program and assistant professor of social and behavioral sciences at NYU School of Global Public Health. As a sociologist, Merdjanoff focuses on the long-term recovery and resilience in populations affected by disasters, from Hurricanes Katrina, Sandy, and Ian to the Deepwater Horizon oil spill.

"Recovery programming is often focused on the first three to six months after a disaster, but people still need help after that time," says Merdjanoff. "They may not realize what they need until their housing is settled and their kids are back in school. After those more immediate needs are met, they may require a small business loan or mental health services."

For the past 15 years, Merdjanoff has been analyzing data from the Gulf Coast Child and Family Health Study, a longitudinal research study led by NYU School of Global Public Health's David Abramson of more than a thousand families in Louisiana and Mississippi who were displaced or experienced major disruptions due to Hurricane Katrina. Now, two decades after the storm, she reflects on what researchers have learned from these residents and how their findings can help communities recover from future disasters.

Lessons From Lasting Aftermaths

Studies show that having strong social ties and community support increases resiliency and people's ability to recover after disasters. In contrast, being displaced from one's home can have a range of negative effects, from hurting employment prospects to harming mental health.

Using survey data from New Orleans residents, Merdjanoff's research found that housing damage and being a renter (rather than a homeowner) were linked to greater emotional distress. These poor mental health outcomes often persisted for more than a decade after the hurricane; in fact, a delayed onset of PTSD symptoms was common after Hurricane Katrina, which short-term disaster programs fail to address.

Many Gulf Coast residents were able to return to their homes after Katrina, with studies showing better mental health outcomes for this group than for those who relocated or were unstably housed. But others never returned, permanently relocating to other areas. In a new study published in Traumatology, Merdjanoff found three factors that came up in conversations with New Orleans residents in determining whether to return to the city or relocate: post-Katrina housing affordability and the cost of living, including increases in insurance and taxes in New Orleans; family ties and social support influencing both relocation and returning to New Orleans; and a strong attachment to New Orleans.

Merdjanoff believes we can learn lessons from the long-term impact of Hurricane Katrina and use the research findings to predict future mental health needs following other disasters, like the recent California wildfires and Texas floods. For instance, she argues that mental health services should be available to residents at least a year after a disaster, not just a few months. Moreover, disaster programs can provide targeted mental health support for those displaced from their homes for extended periods.

And while recovery programs at the federal level need longer-term models and investments, focusing at the community level is also critically important. This includes leveraging trusted community organizations in the recovery process-for instance by embedding mental health programs in institutions like schools, as was done in New Orleans after Katrina, or providing housing resources and assistance through existing community organizations.

"A lot of the work has to be done at the community level, because so much of disaster recovery is about social cohesion," says Merdjanoff.

Aging in Place When Your Place Is Vulnerable

While a significant amount of disaster research has focused on families and children, a growing area of research for Merdjanoff is the impact of disasters on older adults.

"People like to age in areas that are at risk for hurricanes, heat waves, flooding, and wildfires," she says of the common goal of retiring to beach towns and warm-weather communities across the country. "While some embrace the idea of moving people away from vulnerable areas, if you know anything about older adults, they don't want to leave their homes. If that's the reality we're dealing with, what do older adults need to be able to age in areas that are at risk for frequent climate-related disasters?"

To answer this question, Merdjanoff has spent a lot of time talking with older adults in Louisiana in the decades since Hurricane Katrina, in coastal areas of New Jersey and New York affected by Hurricane Sandy, and in the line of Hurricane Ian in Florida. Through interviews, focus groups, and surveys, she listens to their stories and personal experiences with disasters and the challenges they've faced in recovering.

Merdjanoff has learned that disasters pose a heightened risk to older adults, and not just because of health challenges or social isolation. Older adults are also particularly at risk of being scammed-by predatory contractors, people posing as FEMA officials, or fraudsters stealing identities to collect insurance funds or recovery assistance.

While she sees some geographic differences-for example, older adults in New York City are less lonely than those in other areas, although housing is far less affordable-she also has found shared experiences across disasters and locations. These common challenges and solutions have led Merdjanoff to develop a pilot program to increase disaster resilience among older adults.

The program, which she plans to test in New York City, the Jersey shore, and Florida, will partner older adults with young people to work through a series of exercises around disaster preparedness, memory sharing, and identifying and avoiding scams. Along the way, the pairs will build social cohesion and learn from one another-because this is not just about older adults getting help from their younger counterparts. Older adults are often framed as victims during disasters, but they bring valuable experience to difficult situations that may actually increase their resiliency.

"Older adults have lived through a lot. They may have lost a spouse or friends, or recovered from illness themselves," says Merdjanoff. "They've experienced enough to put things in perspective. How do we tap into this perspective for others and use older adults as a resource?"

While natural disasters are inevitable, their outcomes are not. Merdjanoff hopes that a deeper understanding of their long-term impact on people across the lifespan will help communities to stop making the same mistakes.

"It's frustrating to see that the same things that happened in Hurricane Katrina also happened in Sandy and Ian and the recent floods in Texas," says Merdjanoff. "We need to think creatively about what we take from the important lessons of Katrina to make sure people don't suffer the same consequences."

/Public Release. This material from the originating organization/author(s) might be of the point-in-time nature, and edited for clarity, style and length. Mirage.News does not take institutional positions or sides, and all views, positions, and conclusions expressed herein are solely those of the author(s).View in full here.