title: Hurricane Katrina: prior trauma, poverty and health among Vietnamese-American survivors.
abstract: BACKGROUND
  The flooding of New Orleans after Hurricane Katrina revealed the disproportionate vulnerability of ethnic minority communities for emergency preparedness, disaster relief and health. Nurses need to analyse Katrina's health consequences for the most vulnerable segments of our society.
  
  
  OBJECTIVE
  To examine factors contributing to differential health outcomes among the New Orleans Vietnamese community in response to Katrina.
  
  
  METHODS
  A sample of 113 adult Vietnamese Katrina survivors from New Orleans was recruited. A mixed-method approach, including survey and focus groups, was used to collect data. Survey questions were modified from standardized instruments to evaluate survivors' health status and factors contributing to health outcomes. Multivariate and content analysis were used to investigate effects of prior trauma, financial strain, social support and acculturation level in predicting survivors' health outcomes.
  
  
  RESULTS
  Findings suggested financial strain was the strongest risk factor for Vietnamese survivors' post-traumatic stress disorder (PTSD) symptoms, and physical and mental health post-disaster; while social support was a strong protective factor for health. Survivors who perceived higher impact from previous traumatic experiences had poorer physical health, but not PTSD symptoms or poor mental health after controlling for financial strain and social support, suggesting complex relationships among these measures in predicting PTSD symptoms and health. Less-acculturated individuals also reported higher levels of PTSD symptoms and poorer physical health.
  
  
  CONCLUSIONS
  Catastrophic events like Katrina can result in disproportionate risk of negative health outcomes among vulnerable populations. Nurses should take into account prior trauma, financial strain, social support network and acculturation level, to adequately address survivors' needs.
authors.affiliation: College of Nursing and Healthcare Innovation, Arizona State University, Phoenix, AZ 85004-0698, USA. angela.ccchen@asu.edu
authors.forename: A C-C
authors.initials: AC
authors.lastname: Chen
authors.forename: V M
authors.initials: VM
authors.lastname: Keith
authors.forename: K J
authors.initials: KJ
authors.lastname: Leong
authors.forename: C
authors.initials: C
authors.lastname: Airriess
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.forename: K-Y
authors.initials: KY
authors.lastname: Chung
authors.forename: C-C
authors.initials: CC
authors.lastname: Lee
mesh_terms: D000069:Acculturation; D000223:Adaptation, Psychological; D000328:Adult; D001213:Asian / Q000208:ethnology*; D001294:Attitude to Health / Q000208:ethnology*; D004189:Disaster Planning; D004190:Disasters; D005260:Female; D017144:Focus Groups; D006301:Health Services Needs and Demand; D006304:Health Status; D006801:Humans; D008016:Life Change Events; D008145:Louisiana; D008297:Male; D015999:Multivariate Analysis; D024802:Nurse's Role; D015404:Nursing Methodology Research; D011203:Poverty / Q000208:ethnology*; D012307:Risk Factors; D012944:Social Support; D013313:Stress Disorders, Post-Traumatic / Q000208:ethnology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D013781:Texas; D014744:Vietnam / Q000208:ethnology; D035862:Vulnerable Populations