title: Conceptualizing health consequences of Hurricane Katrina from the perspective of socioeconomic status decline.
abstract: OBJECTIVE
  The long-term health impact of acute unemployment and socioeconomic resource deficit has not been shown to be unique from the effects of stable socioeconomic status (SES) and serious life circumstances, such as trauma. This study examined associations between these acute socioeconomic declines and health of hurricane survivors, independent of prehurricane SES and hurricane trauma.
  
  
  METHODS
  Participants were 215 African American adults (60% female, mean age = 39 years) living in the Greater New Orleans area at the time of Hurricane Katrina and survey 4 years later. The survey included prehurricane SES measures (i.e., education and neighborhood poverty level); acute unemployment and deficits in access to SES resources following Hurricane Katrina; and posthurricane health events (i.e., cardiometabolic events, chronic pain, posttraumatic stress disorder [PTSD], and major depressive disorder [MDD]).
  
  
  RESULTS
  Acute unemployment was associated with odds of experiencing a cardiometabolic event (odds ratio [OR] = 5.65, p < .05), MDD (OR = 2.76, p < .05) and chronic pain (OR = 2.76, p < .05), whereas acute socioeconomic resource deficit was associated with odds of chronic pain (OR = 1.93, p < .001) and MDD (OR = 1.19, p < .05). Associations were independent of prehurricane SES, hurricane trauma, potentially chronic SES resource deficits, and current unemployment.
  
  
  CONCLUSIONS
  This study shows that acute socioeconomic decline following a natural disaster can create long-term health disparities beyond those created by prehurricane SES level and traumatic hurricane experiences. Findings suggest that early intervention postdisaster to reduce pervasive socioeconomic disruption may reduce the long-term health impact of disasters.
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Nataria T
authors.initials: NT
authors.lastname: Joseph
authors.affiliation: Department of Psychiatry, University of Pittsburgh.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.affiliation: Department of Psychology, University of California.
authors.forename: Hector F
authors.initials: HF
authors.lastname: Myers
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D059350:Chronic Pain / Q000453:epidemiology; D055867:Cyclonic Storms; D003865:Major Depressive Disorder / Q000453:epidemiology; D004190:Disasters / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D054624:Health Status Disparities; D006305:Health Status Indicators; D006331:Heart Diseases / Q000453:epidemiology; D006801:Humans; D008016:Life Change Events; D008297:Male; D055820:New Orleans / Q000453:epidemiology; D016017:Odds Ratio; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D012923:Social Class; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D014478:Unemployment / Q000706:statistics & numerical data*