Obstacles and Facilitators to Evacuation
from Hurricane Katrina
David Eisenman, MD MSHS
AcademyHealth, Annual Research Meeting
June 27, 2006
UCLA Division of General Internal Medicine and
Health Services Research & RAND Corporation
Co-authors
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Kristina Cordasco, MD MPH
Steve Asch, MD MPH
Deborah Glik, ScD
Joya Golden, BA
Research on minorities and disasters
• Surprisingly little known about minority communities
and disasters
• Studies describe disparities but factors operating
within minority groups less understood
• Most commonly cited reasons for non-evacuation
were transportation & risk perception*
– Social psychological theory predicts decision-making is
multifactorial and socially embedded
– Invites questions about circumstances and relationships of
reasons and reasons not included in surveys
• Qualitative research provides detailed, in-depth
accounting of cultural context, social environment,
individual cognition leading to evacuation behavior
(*Brodie et al, AJPH 2006)
Purpose
To study the experience of Hurricane Katrina
evacuees to understand evacuation decisionmaking in impoverished, urban, minority
communities.
Participants describe factors affecting evacuation
that are complex, interacted with one another,
and were socially influenced.
Methods
Study Recruitment
• Adult evacuees residing in major centers
• Random selection
• September 9-12, 2005
Data Collection
• Semi-structured
– Sources and understanding of information
prior to the hurricane
– Knowledge, perceptions and resources that
influenced evacuation
– Reflections on factors that might have
altered their behavior
• Recorded, professionally transcribed
Data Analysis
• Grounded theory approach
• In-vivo & theoretical coding
• 2 of 3 ‘coders’ independently applied
codes and resolved differences by
consensus
• Atlas.ti software
Results
Socio-demographic Characteristics of Study
Participants (N=58)
New Orleans resident
Gender
95%
52% Male
Ethnicity
African American
White
Latino
Asian/PI
81%
10%
5%
3%
Age
18-34 years old
35-54 years old
55-74 years old
75+ years old
Missing
16%
46%
31%
5%
2%
Socio-demographic Characteristics of Study
Participants (N=58)
Income
< $20, 000
$20,000-30,000
30,000 - 40,000
40,000-50,000
50,000 +
Refused
50%
31%
9%
2%
5%
3%
Education
< High School
High School
> High School
45%
40%
10%
Results: Major Themes
1194 statements
coded
Shelter
Trust
Transportation
Risk
perception
Money, jobs,
property
Message
understanding
Health
Social network
Transportation
• One car was not enough if others had
evacuated earlier with it or if the
family was too large for it
– “I mean, if you've got 20 people trying to
get in one car it's not going to happen.
So some people, you just stay because
you have to.”
Shelter
• Having extended family outside of
New Orleans influenced evacuation
– “Really truly, we had cars, but we
didn't know anybody to go to.”
– “They said go to Texas but I didn't
know anybody in Texas.”
Money, property, jobs
• “You have to be able to feed your children when
you leave. You have to be able to have a place
to stay, you have to have gas money, you have
to have rental car money. I couldn't afford to do
that. You need at least $500/$600, and that's the
least amount of money.”
Discussing clients from HIV/AIDS group home:
“We had five of them placed, two of them were
not placed, so that means when we had to
evacuate…I had to take them with me.”
Money, property, jobs
• “They were already robbing. And
my dad, he had to stay behind
because we had a lot of tools and
belongings there.”
Money, property, jobs
• Fear of job loss influenced
evacuation
– “If you don't come around then, you
know, I'll just see you when I see
you.’…That means when I see you
you're going to be fired.”
Health
• Health of extended family
influenced evacuation
– “I could have made it on my own,
but it was just my aunt and my
uncle. Every few steps he
made…she forgot his
walker…every few steps he made
he was falling down.”
Social networks
• Obstacle or facilitator to evacuation
• Overlapped with transportation,
shelter, and health themes
– “I started making phone calls to my
children warning them to get out. And
after that, my sister, she had called
me. So I went to pick her and her
children up, and grand children, and
we just started driving, heading toward
Florida.”
Social networks
• Obligations to elderly influenced
evacuation
– “My plans were to leave. Unfortunately we
received a call and we had to come back
home. My mother-in-law had called for us
to come back…. You know when they get a
certain age they get confused.”
Discussion
The influence of social networks
• Broad networks hindered and facilitated
evacuation
– Stretched limited resources
– Obligations to extended family, especially
elderly who resisted evacuation or were frail,
inhibited individuals and nuclear families
– Extended families remained together and
stayed as units, even at the cost of overriding
dissenting opinions
Policy and research implications
• Disaster research and programs must address
social units (households, extended families,
neighborhoods) and institutions (churches) not
just individuals.
• Emergency food and gas vouchers must be
provided to urban poor in hazard zones
• Need further research on the frequency of
threatened job loss as an obstacle; do we need
job protection laws?
Limitations
Strengths
• Social response bias • Adds to understanding
of the influence of
• Specific urban
social networks on
community
decisions and behavior
• Not representative of • Evaluating interactions
between factors
all evacuees
influencing evacuation
• Sample randomly
selected (and similar to
concurrent study
sample)
Funding for this study was provided by the CDC
(grant # K01 CD000049-01) & the National
Hazards Research and Applications
Information Center
We gratefully acknowledge the participants who
were willing to participate during a time of
intense personal difficulty.
Special thanks to Michele Allen, M.D., M.S.
Sample questions
• Were you aware of the
recommendations to evacuate?
• When did you learn this information?
From what source?
• Did you consider leaving? Did you want
to leave?
• What made evacuating easy/hard for
you?
Health
• …because I'm a
diabetic and I have to
be close by to get to
doctors and hospital...
• I no healthy to drive too
far.
• I take so much
medication by that time
I was like groggy
Social networks
• My mother-in-law wouldn't leave the
house. My husband wouldn't leave
her and I'm not going to leave him.
Risk perception
• I know it’s a flooding city but the street I
live on does not flood
Risk perception
• Flooding became dangerous to one
person only “when it got up to my
neck… I'm an excellent swimmer.”
Risk perception
• The last storm we had there, it was more
people got hurt on the highway traveling
away from the storm, running out of gas,
accidents, than it would have been if
they stayed home.
Risk perception
• “I probably would ride another one
out….I mean, even though it was a
category 5, all it did was tore the roof off
my house.”
Trust
• It was from them opening flood gates,
telling lies about the levee breaking and
stuff...I believe they do these things
intentionally...so they can flood out those
black neighborhoods.