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| January 31, 2008 |
Impact of Hurricanes Katrina and Rita on Substance Use and Mental Health
In Brief
- In the Gulf State areas affected by Hurricanes Katrina and Rita, the rate of past month marijuana use among adults aged 18 or older was lower in the year following the hurricanes than in the year before the hurricanes. There were no significant differences in the prevalence of illicit drug use, binge alcohol use, cigarette use, mental health problems, mental health treatment, or unmet need for mental health treatment in the same time period
- Adults aged 18 or older who were displaced from their homes for 2 or more weeks following the hurricanes had higher past month rates of illicit drug use, marijuana use, and cigarette use and higher past year rates of serious psychological distress, major depressive episode, and unmet need for mental health treatment or counseling in 2006 than those who were not displaced in the affected areas
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In August 2005, Hurricane Katrina caused extensive damage to the coastal regions of Louisiana, Mississippi, Alabama, and Florida, leading to a disaster area that covered 90,000 square miles and leading to more than 1,800 deaths.1 In September 2005, Hurricane Rita devastated coastal regions in Southeast Texas and Louisiana. These hurricanes and their aftermath resulted in extremely high levels of trauma for many individuals living in the affected regions, including prolonged displacement from their homes.2
A number of studies have documented that individuals exposed to disasters such as hurricanes3 and terrorist attacks4-6 can experience substantial adverse substance use and mental health effects. However, this pattern has not been found in all studies. A study that used the National Survey on Drug Use and Health (NSDUH) to compare the prevalence of substance use and mental health problems among residents of the New York City area before and after the events of September 11, 2001, found a significantly higher prevalence of marijuana use among males after the attacks, but found no other differences in substance use; moreover, it found no differences in indicators of mental disorders or in the utilization of mental health services.7
Although few data are available on the effects of Hurricanes Katrina and Rita on substance use among Gulf Coast residents, there is a growing literature that documents the effects of the hurricanes on mental health. The Centers for Disease Control and Prevention, surveying individuals in the New Orleans area in October 2005, reported that 50 percent of those surveyed showed a possible need and 33 percent showed a probable need for mental health counseling.8 In a 2006 survey of trailer or hotel residents displaced due to the hurricanes, 68 percent of female caregivers reported a mental health disability due to symptoms of depression, anxiety, or other psychiatric disorders, and those female caregivers reported that 44 percent of their children had symptoms of new psychiatric problems.9 Similarly, a survey of Louisiana residents living in Federal Emergency Management Agency (FEMA) trailer parks in March and April 2007 showed a markedly higher prevalence of symptoms of depression compared with residents of the State as a whole.10 A survey of individuals affected by Hurricane Katrina found that they had significantly higher rates of mental illness when compared with persons surveyed in 2001 from two U.S. census divisions in the affected area; however, those in the post-Katrina sample who had mental health problems reported significantly lower rates of thoughts of suicide or plans to commit suicide than were found in the 2001 sample.2 A study of veterans in the Gulf Coast area indicated that destruction of facilities offering health services in the areas most affected by Hurricane Katrina led to significant disruptions in services for veterans, especially services related to mental health and substance abuse, following the hurricane.11
This special issue of The NSDUH Report presents two analyses. The first analysis focuses on the overall prevalence of substance use and mental health problems, mental health treatment, and unmet treatment needs before and after Hurricanes Katrina and Rita among adults aged 18 or older who lived in the Gulf State Disaster Area and, for comparison, in the rest of the United States. Estimates of substance use and mental health problems before Hurricanes Katrina and Rita were based on NSDUH data from July 2004 through June 2005. Estimates for the post-hurricane period were based on NSDUH data from January 2006 through December 2006.
The second analysis examines post-hurricane prevalence rates of substance use and mental health problems among Gulf State adults who were displaced from their homes as a result of the hurricanes compared with those in the disaster area who were not displaced. These estimates were based on 2006 NSDUH data.
The Gulf State Disaster Area includes the counties and parishes in Alabama, Florida, Louisiana, Mississippi, and Texas that were declared by FEMA as eligible for Individual Assistance and/or Public Assistance following Hurricane Katrina and/or Hurricane Rita, with the exception of counties and parishes that were declared by FEMA as eligible only for Public Assistance (Categories A or B) (Figure 1).
Below is a map and legend, click here for the text describing this map.
Figure 1. Gulf State Disaster Areaa
 |
| Source: Adapted from National Hurricane Center data and Federal Emergency Management Agency data for SAMHSA, 2007. |
Measures and Study Population
NSDUH provides data on the prevalence, correlates, and patterns of substance use and abuse, as well as data on mental health problems and treatment. An annual survey of the civilian, noninstitutionalized U.S. population aged 12 or older, with interviews from approximately 67,500 people, NSDUH yields a sample sufficient to generate national, State, and substate-level estimates. This report on the impact of Hurricanes Katrina and Rita focuses on adults aged 18 or older and their past month use of illicit drugs,12 cigarettes, and binge use of alcohol,13 as well as past year serious psychological distress (SPD),14 major depressive episode (MDE),15 substance use disorder (SUD),16 receipt of mental health treatment or counseling,17 and unmet need for mental health treatment or counseling.18 In addition, NSDUH includes questions about age, gender, and race/ethnicity.19
Approximately 14.2 million adults were living in the Gulf State Disaster Area in the year before Hurricanes Katrina and Rita, and approximately 14.4 million adults were living there in 2006 (Table 1). There were some small changes from the pre- to post-hurricane periods in the demographic distributions in the Gulf State Disaster Area, but these changes were not statistically significant (Table 2).20
Table 1. Population Aged 18 or Older in the Gulf State Disaster Areaa and in the Total State before and after Hurricanes Katrina and Rita, by State of Residence: Numbers (in Thousands), July 2004 to June 2005 and January to December 2006
| State |
Gulf State Disaster Area |
Total State |
July 2004 to
June 2005 |
2006 |
July 2004 to
June 2005 |
2006 |
| Total |
14,237 |
14,361 |
37,869 |
38,791 |
| Alabama |
1,389 |
1,404 |
3,343 |
3,398 |
| Florida |
3,999 |
4,062 |
13,314 |
13,732 |
| Louisiana |
2,577 |
2,442 |
3,229 |
3,103 |
| Mississippi |
1,840 |
1,843 |
2,078 |
2,089 |
| Texas |
4,431 |
4,610 |
15,905 |
16,469 |
| Source: SAMHSA, 2004 to 2006 NSDUHs. |
Table 2. Residents Aged 18 or Older in the Gulf State Disaster Areaa and in the Remainder of the United States, by Demographic Characteristics: Numbers (in Thousands) and Percentages, July 2004 to June 2005 and January to December 2006
| Demographic Characteristic |
Gulf State Disaster Area |
Remainder of United States |
July 2004 to
June 2005 |
2006 |
July 2004 to
June 2005 |
2006 |
| Population Estimate |
14,237 |
14,361 |
202,056 |
206,159 |
| |
|
| |
Percent |
| Age |
|
| 18 to 25 |
15.2% |
14.9% |
15.0% |
14.8% |
| 26 to 49 |
46.5% |
45.7% |
46.5% |
45.5% |
| 50 or older |
38.3% |
39.4% |
38.5% |
39.7% |
| Gender |
|
| Male |
47.6% |
47.7% |
47.8% |
48.2% |
| Female |
52.4% |
52.3% |
52.2% |
51.8% |
| Hispanic Origin and Race |
|
| Not Hispanic or Latino |
80.8% |
80.0% |
88.0% |
87.4% |
| White |
55.2% |
54.3% |
71.5% |
70.5% |
| Black or African American |
21.9% |
22.0% |
10.3% |
10.7% |
| Hispanic or Latino |
19.2% |
20.0% |
12.0% |
12.6% |
| Educationb |
|
| < High School |
19.2% |
21.7% |
16.1% |
16.2% |
| High School Graduate |
32.2% |
33.9% |
31.3% |
31.1% |
| Some College |
25.0% |
23.7% |
25.5% |
25.1% |
| College Graduate |
23.5% |
20.7% |
27.1% |
27.5% |
| Current Employmentb |
|
| Full-Time |
53.2% |
56.2% |
55.9% |
55.0% |
| Part-Time |
11.3% |
9.8% |
13.2% |
13.3% |
| Unemployed |
3.7% |
3.6% |
3.5% |
3.2% |
| Otherc |
31.8% |
30.4% |
27.5% |
28.5% |
| Family Incomeb |
|
| Less Than $20,000 |
27.7% |
25.3% |
19.1% |
18.8% |
| $20,000 to $49,999 |
35.5% |
34.8% |
34.8% |
34.7% |
| $50,000 to $74,999 |
16.1% |
15.5% |
18.3% |
17.6% |
| $75,000 or More |
20.6% |
24.4% |
27.9% |
28.9% |
| Source: SAMHSA, 2004 to 2006 NSDUHs. |
Based on special questions added to NSDUH in 2006, respondents were classified as displaced in 2006 if they reported that they had lived in a State bordering the Gulf of Mexico before Hurricanes Katrina and Rita and that they left their home and stayed overnight in temporary housing (any place someone stays overnight or longer that is not thought of as his or her permanent home) as a result of either Hurricane Katrina or Rita.21 In 2006, 65.7 percent of adults aged 18 or older who lived in the Gulf State Disaster Area after the hurricanes indicated that they had not been displaced, 23.9 percent (3.4 million) were displaced for less than 2 weeks, and 10.4 percent (1.5 million) were displaced for 2 weeks or longer (Table 3). Gulf State residents aged 50 or older were less likely than younger residents to have been displaced. More than half of the adult residents living in the affected areas of Louisiana and Texas before the hurricanes were displaced. Texas had the highest percentage of disaster area adult residents who were displaced for less than 2 weeks (46.3 percent). Louisiana had the highest percentage of adult residents displaced for 2 weeks or longer (32.1 percent).
Of all adult Gulf State residents who were displaced for less than 2 weeks, more than half lived in Texas before the hurricanes (60.2 percent), while more than half of all adult residents who were displaced for 2 weeks or longer lived in Louisiana before the storms (55.2 percent) (Table 4).
Table 3. Gulf State Disaster Areaa Residents Aged 18 or Older, by Length of Displacement from Their Homes Due to Hurricane Katrina and/or Hurricane Rita, by Age, Gender, and State of Residence: Row Percentagesb, 2006
| Demographic Characteristicd/State |
Not Displaced |
Displaced |
| Less Than 2 Weeks |
2 Weeks or Longer |
| Total |
65.7% |
23.9% |
10.4% |
| Age |
|
|
|
| 18 to 25 |
61.5% |
26.2% |
12.3% |
| 26 to 49 |
61.6% |
27.6% |
10.8% |
| 50 or Older |
71.9% |
18.8% |
9.3% |
| Gender |
|
|
|
| Male |
66.9% |
23.5% |
9.6% |
| Female |
64.6% |
24.3% |
11.2% |
| State Lived in Before Hurricanes Katrina and/or Ritae |
|
|
|
| Alabama |
89.9% |
5.9% |
4.2% |
| Florida |
91.7% |
6.8% |
1.5% |
| Louisiana |
42.7% |
25.3% |
32.1% |
| Mississippi |
65.2% |
20.8% |
13.9% |
| Texas |
47.4% |
46.3% |
6.3% |
| State Lived in After Hurricanes Katrina and/or Rita |
|
|
|
| Alabama |
90.1% |
5.8% |
4.2% |
| Florida |
91.5% |
6.6% |
1.9% |
| Louisiana |
43.2% |
25.6% |
31.2% |
| Mississippi |
65.2% |
20.9% |
13.9% |
| Texas |
48.0% |
44.8% |
7.2% |
| Source: SAMHSA, 2006 NSDUH. |
Table 4. Gulf State Disaster Areaa Residents Aged 18 or Older, by Length of Displacement from Their Homes Due to Hurricane Katrina and/or Hurricane Rita: Numbers (in Thousands) and Column Percentagesb, 2006
| Demographic Characteristicd/State |
Totalf |
Not Displaced |
Displaced |
| Less Than 2 Weeks |
2 Weeks or Longer |
| Population Estimate |
14,061 |
9,234 |
3,363 |
1,465 |
| |
|
| |
Percent |
| Age |
|
| 18 to 25 |
14.5% |
13.6% |
15.9% |
17.1% |
| 26 to 49 |
45.8% |
42.9% |
52.8% |
47.3% |
| 50 or older |
39.7% |
43.5% |
31.2% |
35.6% |
| Gender |
|
| Male |
47.5% |
48.3% |
46.7% |
43.7% |
| Female |
52.5% |
51.7% |
53.3% |
56.3% |
| State Lived in Before Hurricanes Katrina and/or Ritae |
|
| Alabama |
9.9% |
13.6% |
2.4% |
4.1% |
| Florida |
28.2% |
39.4% |
7.9% |
* |
| Louisiana |
17.7% |
11.5% |
18.5% |
55.2% |
| Mississippi |
12.7% |
12.7% |
11.0% |
17.3% |
| Texas |
31.5% |
22.8% |
60.2% |
19.3% |
| State Lived in After Hurricanes Katrina and/or Rita |
|
| Alabama |
9.8% |
13.5% |
2.4% |
3.9% |
| Florida |
27.9% |
38.8% |
7.6% |
5.2% |
| Louisiana |
17.1% |
11.3% |
18.4% |
51.4% |
| Mississippi |
12.9% |
12.8% |
11.3% |
17.3% |
| Texas |
32.2% |
23.6% |
60.3% |
22.2% |
| Source: SAMHSA, 2006 NSDUH. |
Prevalence Rates Before and After the Hurricanes
Substance Use and SUD. The prevalence of past month marijuana use among adults aged 18 or older in the Gulf State Disaster Area was significantly lower in the post-hurricane than the pre-hurricane period (Table 5). The prevalences of past month illicit drug use, binge alcohol use, and cigarette use, as well as the prevalence of past year SUD (Table 6), were not significantly different in the post-hurricane and pre-hurricane period. In the remainder of the United States, there were no statistically significant differences in substance use or SUD except for a higher rate of nonmedical use of prescription-type drugs in the post-hurricane period (Table 5).
Table 5. Past Month Substance Use among Persons Aged 18 or Older: Percentages, July 2004 to June 2005 and January to December 2006
| Substance Use |
Gulf State Disaster Areaa |
Remainder of United States
|
July 2004 to
June 2005 |
2006 |
July 2004 to
June 2005 |
2006 |
| Illicit Drug Useg |
7.5% |
6.2% |
7.7% |
8.2% |
| Marijuana Use |
5.1%h |
3.7% |
6.0% |
6.1% |
| Nonmedical Use of Prescription-Type Drugs |
3.1% |
3.0% |
2.4%h |
2.8% |
| Binge Alcohol Usei |
25.1% |
22.7% |
24.6% |
24.6% |
| Cigarette Use |
26.9% |
26.0% |
26.4% |
26.7% |
| Source: SAMHSA, 2004 to 2006 NSDUHs. |
Mental Health Problems and Treatment. Although the prevalence estimates for past year SPD, receipt of mental health treatment or counseling, and unmet need for mental health treatment or counseling in the Gulf State Disaster Area among adults aged 18 or older were lower post-hurricane than they had been before the hurricanes, these differences were not statistically significant (Table 6). There also was no change in MDE prevalence between the pre- and post-hurricane periods. There were no pre- and post-hurricane differences in mental health problems and treatment for the remainder of the United States.
Table 6. Past Year Substance Use Disorder, Mental Health Problems, and Mental Health Treatment among Gulf State Disaster Areaa Residents Aged 18 or Older: Percentages, July 2004 to June 2005 and January to December 2006
Mental Health Problem
or Treatment |
Gulf State Disaster Areaa |
Remainder of United States |
July 2004 to
June 2005 |
2006 |
July 2004 to
June 2005 |
2006 |
| Serious Psychological Distressj |
12.2% |
10.7% |
11.5% |
11.3% |
| Major Depressive Episodek |
7.4% |
7.4% |
7.5% |
7.2% |
| Substance Use Disorderl |
10.7% |
9.1% |
9.1% |
9.3% |
| Receipt of Mental Health Treatment or Counselingm |
13.1% |
11.0% |
13.0% |
13.0% |
| Unmet Need for Mental Health Treatment or Counselingn |
4.8% |
3.8% |
5.0% |
4.8% |
| Source: SAMHSA, 2004 to 2006 NSDUHs. |
Effect of Displacement on Substance Use and Mental Health
Gulf State Disaster Area residents aged 18 or older who were displaced from their homes for 2 weeks or longer had significantly higher rates of past month use of illicit drugs, marijuana, and cigarettes than those who were not displaced (Figure 2).22 Rates of marijuana use and cigarette use were significantly higher among those displaced 2 weeks or longer than those displaced less than 2 weeks. Adult residents of the area who were displaced from their homes for less than 2 weeks had significantly higher rates of past month binge alcohol use compared with residents who were not displaced.
Figure 2. Prevalence of Past Month Substance Use among Gulf State Disaster Areaa Residents Aged 18 or Older, by Length of Displacement from Their Homes Due to Hurricane Katrina and/or Hurricane Rita: Percentages, 2006
|
Figure 2 Table. Prevalence of Past Month Substance Use among Gulf State Disaster Areaa Residents Aged 18 or Older, by Length of Displacement from Their Homes Due to Hurricane Katrina and/or Hurricane Rita: Percentages, 2006
| Substance Use |
Not Displaced |
Displaced Less Than 2 Weeks |
Displaced 2 Weeks or Longer |
| Illicit Drugsg,r,s |
4.9% |
7.4% |
10.5%o,p |
| Marijuanar,s |
2.9% |
3.7% |
8.1%o,p |
| Nonmedical Use of Prescription-Type Drugs |
2.7% |
3.7% |
2.7% |
| Binge Alcoholi,t |
20.4% |
27.1%o,q |
25.2% |
| Cigarettesr,s |
24.9% |
24.7% |
34.1%o,p,q |
| Source: SAMHSA, 2006 NSDUH. |
Gulf State Disaster Area residents aged 18 or older who were displaced from their homes for 2 weeks or longer had significantly higher rates of SPD, MDE, and unmet need for mental health treatment or counseling in the past year compared with residents who were not displaced or who were displaced for less than 2 weeks (Figure 3). Approximately one in four residents who were displaced for 2 weeks or longer reported SPD; rates of MDE were more than 3 times higher among those who had been displaced for 2 weeks or longer compared with those who were not displaced. Adult residents of the Gulf State Disaster Area who were displaced for 2 weeks or longer were more likely to have received mental health treatment or counseling compared with residents who were not displaced, although this difference was not statistically significant.
Figure 3. Prevalence of Past Year Substance Use Disorder, Mental Health Problems, and Mental Health Treatment among Gulf State Disaster Areaa Residents Aged 18 or Older, by Length of Displacement from Their Homes Due to Hurricane Katrina and/or Hurricane Rita: Percentages, 2006
|
Figure 3 Table. Prevalence of Past Year Substance Use Disorder, Mental Health Problems, and Mental Health Treatment among Gulf State Disaster Areaa Residents Aged 18 or Older, by Length of Displacement from Their Homes Due to Hurricane Katrina and/or Hurricane Rita: Percentages, 2006
Mental Health Problem
or Treatment |
Not Displaced |
Displaced Less Than 2 Weeks |
Displaced 2 Weeks or Longer |
| Serious Psychological Distressj,r,s |
9.2% |
8.5% |
25.7%o,p |
| Major Depressive Episodek,r,s |
5.6% |
6.5% |
19.0%o,p |
| Substance Use Disorder |
8.0% |
10.6% |
12.5% |
| Receipt of Mental Health Treatment or Counselingm |
10.3% |
10.6% |
16.6% |
| Unmet Need for Mental Health Treatment or Counselingn,r,s |
3.5% |
2.7% |
9.0%o,p,q |
| Source: SAMHSA, 2006 NSDUH. |
End Notes
1 Knabb, R. D., Rhome, J. R., & Brown, D. P. (2005, December 20; updated 2006, August 10). Tropical cyclone report: Hurricane Katrina 23-30 August 2005. Retrieved September 21, 2007, from http://www.nhc.noaa.gov/pdf/TCR-AL122005_Katrina.pdf
2 Kessler, R. C., Galea, S., Jones, R. T., & Parker, H. A. (2006). Mental illness and suicidality after Hurricane Katrina. Bulletin of the World Health Organization, 84, 930-939.
3 David, D., Mellman, T. A., Mendoza, L. M., Kulick-Bell, R., Ironson, G., & Schneiderman, N. (1996). Psychiatric morbidity following Hurricane Andrew. Journal of Traumatic Stress, 9, 607-612.
4 North, C. S., Nixon, S. J., Shariat, S., Mallonee, S., McMillen, J. C., Spitznagel, E. L., & Smith, E. M. (1999). Psychiatric disorders among survivors of the Oklahoma City bombing. Journal of the American Medical Association, 282, 755-762.
5 Galea, S., Ahern, J., Resnick, H., Kilpatrick, D., Bucuvalas, M., Gold, J., & Vlahov, D. (2002). Psychological sequelae of the September 11 terrorist attacks in New York City. New England Journal of Medicine, 346, 982-987.
6 Vlahov, D., Galea, S., Resnick, H., Ahern, J., Boscarino, J. A., Bucuvalas, M., Gold, J., & Kilpatrick, D. (2002). Increased use of cigarettes, alcohol, and marijuana among Manhattan, New York, residents after the September 11th terrorist attacks. American Journal of Epidemiology, 155, 988-996.
7 Office of Applied Studies. (2002). Impact of September 11, 2001 events on substance use and mental health (DHHS Publication No. SMA 02-3729, Analytic Series A-18). Rockville, MD: Substance Abuse and Mental Health Services Administration. [Available at http://samhsa.gov/data/katrina/toc.cfm]
8 Centers for Disease Control and Prevention. (2006, January 20). Assessment of health-related needs after Hurricanes Katrina and Rita—Orleans and Jefferson Parishes, New Orleans area, Louisiana, October 17-22, 2005. Morbidity and Mortality Weekly Report, 55(2), 38-41. [Available at http://www.cdc.gov/mmwr/preview/mmwr/mm5502a5.htm]
9 Abramason, D., & Garfield, R. (2006, April 17). On the edge: Children and families displaced by Hurricanes Katrina and Rita face a looming medical and mental health crisis. New York: Mailman School of Public Health, Columbia University, National Center for Disaster Preparedness. [Available at http://www.ncdp.mailman.columbia.edu/program_special.htm]
10 Schafer, M. J., & Singelmann, J. (2007, April). Louisiana FEMA Park Survey. Retrieved September 21, 2007, from http://lra.louisiana.gov/assets/migration/LouisianaFEMAParkSurvey_web.pdf
11 Druss, B. G., Henderson, K. L., & Rosenheck, R. A. (2007). Swept away: Use of general medical and mental health services among veterans displaced by Hurricane Katrina. American Journal of Psychiatry, 164, 154-156.
12 NSDUH defines illicit drugs as marijuana/hashish, cocaine (including crack), inhalants, hallucinogens, heroin, or prescription-type drugs (including pain relievers, tranquilizers, stimulants, and sedatives) used nonmedically.
13 Binge alcohol use is defined as drinking five or more drinks on the same occasion (i.e., at the same time or within a couple of hours of each other) on at least 1 day in the past 30 days.
14 Serious psychological distress (SPD) is an overall indicator of past year nonspecific psychological distress derived from the K6 scale administered in NSDUH to adults aged 18 or older. The K6 questions measure symptoms of psychological distress during the 1 month in the past 12 months when respondents were at their worst emotionally. For a discussion of the methodology used to generate SPD estimates, see Section B.4.4 of Appendix B in both the 2004 and the 2005 national NSDUH results reports at http://www.oas.samhsa.gov/nsduh/reports.htm
#Standard. For details on the K6 scale, see the following paper: Kessler, R. C., Barker, P. R., Colpe, L. J., Epstein, J. F., Gfroerer, J. C., Hiripi, E., Howes, M. J., Normand, S. L., Manderscheid, R. W., Walters, E. E., & Zaslavsky, A. M. (2003). Screening for serious mental illness in the general population. Archives of General Psychiatry, 60, 184-189.
15 NSDUH includes questions to assess past year major depressive episode (MDE). MDE is defined using the diagnostic criteria set forth in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (Washington, DC: American Psychiatric Association, 1994), which specifies a period of 2 weeks or longer during which there is either depressed mood or loss of interest or pleasure and at least four other symptoms that reflect a change in functioning, such as problems with sleep, eating, energy, concentration, and self-image.
16 Substance use disorder (SUD) is defined as dependence on or abuse of illicit drugs or alcohol in the past 12 months. Dependence or abuse is based on definitions found in the DSM-IV.
17 "Mental health treatment or counseling" is defined as having received inpatient care or outpatient care or having used prescription medication for problems with emotions, nerves, or mental health in the past 12 months. Respondents were not to include treatment for drug or alcohol use. Respondents with unknown treatment/counseling information were excluded. Estimates were based only on responses to items in the adult mental health service utilization module.
18 "Unmet need for mental health treatment or counseling" is defined as a perceived need for treatment for mental health problems in the past 12 months that was not received. This measure also includes persons who received some treatment for mental health problems in the past 12 months but also reported that they perceived a need for treatment that they did not receive. Unmet need among those who received treatment may be interpreted as delayed or insufficient treatment in the past 12 months.
19 Race/ethnicity categories are determined by combining the responses from two separate questions. For this report, respondents identifying themselves as *Hispanic were assigned to the Hispanic group regardless of their racial identification. Respondents identifying themselves as non-Hispanic were grouped according to their racial identification. Thus, "white" refers to those identifying themselves as non-Hispanic and white.
20 To reflect population changes in the Gulf State Disaster Area following the hurricanes, the analysis weights for the 2006 NSDUH were adjusted to the county- or parish-level population estimates derived from the 2006 U.S. census. For each of the five States that border the Gulf of Mexico, counties or parishes were aggregated to affected and unaffected areas. Within the affected and unaffected areas, two strata were defined depending on population gain or loss from July 2005 to July 2006. The poststratification of the weights was done in such a way that for each stratum within the affected or unaffected area, the adjusted weights for age group (18 to 25, 26 to 34, 35 to 49, 50 to 64, 65 or older), race (white, black, others), gender, and Hispanic origin within a State could be summed up to the corresponding population estimates from the U.S. census. The analysis weights for the pre-hurricane period also were adjusted to the county- or parish-level population estimates derived from the 2004 and 2005 U.S. census. The poststratification for the pre-hurricane data was similar to the poststratification of the post-hurricane data, except that there were no strata defined within affected and unaffected areas within the five States.
21 Depending on their State of residence before the hurricanes, respondents were asked whether they had to leave their homes and stay in temporary housing because of the hurricanes. Respondents residing in Alabama, Florida, or Mississippi were asked about staying in temporary housing due to Hurricane Katrina; respondents residing in Texas were asked about staying in temporary housing due to Hurricane Rita; and respondents residing in Louisiana were asked about staying in temporary housing due to either hurricane. Standard NSDUH data collection procedures were used to identify displaced persons and temporary housing units. Specifically, if the person met the standard eligibility requirement of living in the selected dwelling unit at least half of the quarter, survey field staff were reminded to survey displaced persons wherever they currently were residing (e.g., at a friend's or relative's home). In addition, temporary housing units (e.g., hotel rooms, trailer homes on the grounds of selected dwellings, or groups of trailer homes that had not been present when the sample frame was initially built) that were observed by field staff were included as part of the sample if the unit fell in the geographic interval between a sampled dwelling unit and the next dwelling unit on the sample frame. If a large number of temporary units were encountered, these units were sampled at the same rate as the original sample. In addition to these standard procedures, some special procedures were employed. In the fourth quarter of 2005, NSDUH field staff were instructed to assign a pending status code to housing units that were vacant or damaged and to return midway through the quarter to see whether the dwelling unit had become re-occupied. In 2006, the first quarter sample was supplemented in the areas most affected by the hurricanes. For more information on the methods used to include displaced individuals, see the 2005 and the 2006 NSDUH sample design reports at http://samhsa.gov/data/nsduh/methods.cfm.
22 All significant differences between displacement categories reported in this section were further tested in logistic regression models that controlled for age, gender, education, race/ethnicity, family income, and State. Only three of the significant differences became nonsignificant with these statistical controls. These were comparisons of "displaced 2 weeks or longer" and "not displaced" for past month cigarette use (OR = 1.47; p = .067) and unmet need for mental health treatment or counseling (OR = 1.82; p = .230), as well as the comparison of "displaced less than 2 weeks" and "not displaced" for binge alcohol use (OR = 1.33; p = .114).
Figure and Table Notes
a The Gulf State Disaster Area includes the counties and parishes in Alabama, Florida, Louisiana, Mississippi, and Texas that were declared by FEMA as eligible for Individual Assistance and/or Public Assistance following Hurricane Katrina and/or Hurricane Rita, with the exception of counties or parishes declared as eligible only for Public Assistance (Categories A or B).
b Percentages may not add to 100 percent because of rounding.
c The "other" employment category includes retired persons, disabled persons, homemakers, students, or other persons not in the labor force.
d Data are not presented for other demographic characteristics due to lack of precision.
e In 2006, respondents provided the State, but not the county or parish, where they lived in 2005 before Hurricane Katrina or Rita. For this reason, these estimates may include individuals who lived in the State before Hurricane Katrina or Rita but did not live in a county or parish declared a disaster area.
f Respondents with unknown displacement information were not included.
g See End Note 12.
h Difference between this estimate and 2006 estimate is statistically significant at the 0.05 level.
i See End Note 13.
j See End Note 14.
k See End Note 15.
l See End Note 16.
m See End Note 17.
n See End Note 18.
o Difference between estimate and not displaced estimate is statistically significant at the 0.05 level.
p Difference between estimate and displaced less than 2 weeks estimate is statistically significant at the 0.05 level.
q Difference between estimate and not displaced estimate was not significantly different when further tested in a logistic regression model that controlled for age, gender, education, race/ethnicity, family income, and State (see End Note 22).
r Displaced 2 weeks or longer significantly higher than not displaced (p < .05).
s Displaced 2 weeks or longer significantly higher than displaced less than 2 weeks (p < .05).
t Displaced less than 2 weeks significantly higher than not displaced (p < .05).
Suggested Citation
Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (January 31, 2008). The NSDUH Report - - Impact of Hurricanes Katrina and Rita on Substance Use and Mental Health. Rockville, MD.
Note
Additional data tables from this analysis are available online: http://samhsa.gov/data/katrina/toc.cfm.
The National Survey on Drug Use and Health (NSDUH) is an annual survey sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA). The data in this report from July 2004 to June 2005 are based on information obtained from 44,803 persons aged 18 or older, including 2,663 persons who lived in the Gulf State Disaster Area. The data in this report from 2006 are based on information obtained from 44,931 persons aged 18 or older, including 2,699 persons who lived in the Gulf State Disaster Area. The survey collects data by administering questionnaires to a representative sample of the population through face-to-face interviews at their place of residence.
The NSDUH Report is prepared by the Office of Applied Studies (OAS), SAMHSA, and by RTI International in Research Triangle Park, North Carolina. (RTI International is a trade name of Research Triangle Institute.)
Information on NSDUH used in compiling data for this issue is available in the following publications:
Office of Applied Studies. (2007). Results from the 2006 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 07-4293, NSDUH Series H-32). Rockville, MD: Substance Abuse and Mental Health Services Administration.
Office of Applied Studies. (2006). Results from the 2005 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 06-4194, NSDUH Series H-30). Rockville, MD: Substance Abuse and Mental Health Services Administration.
Office of Applied Studies. (2005). Results from the 2004 National Survey on Drug Use and Health: National findings (DHHS Publication No. SMA 05-4062, NSDUH Series H-28). Rockville, MD: Substance Abuse and Mental Health Services Administration.
Also available online: http://oas.samhsa.gov.
Because of improvements and modifications to the 2002 NSDUH, estimates from the 2002 through 2006 surveys should not be compared with estimates from the 2001 or earlier versions of the survey to examine changes over time. |
| The NSDUH Report is published periodically by the Office of Applied Studies, Substance Abuse and Mental Health Services Administration (SAMHSA). All material appearing in this report is in the public domain and may be reproduced or copied without permission from SAMHSA. Additional copies of this report or other reports from the Office of Applied Studies are available online: http://oas.samhsa.gov. Citation of the source is appreciated. For questions about this report, please e-mail: shortreports@samhsa.hhs.gov. |
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