Katrina Death Rates Murky - State, City Using Different Numbers Submitted By: N.O.V.A Source: Times Picayune 06-1-2007 ********************************************** Copyright. All rights reserved. http://usgwarchives.net/copyright.htm http://usgwarchives.net/la/lafiles.htm ********************************************** State Epidemiologist Raoult Ratard On Thursday Released A Study Showing That The Death Rate Has Not Drastically Escalated Since Hurricane Katrina, Challenging A Study Mayor Ray Nagin Cited When He Claimed "People Are Dying" Because The Local Health System Remains In Tatters. In His State Of The City Address On Wednesday, Nagin Said New Orleans' Mortality Rate Had Swollen 47 Percent Since Hurricane Katrina, A Figure He Drew From The City Health Director's Recent Analysis Of Newspaper Obituaries. That Number Did Not Jibe With The State's Findings, Which Showed That The Death Rate Has Held Steady In The Region Since Katrina, With A Few Exceptions. Most Notably, The Death Rate Climbed In New Orleans In The Early Part Of 2006 Before Subsiding To Pre-Storm Levels About June. The State And The City Approach Their Analyses Of The Death Rate From Different Perspectives. Ratard Examined Death Certificates, Which Account Only For Deaths That Happened Locally. Kevin Stephens, The City's Health Director, Used Newspaper Death Notices To Account For Evacuees Who Died Out Of State And Would Not Show Up In Louisiana's Vital Statistics Registry. Stephens Said The People Who Have Returned To New Orleans Are Those Healthy Enough To Put Their Houses Back Together. He Said The State's Death Rate Is Artificially Low Because It Does Not Account For Frail People Who Died Before Making It Back. By Homing In On Local Deaths, However, The State Data Provides A More Accurate Portrait Of The Viability Of The Local Health System, Officials Said. "We Used Vital Records, And We Think This Is A Factual Analysis," Said Fred Cerise, Secretary Of The Department Of Health And Hospitals. "There Is No Doubt That There Are Legitimate Challenges In The City, And We Are Trying To Be As Factual As We Can As We Approach Those Problems. The Numbers That Are Coming Out Of The City -- The 47 Percent Increase -- Are Exaggerated." Not So, Said Stephens, Whose Report On The Death Rate Will Be Published Later This Month In The Journal "Disaster Medicine And Public Health Preparedness." For Months He Has Declined To Release His Study, Saying Thursday That He Cannot Release The Data Before His Study Is Published. But He Asserted That "The Article Proves There Are Other Ways To Get Reliable Data About Mortality Rates Other Than Vital Statistics." Neither The City Nor The State Study Offers A Completely Current Picture Of How Katrina Has Affected Mortality Rates. The City Report Accounts Only For Deaths Through June 2006, While The State Report Covers The Period Through Last August. Ratard Said The State Is Still Compiling Statistics Since September. The State Report Also Does Not Include Mortality Rates For The Last Four Months Of 2005. Nonetheless, Stephens Said The State's Report Showed Some Troubling Trends. While The Death Rate In The Region Remained Constant, It Climbed In New Orleans In The First Months Of 2006. In A Typical January, The City Logs About 12 Deaths Per Thousand Residents. In January 2006, The Rate Jumped To 15.8 Per Thousand -- About A 25 Percent Increase. "That Is Not A Slight Increase," He Said. "It Is A Major Increase." The Death Rate In New Orleans Fell Steadily After January 2006, However, And It Had Returned To Its Pre-Storm Level By June 2006. More In St. Bernard While Jefferson, St. Tammany And St. Charles Parishes Showed No Notable Changes During That Period, St. Bernard Also Saw A Vertiginous Rise In Its Mortality Rate In January 2006, To 24.8 Deaths Per Thousand Residents. The Parish's Death Rate Declined Within A Month, However. Stephens Said Such Numbers Are Especially Unsettling When Compared To The National Mortality Rate, Which Is Less Than 8.2 Deaths Per Thousand. "We Are Starting From A Mortality Rate Of 11, When It Should Have Been Closer To The National Average," He Said. "Now We Are At 14.3, And That Is Sky-High." While The State Figures Offer Only A Snapshot In Time, Ratard Said He Did Not Want To Wait Years For A Complete Set Of Data. He Said It Was Important To Offer Figures For Public Discussion As Quickly As Possible To Dispel Rumors That New Orleans Is Suffering From A Wild Increase In The Death Rate. "You Hear Some People Saying There Is A Huge Increase In The Number Of Deaths, While Some People Would Say It Is About The Same. What We Usually Do When There Is A Controversy Is Tell People What We Know When We Know It," Ratard Said. He Echoed Cerise's View That Tabulating Newspaper Death Notices Is Not A Reliable Way Of Gauging The Mortality Rate. "Obituaries Are A Voluntary Notice That Is Put In The Newspaper By The Families," Ratard Said. "You Can See That There Are All Kind Of Things That Can Influence That." He Said The State Probably Never Will Have A Complete Portrait Of How Many Deaths Outside Louisiana Resulted From Katrina. "We Do What We Can With What We Have. The Deaths Out Of State Will Always Be A Problem," Ratard Said. "There Will Always Be Some Uncertainty. I Am Sure There Are People Out Of State Who Were So Disturbed By Katrina That It Probably Accelerated Their Death. It Is Tough To Document That." Ratard's Study Examined Raw Numbers, And Not Causes Of Death. He Said He Could Not Offer An Explanation For Why The Death Rate Briefly Accelerated In New Orleans And St. Bernard During The Early Months Of Last Year. During His Address This Week, Nagin Attributed The Uptick In The Death Rate To Lack Of Access To Health Care. He Did Not Single Out Uninsured Patients In His Talk, But They Have Been Especially Vulnerable Since The Closing Of Charity Hospital. "Health Care In Our City Is In Crisis," Nagin Said. "In New Orleans And The Region, Our Patients Are Suffering From A Lack Of Primary Care And Long Wait Lines In The Emergency Room. Our Mental Health Patients Have Been Abandoned." Cerise Said It Was Difficult To Make That Leap.