• Injuries,

  • Mental health,

  • Damp indoor spaces,

  • Newborn screening,

  • Occupational safety and health,

  • Human immunodeficiency virus, sexually transmitted diseases, and tuberculosis program evaluation, and

  • Environmental health issues, including water, sewer, solid waste, vector control, and food.

Social, Scientific, and Organizational Challenges

A range of agencies, including the Department of Health and Human Services (DHHS), the Federal Emergency Management Agency, the Department of Homeland Security, the Environmental Protection Agency, and the Department of Defense, are the first to respond to disasters when federal assistance is necessary. State and local agencies also have important responsibilities that sometimes, but not always, overlap with federal agencies’ responsibilities and can lead to a very complex set of challenges. The central challenges were communication among the agencies and responding to environmental health issues. Housing quality and levels of mold in private homes proved to be particularly difficult to address because these issues do not belong to any particular agency.

Throughout the course of the hurricane response, situational awareness and data management were a challenge. The agencies and organizations involved in the response amassed considerable data; however, there was a lack of centralization of these data in a data repository. Furthermore, sampling results could be easily found; however, interpreting the

In the absence of complete data, we need rapid interpretation of the data we do have, coordination among the various agencies in performing this interpretation, and consistent messaging to the public and policy makers.

—Howard Frumkin

meaning of the results for both policy makers and the public in order for them to make decisions was not easy. Inconsistent messages coming from multiple sources created difficulties for the widely dispersed target population and a challenge for the agencies responsible for distributing the messages. In the absence of complete data, public health officials needed rapid interpretation of the available data, coordination among the various agencies in performing this interpretation, and consistent messaging to the public and policy makers.

Environmental justice was a profound concern in New Orleans. As the media pointed out, the suffering in the aftermath of Hurricane Katrina was not equally distributed among the different subpopulations in the city. Vulnerability was



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