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Abstract
It is well established that disasters negatively affect use of healthcare services. Immigrants are particularly vulnerable to disruption in healthcare after disasters due to language barriers, cultural beliefs, unfamiliarity with recovery resources and with the health care system more generally and inadequate financial resources. On August 29, 2005, Hurricane Katrina flooded much of New Orleans, including the healthcare infrastructure. Eastern New Orleans, which has a large Vietnamese American population, was heavily flooded. This dissertation aims to assess one principal trajectory of post-disaster recovery for this community, focusing on healthcare utilization in the Vietnamese immigrant enclave just before Katrina and during the first five years after Hurricane Katrina. I employed panel data from the Katrina Impacts on Vietnamese-Americans study. The sample of Vietnamese American respondents was selected from a population register of all Vietnamese-American households in the greater New Orleans area just before Hurricane Katrina. The same individuals were assessed in 2005 (just before Katrina), 2006, 2007, and 2010. Several random effects logit models and fixed effects models were estimated to address the central research questions. The roles that social support and acculturation play in post- disaster access to healthcare are key to this dissertation. The findings demonstrated that Katrina disrupted healthcare use resulting in a significant declining pattern of obtaining routine health care over the time. Even at the fifth anniversary of Katrina, access to routine physical exams had yet to fully recover to the level of access previously attained by Vietnamese immigrants. The result of this dissertation also reveals that the impact of Katrina significantly influenced effects of acculturation on obtaining a routine physical exam.
