As the Carolinas begin to deal with the aftermath of Hurricane Florence, an analysis of health insurance claims reveals how Hurricane Harvey affected people's health across a wide swath of Southeast Texas last year.
Hurricane Harvey hit the Texas coast on Aug. 25, 2017. In a matter of days, it dumped 27 trillion gallons of water on southern Texas and Louisiana. The category 4 storm may go down as one of the most damaging and costly hurricanes in U.S. history, second only to Hurricane Katrina in 2005. It’s long-term effects on the health of those caught in its path will be a topic of case studies for years to come.
Making the Health Care System Work asked Leanne Metcalfe, Ph.D., executive director of research and strategy for Blue Cross and Blue Shield of Illinois, Montana, New Mexico, Oklahoma and Texas, about the insights gained from member claims data one year later.
MHCSW: How did you go about doing this analysis?
Metcalfe: Blue Cross and Blue Shield is in all the counties across the state. Because we cover more Texans than any other insurer in the state, we can infer that this is what happened, in general, to people affected by the hurricane. We focused on the 41 counties identified by FEMA as being affected, around 1.2 million people. We looked at the claims data from our members in those counties to see what was covered, what health care services were being used, and then we compared those to the same period in past years, so we could make some assumptions about what was due to the hurricane itself.
MHCSW: What did you find?
Metcalfe: We found some pretty interesting things. We know that a traumatic event like a hurricane can cause a significant amount of mental and physical health stress. One area we looked at was claims for mental health care. We found that the number of claims we had for post-traumatic stress disorder actually doubled from the same period in prior years. We saw a small increase in the number of drug abuse claims, as well.
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MHCSW: What other health concerns that could be traced to the hurricane did you find in your data?
Metcalfe: We know that the water from the hurricane wasn’t the cleanest, carrying diseases and bacteria. During rescue and cleanup efforts, people were wading through that water. As a result, we saw claims also doubled for health issues linked to infectious or parasitic diseases. This included meningitis, TB, cholera, food poisoning and typhoid. We also saw that those diagnoses were about 12% higher than in other parts of the state.
Another concern came with the air quality — all the mold and mildew in the air once the water receded and cleanup began. We saw quite a bit of increase in cases of pneumonia and COPD, with about 6,300 new diagnosis in those counties.
MHCSW: Did you also find an impact on long-term health issues, like diabetes or heart conditions, because people weren’t able to get care for health issues they already struggled with?
Metcalfe: We did. It was a little harder to look at because there were so many factors. Did chronic kidney disease get worse because they couldn’t get to a dialysis center? Things like that. We were able to study the patterns of where people went for care to manage their chronic diseases.
MHCSW: What was the reason for looking at this data? How will the results be used?
Metcalfe: One of the things we want to do as we keep looking at this is to make sure our members are getting the help they need. Did the people who were affected get the help they needed right away, and then those who still feel these effects, how did we help them as well? It really helps us think about how we as an organization can better prepare to help our members when these types of catastrophic disasters happen, and then how we deal with the issues that result from them.
[Related video: Learn more about this analysis in a Blue Promise video interview produced by Blue Cross and Blue Shield of Texas.]
Note: The findings are based on claims received in the six months after Hurricane Harvey compared with the same timeframes in each of the previous two years.