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08-20-2023

Hurricane-related deaths on the rise, especially in vulnerable communities

A recent study in the United States has revealed alarming disparities in excess deaths following hurricanes, with higher mortality rates in recent years and in areas where the population is more socially vulnerable. 

The research, published in the journal Science Advances, demonstrates how these excess deaths have varied greatly across different hurricane seasons and regions.

Researchers from institutions including Columbia University Mailman School of Public Health, Colorado State University, Imperial College London, University of California Irvine, and Harvard T. H. Chan School of Public Health analyzed variations in cyclone-related excess deaths by several factors. 

What the researchers discovered 

The experts found that over recent decades, 83 percent of hurricane-related deaths occurred more recently and 94 percent occurred in socially vulnerable counties.

The study sheds light on the variability of the impacts of tropical cyclones, highlighting how demographic, economic, and social factors can drive differences. The total excess deaths were particularly elevated in counties with the largest proportion of minorities, filling a critical knowledge gap in understanding post-hurricane excess deaths.

Excess death counts

The findings reveal some alarming numbers. For example, the largest number of excess deaths was in Orleans Parish, LA, after Hurricane Katrina in 2005, with 719 excess deaths. 

This was followed by Harris County, TX, after Hurricane Rita in 2005 (309 excess deaths), Broward County, FL, after Hurricane Matthew in 2016 (185 excess deaths), and Nassau County, NY, after Hurricane Sandy in 2012 (178 excess deaths)

The most significant number of estimated excess deaths in a single year was in 2005, with 2,163 estimated post-tropical cyclone excess deaths, including 1,491 from Hurricane Katrina. 

Long-standing systemic issues 

“In our study, excess death counts after tropical cyclones were higher more recently and for the most socially vulnerable,” said study lead author Dr. Robbie M. Parks, assistant professor of Environmental Health Sciences at Columbia University Mailman School of Public Health.

Dr. Parks attributed the surge in these deaths partly to long-standing systemic issues. 

“This was likely in part due to lack of access to adequate short-term transportation, as well as inequitable access to financial resources, education, employment opportunities and timely warnings on tropical cyclone proximity, all of which are results of long-term institutional neglect.”

Study implications 

The study emphasizes the necessity of understanding short-term excess deaths following tropical cyclones as a key metric for grasping the public health burden of climate-related disasters. 

This information is vital, as deaths can arise from several major causes, including injuries, diseases, cardiovascular issues, neuropsychiatric conditions, and respiratory ailments.

Using extensive death registration data and statistical models, the researchers estimated the number of excess deaths after tropical cyclones across four decades, offering insights that are compared with data from official sources and international disaster databases.

Hurricanes remain a public health concern 

“Trends of heightened activity and increased intensity of tropical cyclones in recent years indicate that tropical cyclone exposure is and will remain a public health concern,” said study senior author Marianthi-Anna Kioumourtzoglou, ScD.

“Future research may be able to study associations by smaller areal units – ZIP Codes, for example – as appropriate exposure and outcome data become available.”

“It is also essential to prepare for tropical cyclones by accounting for the social determinants of risk and vulnerability of exposed communities, since the most socially vulnerable bear the greatest burden of excess mortality.”

“Our work highlights how deaths are impacted by tropical cyclones, an understudied exposure in relation to public health, and one which will remain an important threat as the climate changes,” said Dr. Parks. 

“As a public health priority, future research should focus on understanding the biological and structural drivers of cyclone-related mortality, how to minimize the number of excess deaths related to tropical cyclones, and the impacts on the scale from years to decades.”

More about post-hurricane excess deaths 

Post-hurricane excess deaths refer to the additional deaths that occur in the aftermath of a hurricane beyond what would be expected under normal circumstances. 

These deaths are not only the direct result of storm impacts (e.g., deaths due to flooding, falling debris, or storm surge) but also from indirect and longer-term effects of the hurricane on the affected community. 

Direct vs. indirect deaths

Direct deaths result directly from the forces of the hurricane. This includes drowning due to storm surge or flooding, injuries from flying debris, or deaths from structural collapses.

Indirect deaths occur after the storm has passed and can be attributed to conditions caused or exacerbated by the hurricane. 

Examples include deaths from lack of medical services, worsening of chronic illnesses due to stress or lack of resources, electrocution from downed power lines, and more.

Factors contributing to excess deaths

Infrastructure damage

Destruction of health care facilities, transportation systems, and essential utilities can lead to delays in emergency response, hampered medical care, and lack of essential services.

Lack of access to medical care

Chronic patients might miss treatments or medication doses, leading to deterioration of their conditions.

Disease outbreaks

Stagnant floodwaters can become breeding grounds for disease vectors like mosquitoes, leading to outbreaks of diseases like dengue or Zika. Contaminated water sources can also lead to waterborne diseases.

Mental health

The trauma from experiencing a hurricane can lead to mental health issues, with some studies suggesting an increase in suicides and other related fatalities post-hurricanes.

Economic strain

The loss of jobs, homes, and resources can lead to prolonged stress and its associated health risks.

Vulnerable populations

As highlighted in the study, socially vulnerable populations often face a higher risk of post-hurricane excess deaths. Factors such as poverty, lack of access to transportation or medical care, language barriers, and more can all contribute to increased vulnerability.

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