A new study found that hurricanes and tropical storms are associated with an increase of up to 33.4% in death rates in the months after the weather event. Driving this uptick are injuries, infectious and parasitic diseases, cardiovascular disease, and neuropsychiatric disorders. And the burden of these diseases is greatest on economically disadvantaged communities that are in the storms’ path.
For the study, researchers looked at data from 33.6 million death records in the United States from 1988 to 2018. The data came from 1,206 counties in the country that had experienced a median of two days of weather activity from tropical cyclones—in the form of tropical storms or hurricanes—during those years. The researchers used a statistical model that compared deaths in the weeks after a tropical storm or hurricane to similar periods in years when there were no storms. The study was published in JAMA.
The study design revealed an association between the time of a cyclone and changes in certain patterns of death rates, Robbie Parks, PhD, lead study author and post-doctoral research scientist at Columbia University Mailman School of Public Health, told Verywell. Recent hurricane seasons in the United States have had stronger, more active storms that lasted longer and traveled further inland from where they first made landfall, he noted.
The difference between a tropical storm and a hurricane is a matter of wind speed. A tropical storm is a cyclone that has maximum sustained winds of between 39 and 73 miles per hour or less. A hurricane has sustained winds of 74 miles per hour or higher.
“The climate science is clearer and clearer that a cyclone will be stronger on average and make peak wind closer to land,” Parks said. “But in terms of what that association will be with public health outcomes, such as death and hospitalization, it really is a function of future resilience.”
Communities will need better preparations in advance of the storm, “but also capacity to tolerate a cyclone, both during and then the recovery period afterward. That recovery period could be weeks, days, and decades," he added.
The Health Impacts of the Storm
Deaths after a tropical storm or hurricane may be undercounted in the immediate aftermath, James Shultz, PhD, associate professor at the University of Miami Miller School of Medicine and lead author on an editorial in JAMA that commented on the study, told Verywell.
The study led by Parks shows that there is an incremental increase in deaths due to various causes that occur even far inland, he said.
“Hurricanes don’t stop at the coast,” Shultz said. “The storm systems go inland.” Tropical storms bring high winds and heavy rain that cause flooding and other dangerous situations. Hurricane Sandy dumped up to three feet of snow in the Appalachian Mountains after it went inland, he pointed out.
Deaths due to injuries generally occur within a day or so of a tropical storm or hurricane. But deaths due to infectious or parasitic diseases may occur some time after the storm and may be due to damage to water and sewage systems or even to people being moved into crowded shelters or temporary housing, Parks said.
Although Hurricane Katrina in 2005 and Hurricane Sandy in 2012 might be examples of just how devastating these storms can be, the data collected in this study included many storms that were much less intense, Parks noted.
“Maybe we should focus on cyclones that don’t necessarily grab the headlines,” Parks added.
The analysis calculated the number of additional deaths that may have been due to a storm. Each additional day of cyclone activity per month was associated with an increased death rate in the month following the storm. The largest increase in deaths was related to injuries, with an increase of 33.4% in the month in which a hurricane occurred and a 3.4% increase in the month afterward.
Deaths due to infectious or parasitic diseases peaked one to two months after the storm, Parks said.
Researchers have documented the health impacts of hurricanes for years. Typically, injuries following the storm are most well documented. But research shows that chronic diseases, including cardiovascular disease and mental disorders, continue to occur for years following the hurricane’s impact.
Behind some of these health issues are troubles accessing medications after the storm, not having access to proper care and medical equipment, and environmental factors like carbon monoxide poisoning risk from generators.
Preparing for the Storm
Preparedness in advance of a storm and resilience afterward are equity issues, Parks pointed out. Low-income communities might not be able to evacuate rapidly in advance of a storm or have the ability to cope with widespread damage afterward, he said.
These communities may have to cope with water and sanitation systems that are damaged for longer periods of time. The inclusion of the effects of economic vulnerability on the outcome of cyclones was an important part of the study, Shultz noted.
The Centers for Disease Control and Prevention (CDC) provides some tips for staying safe and preventing injuries or illnesses after a tropical storm, including:
Stay out of floodwaterNever use a wet electrical deviceIf the power is out, use flashlights instead of candlesPrevent carbon monoxide poisoningBe careful near damaged buildingsStay away from power linesProtect yourself from animals and pestsDrink safe water and eat safe foodWash your handsTake care of any wounds or injuries to prevent infectionClean up your home safelyTale care of your emotional health
