Tropical cyclones and mortality in the United States

Abstract

BACKGROUND AND AIM: In the US, tropical cyclones, such as hurricanes and tropical storms, have a devastating impact on society and are an important public health concern. Previous work has comprehensively examined the association of tropical cyclones with hospitalizations within the week of exposure, and case studies have quantified storm impacts on some causes of death for particular powerful hurricanes. But a comprehensive assessment of multiple causes of mortality across multiple years of study is currently missing. METHODS: In the present study, we used data from over 85 million deaths from the National Center for Health Statistics and a comprehensive record of tropical cyclone occurrence in the US over 30 years (1988 – 2017). We formulated a Bayesian conditional quasi-Poisson model to examine how monthly tropical cyclone exposure—defined as number of days in a month with a sustained maximal wind speed of greater than 34 knots—by county affects monthly death rates up to six months after exposure using unconstrained distributed lag terms. We will also examine how changes in storm-related mortality vary by age and sex, as well as how less powerful but more common winds also impact mortality. RESULTS:There was a total of 4,624 tropical cyclone exposure days (of which 202 were hurricane-level) in 1,174 counties distributed throughout 31 states during our study period. We found that each additional hurricane exposure day was associated with average increases in death rate for cardiovascular diseases only in the month following exposure (3.3%; 95% credible interval [CrI]:0.2, 6.3%); and for respiratory diseases (5.3%; 95%CrI:1.1, 9.7%) in the month of exposure with a positive association remaining until three months afterwards. CONCLUSIONS:Our findings demonstrate the need for targeted interventions and additional preparedness for key causes of death before, during, and after tropical cyclones, especially as they are likely to increase in strength with global climate change. KEYWORDS: Tropical Cyclones, Hurricanes, Climate Change, Natural Disasters, Mortality, Weather