Hurricane Exposure Research Articles

Hurricane exposure, personality traits, and perceived changes in health and health behaviors

Using data from a retrospective pre-/post-longitudinal study of young adults impacted by Hurricane Harvey in 2017 (N = 330), we investigated the main and moderating effects of hurricane exposure and the Big Five personality traits on perceived changes in health and health behaviors. Linear regressions showed that more hurricane exposure was associated with worse perceived diet changes. People who were more extraverted tended to perceive better health changes, whereas people who were more neurotic tended to perceive worse overall health, sleep, diet, and exercise changes. The association between hurricane exposure and perceived diet changes was stronger for people higher in conscientiousness, such that at high levels of hurricane exposure, people who were more conscientious tended to perceive the worst diet changes.

Hurricane disasters and radiation treatment delays among patients diagnosed with non-small cell lung cancer.

98 Background: Hurricanes can disrupt cancer care and adversely affect health outcomes, especially for patients needing daily radiation therapy, which depends on stable electricity and safe facility access. Among patients diagnosed with locally advanced non-small cell lung cancer (NSCLC), disruptions in radiation can decrease survival. This study evaluates the associations of exposure to a hurricane disaster and radiation delays and total dose received among patients diagnosed with NSCLC. Methods: Patients aged ≥18 years who initiated radiation therapy for non-operable stage III NSCLC between 2004-2021 were identified from the National Cancer Database. Exposure was defined as a Federal Emergency Management Agency (FEMA) hurricane disaster declaration at the county of the treating facility during radiation treatment. Patients treated at the same facility, but at a time when no hurricane happened (i.e. unexposed) were propensity score matched in a 1:1 ratio with exposed patients on age at diagnosis, sex, lymph node involvement, comorbidity score, season, and era (radiation start year 2004 – 2009, 2010 – 2015, 2016 – 2021), to account for more active hurricane seasons in recent years. Delays in radiation treatment completion were defined as > 8 weeks between date when radiation started and ended. A two-way t-test and Mantel-Haenszel test were used to examine associations of hurricane exposure and radiation dose and treatment delays respectively. Results: 6,260 matched patients were included, of whom 3,130 were treated at facilities exposed to hurricanes during radiation and 3,130 completed treatment at the same facilities but at a time when no hurricane exposure happened. Patients treated during hurricanes had 1.95 higher odds (95% confidence interval (CI): 1.71 – 2.24) of experiencing treatment delays compared to unexposed patients (23% of exposed patients experienced delays compared to 13% of unexposed patients). Exposed patients were more likely to have received higher radiation doses compared to unexposed patients (mean 5221.81 cGy vs. 4962.75 cGy; p < 0.0001). Conclusions: Patients with locally advanced NSCLC who received radiation during a hurricane disaster were more likely to experience treatment completion delays. Patients treated during a hurricane were also more likely to receive higher total doses of radiation, possibly suggesting compensation to mitigate the detrimental biological impact of radiation delays. As severe weather events become more common, comprehensive emergency preparedness plans that incorporate evidence-based strategies for mitigating adverse effects of treatment delays are essential.

Examining recurrent hurricane exposure and psychiatric morbidity in Medicaid-insured pregnant populations

Examining recurrent hurricane exposure and psychiatric morbidity in Medicaid-insured pregnant populations

Climate change anxiety, hurricane exposure, and climate change actions and attitudes: results from a representative, probability-based survey of US Gulf Coast residents

Exposure to climate change-related threats (eg, hurricanes) has been associated with mental health symptoms, including post-traumatic stress symptoms. Yet it is unclear whether climate change anxiety, which is understudied in representative samples, is a specific mental health threat, action motivator, or both, particularly in populations exposed to climate-change related disasters. We sought to examine the associations between exposure to hurricanes, climate change anxiety, and climate change actions and attitudes in a representative sample of US Gulf Coast residents. This study used data from a 5-year, representative, prospectively assessed, probability-based, longitudinal cohort sample of residents in Texas and Florida (USA) exposed to exogenous catastrophic hurricanes rated category 3 or greater. Participants were adults aged 18 years and older and were initially recruited from the Ipsos KnowledgePanel in the 60 h before Hurricane Irma (Sept 8-11, 2017). Relationships between climate change anxiety, hurricane exposure, hurricane-related post-traumatic stress symptoms, general functional impairment, and climate change-related individual-level actions (eg, eating a plant-based diet and driving more fuel efficient cars) and collective-level actions (eg, petition signing and donating money) and climate change action attitudes were evaluated using structural equation modelling. The final survey was completed by 1479 individuals (787 [53·2%] women and 692 [46·8%] men). Two climate change anxiety subscales (cognitive-emotional impairment and perceived experience of climate change) were confirmed using confirmatory factor analysis. Mean values were low for both climate change anxiety subscales: cognitive-emotional impairment (mean 1·31 [SD 0·63], range 1-5) and perceived climate change experience (mean 1·67 [SD 0·89], range 1-5); these subscales differentially predicted outcomes. The cognitive-emotional impairment subscale did not significantly correlate with actions or attitudes; its relationship with general functional impairment was attenuated by co-occurring hurricane-related post-traumatic stress symptoms, which were highly correlated with general functional impairment in all three models (all p<0·0001). The perceived climate change experience subscale correlated with climate change attitudes (b=0·57, 95% CI 0·47-0·66; p<0·0001), individual-level actions (b=0·34, 0·21-0·47; p<0·0001), and collective-level actions (b=0·22, 0·10-0·33; p=0·0002), but was not significantly associated with general functional impairment in any of the final models. Hurricane exposure correlated with climate change-related individual-level (b=0·26, 0·10-0·42; p=0·0011) and collective-level (b=0·41, 0·26-0·56; p<0·0001) actions. Expanded treatment for post-traumatic stress symptoms after disasters could help address climate change-related psychological distress; experiences with climate change and natural hazards could be inflection points to motivate action. National Science Foundation and the National Center for Atmospheric Research.

Adherence to Gender Roles on PTSD Symptoms of Hurricane Harvey Survivors

The purpose of this study was to explore the relationships between trauma and adherence to gender roles among a sample of Hurricane Harvey survivors (N = 225). Posttraumatic stress disorder (PTSD) resulting from natural disasters has been associated with an increased risk of negative psychological outcomes. Previous studies have found increased risks of PTSD resulting from hurricane exposure, and there also appears to be a correlation between PTSD and gender. Specifically, women have been found to be more likely to endorse PTSD symptoms. However, this relationship has not yet been examined specifically among survivors of trauma from natural disasters. The Hayes Process Macro (v3.5) was utilized to test for the potential moderating effect of adherence to traditional gender roles on the relationship between trauma exposure and PTSD symptoms, as well as trauma exposure and depression. Results indicated that adherence to traditional female gender roles significantly moderated the relationships both between trauma severity and PTSD symptoms and between trauma severity and depression. Those with more androgynous gender roles have been found to have an increased ability to utilize more situation-specific coping skills. Future research could explore the specific aspects of traditional female and male gender roles that increase or decrease ability to cope with trauma.

Universal Behavioral Screening: Inclusion of Student’s Trauma Symptoms and Hurricane Exposure

School-age children are at high risk of experiencing traumatic and stressful events that can negatively impact their academic, emotional, and behavior performance. Students that have been exposed to a traumatic and adverse experience present with high rates of dropout, low academic performance, conduct problems, aggression, depression, and anxiety. The purpose of the present study was to examine the relationship between self-reported trauma symptoms of students identified with behavioral concerns using teacher reported screening data and whether hurricane exposure moderates the relationship. Participants included 75 students from elementary, middle, and high school in a large school district in the Southeastern United States. Students completed a self-rating of their trauma symptoms and hurricane exposure while their teachers completed a universal screening of internalizing and externalizing behaviors. Results from this study indicated that the type of hurricane exposure does not significantly moderate the relationship between trauma symptoms and students’ internalizing and externalizing behaviors. While linear regression showed that students who reported higher levels post traumatic symptoms have higher ratings of internalizing behaviors, results also indicated that there was no significant relationship between trauma symptoms and externalizing behaviors. Result suggest that trauma-informed strategies should be incorporated into the process of universal screening of behavior within the school setting to ensure that students at-risk for internalizing mental health concerns receive early intervention services.

In the Eye of the Storm: Hurricanes, Climate Migration, and Climate Attitudes

Climate disasters raise the salience of climate change’s negative consequences, including climate-induced migration. Policy action to address climate displacement is especially contentious in the United States, where weak support for tackling climate change intersects with high opposition to migration. Do climate disasters foster receptivity toward climate migrants and broader willingness to combat climate change? To study this question, we leverage the occurrence of Hurricane Ian during fielding of a preregistered survey in autumn 2022. Hurricane exposure increased concern about and support for policies to address climate migration. Hurricane exposure also increased support for climate action and belief in anthropogenic climate change. Effects of hurricane exposure cross-cut partisanship, education, age, and other important correlates of climate attitudes but decay within 6 months. Together, these results suggest that climate disasters may briefly increase favorability toward climate migrants and climate policy action but are unlikely to durably mobilize support even in severely impacted areas.

Long-Term Spatial Pattern Predictors (Historically Low Rainfall, Benthic Topography, and Hurricanes) of Seagrass Cover Change (1984 to 2021) in a Jamaican Marine Protected Area

Climate change and other anthropogenic factors have caused a significant decline in seagrass cover globally. Identifying the specific causes of this decline is paramount if they are to be addressed. Consequently, we identified the causes of long-term change in seagrass/submerged aquatic vegetation (SAV) percentage cover and extent in a marine protected area on Jamaica’s southern coast. Two random forest regression (RFr) models were built using 2013 hydroacoustic survey SAV percentage cover data (dependent variable), and auxiliary and 2013 Landsat 7 and 8 reflectance data as the predictors. These were used to generate 24 SAV percentage cover and benthic feature maps (SAV present, absent, and coral reef) for the period 1984–2021 (37 years) from Landsat satellite series reflectance data. These maps and rainfall data were used to determine if SAV extent/area (km2) and average percentage cover and annual rainfall changed significantly over time and to evaluate the influence of rainfall. Additionally, rainfall impact on the overall spatial patterns of SAV loss, gain, and percentage cover change was assessed. Finally, the most important spatial pattern predictors of SAV loss, gain, and percentage cover change during 23 successive 1-to-4-year periods were identified. Predictors included rainfall proxies (distance and direction from river mouth), benthic topography, depth, and hurricane exposure (a measure of hurricane disturbance). SAV area/extent was largely stable, with &gt;70% mean percentage cover for multiple years. However, Hurricane Ivan (in 2004) caused a significant decline in SAV area/extent (by 1.62 km2, or 13%) during 2002–2006, and a second hurricane (Dean) in 2007 delayed recovery until 2015. Additionally, rainfall declined significantly by &gt;1000 mm since 1901, and mean monthly rainfall positively influenced SAV percentage cover change and had a positive overall effect on the spatial pattern of SAV cover percentage change (across the entire bay) and gain (close to the mouth of a river). The most important spatial pattern predictors were the two rainfall proxies (areas closer to the river mouth were more likely to experience SAV loss and gain) and depth, with shallow areas generally having a higher probability of SAV loss and gain. Three hurricanes had significant but different impacts depending on their distance from the southern coastline. Specifically, a hurricane that made landfall in 1988 (Gilbert), resulted in higher SAV percentage cover loss in 1987–1988. Benthic locations with a northwestern/northern facing aspect (the predominant direction of Ivan’s leading edge wind bands) experienced higher SAV losses during 2002–2006. Additionally, exposure to Ivan explained percentage cover loss during 2006–2008 and average exposure to (the cumulative impact of) Ivan and Dean (both with tracks close to the southern coastline) explained SAV loss during 2013–2015. Therefore, despite historic lows in annual rainfall, overall, higher rainfall was beneficial, multiple hurricanes impacted the site, and despite two hurricanes in three years, SAV recovered within a decade. Hurricanes and a further reduction in rainfall may pose a serious threat to SAV persistence in the future.

Changes in Breastfeeding and Related Maternity Care Practices After Hurricanes Irma and Maria in Puerto Rico.

Background: Breastfeeding is recommended globally for most infants, especially during and after natural disasters when risk of adverse outcomes increases because of unsanitary conditions and lack of potable water. Materials and Methods: Using 2017-2019 data from Puerto Rico's Pregnancy Risk Assessment Monitoring System for 2,448 respondents with a recent live birth, we classified respondents into 4 hurricane exposure time periods based on infant birth month and year relative to when Hurricanes Irma and Maria occurred: (1) prehurricane; (2) acute hurricane; (3) posthurricane, early recovery; and (4) posthurricane, long-term recovery. We examined the association between maternity care practices during delivery hospitalization and exclusive breastfeeding at 3 months overall and stratified by time period. We also examined the associations between each maternity care practice and exclusive breastfeeding separately by time period. Results: Exclusive breastfeeding at 3 months was higher during the acute hurricane time period (adjusted prevalence ratio [aPR]: 1.43, 95% confidence interval: 1.09-1.87) than the prehurricane time period. Supportive maternity care practices were positively associated with exclusively breastfeeding, and practices that are risk factors for discontinuing breastfeeding were negatively associated with exclusive breastfeeding. Breastfeeding in the first hour (aPR range: 1.51-1.92) and rooming-in (aPR range: 1.50-2.58) were positively associated with exclusive breastfeeding across all time periods, except the prehurricane time period. Receipt of a gift pack with formula was negatively associated with exclusive breastfeeding (aPR range: 0.22-0.54) across all time periods. Conclusions: Maternity care practices during delivery hospitalization may influence breastfeeding behaviors and can improve breastfeeding during and after natural disasters. Strategies to maintain and improve these practices can be further supported during and after natural disasters.

Self-compassion reduces posttraumatic stress symptom severity in hurricane survivors via perceived social support.

Following disasters such as hurricanes, self-compassion (e.g., being understanding and showing care toward oneself) can be a valuable personal resource that facilitates social support and reduces posttraumatic symptoms. As a result of their increased connection to other people and interpersonal competence, self-compassionate people may perceive more social support following a traumatic event, which in turn reduces posttraumatic stress symptoms (PTSS). The present study is the first to utilize a longitudinal design and latent variable modeling to test this mediation hypothesis. A three-wave longitudinal design was utilized to assess hurricane exposure, self-compassion, perceived social support, and PTSS in hurricane survivors at baseline (T1), 3-month (T2), and 6-month (T3) follow-up. Participants at T1 included 261 hurricane survivors (88.5% women) who were racially diverse and particularly vulnerable to loss of resources (53.2% with an income of less than $30,000). Participants were recruited using online, print, and face-to-face methods, and all survey responses were completed online. Participants reported high hurricane stressor exposure (M = 9.14 serious stressors out of a possible 24). Controlling for hurricane exposure, self-compassion at T1 predicted PTSS at T3, and this was mediated by perceived social support at T2. Following hurricane exposure, self-compassionate people experience less PTSS over time because they perceive their social support resources to be more robust. Implementation of self-compassion education and training following a disaster could improve perceived social support networks that provide an additional protective factor against PTSS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A machine learning approach using migration-related cultural stress to classify depression and post-traumatic stress disorder among hurricane survivors

BackgroundData science approaches have increasingly been used in behavioral health research and may be useful for addressing social factors contributing to disparities in health status. This study evaluated the importance of cultural stress-related factors in classifying depression and post-traumatic stress disorder (PTSD) among adult survivors (N = 319) of Hurricane Maria who migrated from Puerto Rico to the United States mainland. MethodsWe evaluated the performance of random forests (RF) and logistic regression (LR) for classifying PTSD and depression. Models included demographic, hurricane exposure, and migration-related cultural stress variables. We inspected area under the receiver operating characteristic curve (AUC), accuracy, balanced accuracy, F1 score, precision, recall, and specificity. ResultsNegative context of reception and language-related stressors were moderately important for accurately classifying depression and PTSD. For classifying depression, RF showed higher accuracy, balanced accuracy, specificity, precision, and F1. For classifying PTSD, RF showed higher accuracy, specificity, precision, and F1. LimitationsA more thorough classification model would also include biomarkers (e.g., of allostatic load), family, community, or neighborhood-level attributes. Findings may not generalize to other groups who have experienced crisis-related migration. ConclusionsFindings underscore the importance of culturally and linguistically appropriate and trauma-informed clinical services for recent migrants. Use of assessments to identify pre-migration and post-migration stressors could inform clinical practice with migrants presenting with behavioral health-related difficulties.

Examining the role of perceived discrimination stress, disaster communication, and community resilience perceptions in Hurricane Harvey stress reactions among Latinos in Texas

The current study examines (a) how the experience of perceived discrimination stress can exacerbate posttraumatic stress (PTS) reactions following a disaster, and (b) how individual disaster communication and community resilience perceptions can mediate PTS following the same event. We surveyed 397 Latino residents who lived in Texas counties impacted by Hurricane Harvey. Using PROCESS (Hayes, 2018) [1] , results revealed that individuals who experienced more perceived discrimination stress in their daily lives reported more PTS symptoms as hurricane exposure increased when compared to individuals who experienced lower levels of perceived discrimination stress. Additionally, individual disaster communication indirectly reduced PTS symptoms through community resilience perceptions. The results suggest disaster public health models should incorporate multi-phase communicative efforts to address perceived discrimination stress and foster community resilience perceptions.

Response to uncertainty in developmental origins ofhealth and disease research: commentary on Nomura etal. (2022).

We appreciate the comments of Gilman etal. (2023) on our paper and their acknowledgement of its importance in highlighting the significance of this area of research. Further, their acknowledgment that the primary results of our study are in a range that is similar to those from other published studies of children exposed to highly stressful environmental events emphasizes the validity of our findings and the important extension of our results to children experiencing these events in utero. They, however, raised concerns about some of the results regarding specific types of psychiatric disorders and sex-specific results related to the prenatal Superstorm Sandy hurricane exposure. We comment on the various issues related to the paper below but will not respond to comments regarding the press coverage of this article, which we think are beyond the scope of this commentary.

Climate change and extreme weather disasters: evacuation stress is associated with youths' somatic complaints.

Climate-change has brought about more frequent extreme-weather events (e.g., hurricanes, floods, and wildfires) that may require families to evacuate, without knowing precisely where and when the potential disaster will strike. Recent research indicates that evacuation is stressful for families and is associated with psychological distress. Yet, little is known about the potential impact of evacuation stressors on child health. After Hurricane Irma, which led to a mass evacuation in Florida, we examined whether evacuation stressors and hurricane exposure were uniquely associated with youth somatic complaints, and whether youth psychological distress (i.e., symptoms of posttraumatic stress, anxiety, and depression) served as a potential mediating pathway between evacuation stressors, hurricane experiences, and somatic complaints. Three months after Irma, 226 mothers of youth aged 7-17 years (N=226; M age = 9.76 years; 52% boys; 31% Hispanic) living in the five southernmost Florida counties reported on evacuation stressors, hurricane-related life threat and loss/disruption, and their child's psychological distress and somatic complaints using standardized measures. Structural equation modeling revealed a good model fit (χ2 = 32.24, p = 0.003, CFI = 0.96, RMSEA = 0.08, SRMR = 0.04). Even controlling for life-threatening hurricane experiences (β = 0.26) and hurricane loss and disruption (β = 0.26), greater evacuation stressors were associated with greater symptoms of youth psychological distress (β = 0.34; p's < 0.001), and greater psychological distress was associated with more somatic complaints (β = 0.67; p < 0.001). Indirect effects revealed that evacuation stressors (p < 0.001), actual life-threatening events (p < 0.01), and loss and disruption (p < 0.01) were all uniquely and indirectly associated with youths' somatic complaints via youth psychological distress. Findings suggest that even coping with the threat of a disaster may be sufficient to prompt psychological and physical health symptoms in youth. Due in part to climate change, threats of disaster occur much more often than actual disaster exposure, especially for areas that are prone to hurricanes or wildfires. Preparing youth and families residing in vulnerable areas for potential disaster evacuation or sheltering-in-place appears critical. Encouraging families to develop Disaster Plans and teaching stress management skills may reduce both youth distress and somatic health problems.

Parental Influence on Child Mental Health Post-Hurricane Harvey

PurposeMany children who face natural disasters experience significant mental health consequences. Parents play a prominent role in the likelihood of child mental health outcomes after a weather-related disaster. This study aimed to examine the relationship between parent risk factors and children’s psychological well-being post Hurricane Harvey.MethodsParents (n = 140) completed a survey that measured hurricane exposure, parental depression and anxiety, parenting behaviors, and assistance given and received during or after Hurricane Harvey. Additionally, parents were asked to complete questionnaires assessing one of their children’s post-disaster psychosocial functioning and distress.ResultsResults indicated that heightened parent anxiety was significantly associated with an increased risk for emotional symptoms, conduct problems, and hyperactivity-inattention symptoms in children. Additionally, inconsistency in parental discipline was significantly associated with an increased risk of child conduct problems. Further, higher numbers of assistance types received by parents—a proxy indicator of resource loss—was associated with higher child emotional distress scores.ConclusionsBroader systems-level interventions that address parents’ physical and emotional needs may help mitigate maladaptive reactions in children and facilitate greater post-disaster psychosocial adjustment.

"You can't wash your hands in a house without running water": pandemic precautionary behaviors after Hurricane Laura.

Hurricane Laura made landfall in southwestern Louisiana in August 2020 while the world was several months into the COVID-19 pandemic. In the present research, we examined pandemic precautionary behaviors in a sample of adults who varied in exposure and damage due to Hurricane Laura, a destructive Category 4 hurricane. A total of 127 participants responded to an online survey that assessed pandemic worry and precautionary behaviors, hurricane exposure and damage, and health-related quality of life. We found that Hurricane Laura victims neglected pandemic precautionary behaviors at significantly higher levels in the weeks immediately following Hurricane Laura than did indirectly impacted control participants, although the two comparison groups did not differ in COVID-19 worry or adherence to precautionary pandemic behavior 14-22 months after Hurricane Laura made landfall. Older age was negatively correlated with COVID-19 worry prior to Hurricane Laura, which was unexpected given that older people in general were more vulnerable to COVID-19 by their membership in a high-risk group. Future directions for research on post-disaster vulnerabilities during a global pandemic are discussed.

Pre- and peri-natal hurricane exposure alters DNA methylation patterns in children

Hurricane Maria was the worst recorded natural disaster to affect Puerto Rico. Increased stress in pregnant women during and in the aftermath of the hurricane may have induced epigenetic changes in their infants, which could affect gene expression. Stage of gestation at the time of the event was associated with significant differences in DNA methylation in the infants, especially those who were at around 20–25 weeks of gestation when the hurricane struck. Significant differences in DNA methylation were also associated with maternal mental status assessed after the hurricane, and with property damage. Hurricane Maria could have long lasting consequences to children who were exposed to this disaster during pregnancy.

Mortality After Exposure to a Hurricane Among Older Adults Living With Dementia

This cohort study examines mortality after hurricane exposure in older adults living with Alzheimer disease and other related dementias.

Experiences of pregnant women exposed to Hurricanes Irma and Maria in the US Virgin Islands: a qualitative study

IntroductionHurricanes Irma and Maria made landfall in the US Virgin Islands (USVI) in 2017. To date, there is no published literature available on the experiences of pregnant women in the USVI exposed to these hurricanes. Understanding how hurricanes affect pregnant women is key to developing and executing targeted hurricane preparedness and response policies. The purpose of this study was to explore the experiences of pregnancy and birth among women in the USVI exposed to Hurricanes Irma and Maria.MethodsWe employed a qualitative descriptive methodology to guide sampling, data collection, and analysis. Semi-structured interviews of 30–60 min in length were conducted with a purposive sample of women (N = 18) in the USVI who were pregnant during or became pregnant within two months after the hurricanes. Interviews were transcribed verbatim and data managed in MAXQDA. Team members developed a codebook, applied codes for content, and reconciled discrepancies. We thematically categorized text according to a socioecological conceptual framework of risk and resilience for maternal-neonatal health following hurricane exposure.ResultsWomen’s experiences were organized into two main categories (risk and resilience). We identified the following themes related to risk at 3 socioecological levels including: (1) individual: changes in food access (We had to go without) and stress (I was supposed to be relaxing); (2) household/community: diminished psychosocial support (Everyone was dealing with their own things) and the presence of physical/environmental hazards (I was really scared); and (3) maternity system: compromised care capacity (The hospital was condemned). The themes related to resilience included: (1) individual: personal coping strategies (Being calm); (2) household/community: mutual psychosocial and tangible support (We shared our resources); and (3) the maternity system: continuity of high-quality care (On top of their game).ConclusionsA socioecological approach provides a useful framework to understand how risk and resilience influence the experience of maternal hurricane exposure. As the frequency of the most intense hurricanes is expected to increase, clinicians, governments, and health systems should work collaboratively to implement hurricane preparedness and response plans that address pregnant women’s unique needs and promote optimal maternal-infant health.

Hurricane Florence and suicide mortality in North Carolina: a controlled interrupted time-series analysis

BackgroundNatural disasters are associated with increased mental health disorders and suicidal ideation; however, associations with suicide deaths are not well understood. We explored how Hurricane Florence, which made landfall in...