TL;DR
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A study of older Medicare beneficiaries in North Carolina found sustained increases in hospitalizations and deaths during the year after Hurricane Matthew among people using electricity-dependent medical equipment. Flooding-based analyses showed stronger associations, and Black participants had worse short- and long-term outcomes as flood severity increased. The findings are observational and do not establish that hurricanes caused each outcome.
A study published in the Journal of the American Geriatrics Society found that older North Carolina residents who relied on electricity-dependent medical devices experienced sustained increases in hospitalizations and deaths during the year after Hurricane Matthew. Analyses using detailed flood records also linked greater flooding exposure with worse outcomes, highlighting potential long-term risks for medically vulnerable people after hurricanes.
Researchers examined hospitalizations and deaths among Medicare beneficiaries aged 65 and older who used equipment requiring electricity, including ventilators, respirators and dialysis machines. The study assessed effects associated with Hurricanes Matthew, which struck in 2016, and Florence, in 2018. Its focus was not limited to the immediate disaster period: investigators also tracked outcomes over the following year.
Using county-level Federal Emergency Management Agency presidential disaster declarations to define exposure, the team found no significant immediate changes after either storm. It did, however, identify sustained increases in hospitalizations and deaths over the year following Matthew. The supplied study summary does not report equivalent sustained increases after Florence using this county-level measure.
A second analysis used the North Carolina Flood Extent Archive, which provides more detailed information about flooding than county-level declarations. Those analyses showed stronger and more consistent associations between hurricane exposure and hospitalizations and deaths. The researchers also reported that Black participants had worse short- and long-term outcomes as flood severity increased. The summary does not provide effect sizes or explain the pathways behind this difference.
Flood Exposure and Health After Storms
The findings point to a risk that can continue after the immediate emergency: people who need powered medical equipment may face health consequences across the months after a hurricane, not just during a power outage or evacuation. Hospitalization and mortality patterns matter to health systems and emergency planners because they suggest that support for medically vulnerable residents may need to extend beyond the storm’s passage.
The comparison between exposure measures also carries practical weight. County disaster declarations offer a broad indication that a place was affected, while the flood archive allowed the researchers to examine exposure at higher geographic resolution. The stronger associations in the flood-based analyses suggest that local flood conditions may help identify where needs are concentrated. The study does not establish that flood mapping alone can predict an individual’s health outcome.
The reported differences for Black participants add an equity concern to preparedness planning. They show that outcomes varied with both flood severity and race in this study, but do not explain why. Further research would be needed to identify contributing factors and determine which interventions can reduce disparities.
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How Researchers Measured Hurricane Effects
The research team linked hurricane hazard information with health-care utilization records for older adults in North Carolina. It studied two storms, Matthew and Florence, and compared outcomes using two approaches to characterize exposure: FEMA county-level presidential disaster declarations and the state’s flood extent archive. The latter supplied a more geographically detailed view of flooding.
The work was led by researchers including senior author Jennifer L. Lund of the UNC Gillings School of Global Public Health. Lund said the team had spent two years linking hurricane hazard and health-care data while working with communities affected by storms. The paper, by Jackson and colleagues, was published in 2026 with DOI 10.1111/jgs.70757.
The article’s findings concern a specific group—older adults enrolled in Medicare who used electricity-dependent medical equipment—and two hurricanes in one state. They should not be treated as direct estimates for all older people, all storms or other regions. The study’s observational design identifies associations; it cannot by itself show that a storm caused an individual hospitalization or death.
“This work lays the foundation for studying how hurricanes and floods affect medically vulnerable populations more broadly—and for partnering with community organizations and local and state agencies to strengthen disaster preparedness and planning.”
— Jennifer L. Lund, senior author, UNC Gillings School of Global Public Health
Limits of the Available Findings
The study summary does not give the number of participants, size of the observed increases or detailed statistical estimates. It also does not specify which medical devices participants used individually, how long people experienced power interruptions, or whether access to backup power, evacuation and follow-up care affected outcomes.
The reported racial differences are associations, and the available material does not identify their causes. The results also differ by exposure measure: the county declaration analysis found sustained increases after Matthew but no significant immediate changes after either hurricane, while the more detailed flood analysis showed stronger and more consistent associations. The supplied summary does not quantify storm-specific results from that second analysis. It is therefore unclear how much the patterns would hold across other storms, states or groups of patients.
Further Research and Preparedness Planning
The research team said the work will support broader study of how hurricanes and floods affect medically vulnerable populations. Lund also pointed to collaboration with community organizations and local and state agencies as a route toward stronger preparedness and planning. The source material does not announce a specific new program or a timetable for additional results.
Further studies could test whether the observed patterns recur in other locations and storms, examine what factors contribute to the worse outcomes associated with more severe flooding, and assess which preparedness measures help people maintain access to essential equipment and care. For now, the study provides evidence of post-hurricane health associations in a defined North Carolina population—not a clinical recommendation or proof of individual cause. People making medical or device-related decisions should consult a qualified health professional.
Key Questions
Who was included in the study?
The study examined North Carolina Medicare beneficiaries aged 65 and older who used electricity-dependent medical equipment.
Which hurricanes did researchers examine?
The researchers studied Hurricane Matthew in 2016 and Hurricane Florence in 2018, tracking hospitalizations and deaths during the year after each storm.
What did the study find after Hurricane Matthew?
Using county-level FEMA disaster declarations, the researchers reported sustained increases in hospitalizations and deaths over the year after Matthew, but no significant immediate changes following either hurricane.
Did the study prove hurricanes caused the health outcomes?
No. The study reported associations between hurricane or flood exposure and health outcomes. Its findings do not establish that a storm caused a particular hospitalization or death.
What remains unknown about the findings?
The available summary does not provide effect sizes or explain why outcomes were worse for Black participants as flood severity increased. It also does not show whether the findings apply to other regions, storms or older adults who do not use powered medical devices.
Source: rss
