TL;DR
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A study in the Journal of the American Geriatrics Society examined hospitalizations and deaths among North Carolina Medicare beneficiaries aged 65 and older who used electricity-dependent medical equipment. County disaster declarations showed sustained increases in these outcomes during the year after Hurricane Matthew, while flood-map analyses found stronger associations as flooding severity increased; Black participants had worse short- and long-term outcomes as flooding became more severe.
A study published in the Journal of the American Geriatrics Society found that older North Carolina residents who relied on electricity-dependent medical equipment faced health risks associated with hurricane exposure, with stronger and more consistent links when researchers measured flooding in greater detail. The analysis covered hospitalizations and deaths among Medicare beneficiaries aged 65 and older after Hurricanes Matthew and Florence, and found worse outcomes for Black participants as flooding severity increased.
Researchers assessed immediate and longer-term outcomes among people using equipment such as ventilators, respirators and dialysis machines. They examined the period during the storms and up to one year afterward, using Medicare data and two ways of measuring hurricane exposure in North Carolina.
When exposure was measured using county-level Federal Emergency Management Agency disaster declarations, the study found no significant immediate changes following either hurricane. It did find sustained increases in hospitalizations and deaths over the year after Hurricane Matthew in 2016. The supplied study summary does not report a corresponding sustained increase after Florence using this measure.
A second analysis used the North Carolina Flood Extent Archive, which provides more detailed information about where flooding occurred. The researchers reported stronger and more consistent associations between hurricane exposure and hospitalizations and deaths with this higher-resolution measure. They also found that Black individuals experienced worse short- and long-term outcomes as flood severity increased. The findings describe associations; the summary does not establish that flooding alone caused the outcomes.
Flood Exposure and Medical Vulnerability
The findings draw attention to a group for whom power disruptions and damaged infrastructure may have serious consequences: older adults who depend on electricity-powered medical equipment. A hurricane can affect more than immediate access to shelter. Flooding and disruption to health services can coincide with the loss of reliable electricity, transport or routine care, although this study did not isolate those pathways as causes.
The reported differences by race also point to the need to examine how flood severity and unequal health outcomes intersect. The study summary does not identify why Black participants had worse outcomes, so it cannot establish the role of factors such as resources, exposure, access to care or other conditions. Still, the pattern gives disaster planners and health agencies a reason to assess whether preparedness and post-storm support reach medically vulnerable communities effectively.
For readers and public agencies, the work supports treating disaster readiness as a longer-term health issue, not only an evacuation or emergency-response question. It does not show that a particular intervention will prevent hospitalizations or deaths, but it identifies populations and hazards that future preparedness efforts can study.
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How Researchers Measured Storm Effects
The study by B. E. Jackson and colleagues compared outcomes among North Carolina Medicare beneficiaries aged 65 and older who used electricity-dependent medical devices. It focused on two storms, Matthew in 2016 and Florence in 2018, and assessed both immediate and sustained effects on hospitalization and death.
The researchers’ exposure measures matter when interpreting the results. County disaster declarations categorize areas at a broad geographic level, while the state flood archive offers more localized information on flood extent. The stronger associations in the flood-based analyses suggest that the choice and resolution of hazard data can affect what researchers detect; they do not, by themselves, prove a causal mechanism.
Senior author Jennifer L. Lund of the UNC Gillings School of Global Public Health said the team had spent two years linking hurricane hazard data with health-care use in North Carolina and working with affected communities to shape the research. The authors say the work lays a foundation for studying other medically vulnerable groups and for collaboration with community organizations and government agencies. The paper was published in 2026, years after the storms it analyzes.
“Our team has linked hurricane hazard and healthcare utilization data in North Carolina while working with impacted communities to shape this research.”
— Jennifer L. Lund, senior author, UNC Gillings School of Global Public Health
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Limits of the North Carolina Findings
The supplied study summary does not provide the number of participants, the size of the increases, confidence intervals or detailed results for each storm and outcome. It is therefore not possible from this information to quantify the absolute change in risk or compare the scale of effects across groups. The results apply to the studied North Carolina Medicare population and should not automatically be taken to describe all older adults or other regions.
The study reports associations, not proof that hurricane exposure or flooding directly caused a hospitalization or death. The summary also does not explain what drove the worse outcomes among Black participants, identify which equipment users were most affected, or separate the effects of power loss, flooding, disrupted care and other storm-related factors. Whether the findings apply to later hurricanes or different disaster-response systems remains unknown.
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Research and Preparedness After the Study
The authors say they intend to build on the analysis by studying hurricane and flood effects among medically vulnerable populations more broadly. They also point to work with community organizations and local and state agencies to strengthen disaster preparedness and planning. The source material does not give a timetable for further studies or specify new policies or programs arising from this paper.
Further research could test whether the associations hold in other places and storms, clarify why outcomes differed as flood severity increased, and examine which preparedness measures help people who rely on powered medical devices. Until such evidence is available, the study’s findings identify a concern for planners but do not establish the effectiveness of any particular response.
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Key Questions
What did the study examine?
It examined hospitalizations and deaths among North Carolina Medicare beneficiaries aged 65 and older who used electricity-dependent medical equipment, following Hurricanes Matthew and Florence.
What did the researchers find after Hurricane Matthew?
Using county-level disaster declarations, researchers found no significant immediate changes after either storm, but reported sustained increases in hospitalizations and deaths during the year after Matthew.
How did flooding severity relate to outcomes?
Analyses using a detailed North Carolina flood archive found stronger and more consistent associations between hurricane exposure and hospitalizations and deaths. The study summary says Black participants had worse short- and long-term outcomes as flooding severity increased.
Does the study prove hurricanes caused the health outcomes?
No. The reported findings are associations and do not establish that hurricanes or flooding alone caused the hospitalizations or deaths. The summary also does not identify the mechanisms behind the differences observed.
Source: rss
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