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A study of North Carolina Medicare beneficiaries aged 65 and older found that hurricane-related flooding was associated with hospitalizations and deaths among people using electricity-dependent medical devices. County-level disaster declarations showed no significant immediate changes after Hurricanes Matthew or Florence, while flood mapping revealed stronger associations and worse outcomes for Black individuals as flooding severity increased.
A study of North Carolina Medicare beneficiaries aged 65 and older found that hurricane-related flooding was associated with hospitalizations and deaths among people who rely on electricity-dependent medical devices, including ventilators and dialysis machines. The research, published in the Journal of the American Geriatrics Society, found stronger and more consistent associations when researchers measured flooding with detailed geographic data than when they used county disaster declarations.
Researchers examined health outcomes during the year following Hurricanes Matthew in 2016 and Florence in 2018. Their study population consisted of Medicare beneficiaries in North Carolina aged 65 or older who used electricity-dependent medical equipment. The report describes risks during and after hurricanes, with a particular focus on communities exposed to severe flooding.
When the team used county-level Federal Emergency Management Agency disaster declarations to classify exposure, it found no significant immediate changes in hospitalizations or deaths after either storm. It did find sustained increases in both outcomes over the year after Hurricane Matthew. The source report does not provide effect sizes or a corresponding sustained finding for Florence under this measure.
Researchers also analyzed exposure using the North Carolina Flood Extent Archive, a more geographically detailed measure of flooding. Those analyses showed stronger and more consistent associations between hurricane exposure and hospitalizations and deaths. The report says Black individuals experienced worse short- and long-term outcomes as flooding severity increased. It does not give numerical estimates in the material provided.
Flood Exposure and Unequal Health Risks
The findings point to a practical challenge for disaster planning and health care continuity: people who depend on electrically powered equipment may face health risks when storms disrupt power, access to care, or the places and services that support treatment. The study measured hospitalizations and deaths in relation to hurricane hazards; it does not establish which specific disruptions caused the observed outcomes.
The difference between the two exposure methods matters. County-wide disaster declarations did not show the same pattern as detailed flood mapping, suggesting that broad administrative categories may miss local variation in exposure. That could affect how officials identify residents who may need support before, during, and after a storm.
The reported differences by race also raise concerns about unequal effects as flooding worsens. The source describes worse outcomes for Black individuals but does not establish why those differences occurred. Researchers say the work can inform further study and partnerships aimed at strengthening preparedness.
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Two North Carolina Hurricanes Studied
The analysis covered two storms that struck North Carolina: Matthew in 2016 and Florence in 2018. Rather than examining all older residents, the researchers focused on Medicare beneficiaries aged 65 and older who used electricity-dependent medical devices, a group whose health care can be affected by disruptions during disasters.
The study, titled “Assessing the effects of hurricane hazards on hospitalization or death among older adults using electricity-dependent medical devices,” appeared in the Journal of the American Geriatrics Society in 2026. Its DOI is 10.1111/jgs.70757. The report describes both immediate outcomes and changes over the year following each hurricane.
“Over the past two years, our team has linked hurricane hazard and health care utilization data in North Carolina while working with impacted communities to shape this research.”
— Jennifer L. Lund, senior author and researcher at the UNC Gillings School of Global Public Health
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Limits of the Reported Findings
The source material does not provide the study’s sample size, numerical effect estimates, confidence intervals, or detailed methods for adjusting for other factors. It is therefore not possible from the report alone to assess the size or precision of the associations. The findings concern association, not proof of causation.
It also remains unclear which mechanisms—such as power loss, disrupted medical services, evacuation, or other storm-related conditions—account for the outcomes. The report says outcomes were worse for Black individuals as flooding severity rose but does not specify the causes of that disparity or provide numerical comparisons. Further details may be available in the full journal article.
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Further Research and Preparedness Work
Lund said the team’s next broader goal is to study how hurricanes and floods affect medically vulnerable populations and to work with community organizations and local and state agencies on disaster preparedness and planning. The supplied report does not announce a timeline, a new study, or a specific policy change.
Readers seeking more detail on methods and estimates can consult the full paper, “Assessing the effects of hurricane hazards on hospitalization or death among older adults using electricity-dependent medical devices,” published in the Journal of the American Geriatrics Society. Until further results are available, the reported findings should be understood as evidence of associations in this North Carolina population, not as a quantified forecast for every storm or community.
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Key Questions
Who was included in the study?
The researchers studied North Carolina Medicare beneficiaries aged 65 and older who used electricity-dependent medical equipment.
Which hurricanes did researchers examine?
The analysis covered Hurricane Matthew in 2016 and Hurricane Florence in 2018, including outcomes during the year after each storm.
Did the study find immediate increases after both hurricanes?
Not using county-level FEMA disaster declarations. Those analyses found no significant immediate changes after either storm, although the researchers reported sustained increases in hospitalizations and deaths over the year after Matthew.
What did flood mapping add?
Analyses using the North Carolina Flood Extent Archive showed stronger and more consistent associations between hurricane exposure and hospitalizations and deaths than the county-declaration measure.
Does the study prove that flooding caused the outcomes?
No. The report describes associations between exposure and health outcomes. It does not establish the specific causes of the outcomes or show that flooding alone caused them.
Source: rss
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