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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 and Florence, while flood-map analyses found stronger associations and worse outcomes for Black participants as flooding severity increased.
A study published in the Journal of the American Geriatrics Society found that older North Carolina residents who relied on electricity-dependent medical devices faced greater hospitalization and death risks in analyses using detailed flood exposure data after Hurricanes Matthew and Florence. The findings point to a health risk for medically vulnerable people during and after hurricanes, particularly in communities affected by severe flooding.
Researchers assessed hospitalizations and deaths among Medicare beneficiaries aged 65 and older in North Carolina who used equipment such as ventilators, respirators and dialysis machines. They examined immediate and sustained outcomes following Hurricane Matthew in 2016 and Hurricane Florence in 2018, using two ways to measure hurricane exposure.
When exposure was measured using county-level Federal Emergency Management Agency disaster declarations, the researchers found no significant immediate changes after either storm. They did find sustained increases in hospitalizations and deaths over the year following Matthew. The report does not give effect sizes in its summary, so the scale of those changes cannot be stated here.
Analyses using the North Carolina Flood Extent Archive, a more detailed measure of inundation, showed stronger and more consistent associations between hurricane exposure and hospitalizations and deaths. The study also reported that Black participants experienced worse short- and long-term outcomes as flooding severity increased. These results describe associations; the summary does not establish that flooding alone caused each outcome.
Flood Exposure and Medical Dependence
People who depend on powered equipment may face several overlapping risks during a hurricane: electricity can fail, transportation and access to care can be disrupted, and flooding may make it harder to reach services or maintain treatment. The study does not test each of these pathways, but its findings identify flood exposure as a useful factor for understanding health outcomes in this group.
The results also suggest that the way exposure is measured matters. A county-level disaster declaration can classify an area broadly, while detailed flood maps can show where inundation occurred. The stronger associations in the flood-archive analyses indicate that local flood information may reveal risks that broader geographic measures miss. The reported differences by race add reason for researchers and public agencies to examine how disaster impacts vary across communities.
For emergency planners, the research supports attention to older residents who rely on electricity-dependent devices when preparing for storms and recovery. It does not evaluate a particular preparedness program or quantify how many deaths or hospitalizations could be prevented by specific actions.
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Two Hurricanes, Two Exposure Measures
The research focused on North Carolina and two storms with different dates: Matthew, in 2016, and Florence, in 2018. Investigators followed outcomes in the year after the hurricanes to capture both immediate effects and longer-term changes among older Medicare beneficiaries using powered medical equipment.
The study, titled “Assessing the effects of hurricane hazards on hospitalization or death among older adults using electricity-dependent medical devices,” was published in 2026. Its findings build on work by the research team linking hurricane hazards with health care use in North Carolina. The report says the team worked with impacted communities while shaping the research, but provides no further details about the partnerships or their specific contributions.
“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 and researcher at the UNC Gillings School of Global Public Health
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Limits of the Available Findings
The source summary does not provide the number of participants, the size of the observed changes, confidence intervals, or detailed results for each storm. It therefore is not possible to compare the magnitude of risk after Matthew with that after Florence, or to determine how many people were affected.
The findings are reported as associations, and the summary does not establish the mechanisms behind them or show that the hurricanes directly caused the hospitalizations and deaths. It also does not explain why the county-level analysis found no significant immediate changes after either storm while flood-map analyses showed stronger associations. Further detail would be needed to assess how the study handled differences in health status, power access, evacuation and access to medical care.
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Further Research and Preparedness
The study’s authors say the work lays a foundation for examining hurricane and flood effects on medically vulnerable groups more broadly. They also point to future partnerships with community organizations and local and state agencies to strengthen disaster preparedness and planning.
The published report does not announce a specific next study, policy change or timetable. Further research can clarify the size and causes of the observed associations, including how outcomes differ by storm, flood severity and community. For now, the findings add evidence that older adults dependent on powered medical equipment warrant attention in hurricane planning, while leaving open which interventions would reduce health risks.
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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, including ventilators, respirators and dialysis machines.
Which hurricanes did researchers examine?
The researchers assessed outcomes following Hurricane Matthew in 2016 and Hurricane Florence in 2018, looking at immediate and year-long effects.
What did the study find about hospitalizations and deaths?
County-level disaster declarations showed no significant immediate changes after either hurricane, but the study found sustained increases in hospitalizations and deaths over the year after Matthew. Analyses using detailed flood extent data showed stronger and more consistent associations with these outcomes.
Did the study prove flooding caused the outcomes?
No. The report describes associations between hurricane exposure, flooding and health outcomes. Its summary does not establish that flooding alone caused the hospitalizations or deaths.
What remains unknown?
The source summary does not report effect sizes, participant counts or detailed results by storm. It also does not identify the specific pathways behind the associations or establish which preparedness measures would reduce risk.
Source: rss
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