TL;DR
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A 2026 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. The researchers found stronger and more consistent associations using detailed flood mapping than using county disaster declarations; outcomes for Black patients worsened as flooding severity increased.
A study of older North Carolina Medicare beneficiaries who used electricity-dependent medical devices found that hurricane exposure—especially as measured by the severity of local flooding—was associated with hospitalizations and deaths. Published in the Journal of the American Geriatrics Society in October 2026, the research examined outcomes after Hurricanes Matthew in 2016 and Florence in 2018.
The investigators studied people aged 65 and older who relied on equipment such as ventilators, respirators or dialysis machines. They assessed both immediate outcomes and changes over the year following each hurricane, using Medicare data and two ways of measuring exposure to hurricane hazards.
When the researchers classified exposure using county-level federal disaster declarations, they found no significant immediate changes after either storm. They did, however, observe sustained increases in hospitalizations and deaths over the year after Hurricane Matthew. The supplied study summary does not report a corresponding sustained increase after Florence using this measure.
In analyses using the North Carolina Flood Extent Archive, a more detailed source for mapping flood exposure, associations between hurricane exposure and hospitalizations and deaths were stronger and more consistent. The researchers also reported that Black individuals experienced worse short- and long-term outcomes as flooding severity increased. These findings are associations; the summary does not establish that flooding alone caused the outcomes.
Flood Exposure and Medical Vulnerability
People who depend on powered medical equipment may face added risks when hurricanes disrupt electricity, transportation, medical care or access to supplies. The study focuses on a population whose health needs can make disaster preparation and recovery particularly consequential, and it indicates that flood exposure may help identify risk more precisely than county-level disaster status alone.
The reported differences by race also point to unequal outcomes as flooding worsens. The study summary does not explain the mechanisms behind that pattern, so it cannot determine whether the differences reflect variation in exposure, resources, access to care or other factors. Still, the findings give public health agencies and emergency planners evidence to consider when planning support for medically vulnerable residents before and after storms.
The results do not predict an individual patient’s outcome or show that every person using a device will be hospitalized or die after a hurricane. They provide population-level evidence that exposure and the way it is measured matter when researchers assess disaster-related health risks.
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Two Hurricanes, Two Exposure Measures
The research assessed Hurricane Matthew (2016) and Hurricane Florence (2018) in North Carolina. Rather than studying all older adults, it focused on Medicare beneficiaries aged 65 or older identified as using electricity-dependent medical equipment. The study’s title describes its outcomes as hospitalization or death.
One analysis relied on Federal Emergency Management Agency presidential disaster declarations recorded at county level. The other used the North Carolina Flood Extent Archive to evaluate flood exposure at higher resolution. The difference between the results matters: a broad county designation did not show the same consistent relationships as detailed flood mapping, according to the report.
The article was published in the Journal of the American Geriatrics Society in 2026 under the title “Assessing the effects of hurricane hazards on hospitalization or death among older adults using electricity-dependent medical devices.” Its DOI is 10.1111/jgs.70757.
“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 available report does not provide exact counts, effect sizes or confidence intervals, so the scale of the observed associations cannot be assessed from the summary alone. It also does not give enough detail to compare the full results for Matthew and Florence across all measures or to establish why outcomes worsened as flood severity increased for Black individuals.
The findings are specific to older Medicare beneficiaries in North Carolina who used electricity-dependent medical equipment and to two hurricanes. Whether the patterns apply to other age groups, states, storms or types of medical equipment remains uncertain. The report describes associations, not proof that hurricane exposure caused each hospitalization or death.
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Research and Preparedness Planning
The study authors say the work provides a foundation for examining hurricane and flood effects on medically vulnerable populations more broadly. Lund also pointed to collaboration with community organizations and local and state agencies as a route toward strengthening disaster preparedness and planning.
The supplied report does not identify a specific follow-up study, policy change or implementation date. Further research could clarify the size and causes of the observed differences, while emergency planners can weigh the findings alongside local evidence when considering how to support residents who depend on powered medical equipment.
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Key Questions
Who did the study examine?
It examined North Carolina Medicare beneficiaries aged 65 and older who used electricity-dependent medical equipment, including ventilators, respirators and dialysis machines.
Which hurricanes were included?
The researchers studied outcomes after Hurricane Matthew in 2016 and Hurricane Florence in 2018.
What did the researchers find about hospitalizations and deaths?
County-level disaster declarations showed no significant immediate changes after either hurricane, but the researchers observed sustained increases over the year after Matthew. Analyses using detailed flood mapping found stronger and more consistent associations between exposure and hospitalizations and deaths.
Did the study prove hurricanes caused the outcomes?
No. The reported results describe associations between hurricane or flood exposure and health outcomes. The summary does not establish that exposure alone caused an individual hospitalization or death.
What remains unknown?
The summary does not give exact effect sizes or counts, explain the reasons for the reported racial differences, or establish whether the findings apply beyond this population, state and pair of storms.
Source: rss
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