News from the Columbia Climate School

Tropical Cyclones Linked to Rise in Hospitalizations of Older Adults

A new study documents a rise in hospitalizations of older U.S. adults rise in the week following exposure to a tropical cyclone. The study is the first comprehensive investigation of the impact of hurricanes and other tropical cyclones on all causes of hospitalizations. The findings were published this week in the journal Nature Communications.

The researchers used data on 70 million Medicare hospitalizations over 16 years, and a comprehensive database of county-level winds associated with tropical cyclones to examine how tropical cyclone wind exposures affect hospitalizations from 13 mutually exclusive causes, along with more than 100 sub-causes.

The work was carried out by researchers at Columbia University’s Earth Institute, Columbia’s Mailman School of Public Health,  Colorado State University and Harvard University’s T.H. Chan School of Public Health.

Over 16,000 additional hospitalizations were associated with tropical cyclones over a 10-year average exposure. Analyses showed that the day after tropical cyclones with hurricane-force winds struck, respiratory disease hospitalizations doubled. Hospitalizations from chronic obstructive pulmonary disease surged 45 percent in the week following. Overall, there was a 14 percent average rise in respiratory diseases in the week after exposure. Also reported was an average 4 percent uptick in infectious and parasitic diseases, and a 9 percent rise in injuries.

Illustration by Amy Wolfe

This rises were driven primarily by increases in emergency hospitalizations. But the researchers point out that there may have been cases where exposure to the cyclones prevented normal medical care, compelling people to go to the hospital to access services that they might otherwise get outside a hospital. For example, if those with respiratory issues experienced loss of power—often a result of high winds—they may have turned to hospitals if they needed power for medical equipment that a hospital could furnish.

For some causes, such as certain cancers, the authors reported decreases in hospitalizations. These decreases were driven by non-emergency hospitalizations, indicating that people possibly cancelled scheduled hospitalizations because of a storm. Such cancellations could have longer-term impacts on health, say the researchers.

“We know that hurricanes and other tropical cyclones have devastating effects on society, particularly on the poorest and most vulnerable,” said Robbie M. Parks, an Earth Institute postdoctoral fellow at the Mailman School of Public Health and first author. “But until now only limited previous studies have calculated their impacts on health outcomes.” Parks said that current weather trends and the ongoing effects of climate change suggest that tropical cyclones are a continuing, and possibly increasing threat. “Our study is a major first step in understanding how tropical cyclone exposure impacts many different adverse health outcomes,” he said.

The researchers anticipate that adequate forecasting of tropical cyclones might help in plans to set up shelters to provide electricity and common medications, and create easier ways for vulnerable people with certain chronic conditions to find and use those resources outside of the hospital.

The study was facilitated by G. Brooke Anderson of Colorado State University, who curated an open-source data set that allows researchers to easily assess exposure to tropical cyclones for epidemiological studies. The authors coupled the exposure data with comprehensive hospitalization data among Medicare enrollees.

“While serious gaps in knowledge remain, we gained valuable insights into the timing of hospitalizations relative to exposure and how cause-specific hospitalizations can be impacted by tropical cyclones,” said Mailman researcher Marianthi-Anna Kioumourtzoglou, the study’s senior author. “These important discoveries will be key for preparedness planning, including hospital and physician preparedness. Our study is just a first step in this process.”

Adapted from a press release by Columbia University’s Mailman School of Public Health and Harvard University’s T.H. Chan School of Public Health.

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