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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. County disaster declarations showed no significant immediate changes after Hurricanes Matthew and Florence, while analyses using detailed flood maps found stronger associations and worse outcomes for Black individuals as flooding severity increased.
A study published in the Journal of the American Geriatrics Society found that hurricane-related flooding was associated with higher hospitalizations and deaths among North Carolina Medicare beneficiaries aged 65 and older who used electricity-dependent medical devices. The research examined outcomes following Hurricanes Matthew in 2016 and Florence in 2018, and found that associations were clearer when investigators measured flooding using detailed geographic data rather than county disaster declarations.
The researchers assessed the immediate and year-long effects of the two hurricanes among older adults who relied on equipment such as ventilators, respirators and dialysis machines. Using county-level Federal Emergency Management Agency presidential disaster declarations to classify exposure, they found no significant immediate changes in hospitalizations or deaths after either storm. They did, however, observe sustained increases in both outcomes during the year after Hurricane Matthew.
A second analysis used the North Carolina Flood Extent Archive, a more geographically detailed measure of flood exposure. With that approach, the researchers found stronger and more consistent associations between hurricane exposure and hospitalizations and deaths. The report also says that Black individuals experienced worse short- and long-term outcomes as flooding severity increased.
The findings concern associations, not proof that flooding directly caused each hospitalization or death. The supplied report does not give effect sizes, patient counts or detailed estimates for particular devices, so it does not establish how large the risks were for an individual patient or whether the patterns differed between ventilator, respiratory and dialysis users.
Flood Exposure and Medical Dependence
For people who depend on powered medical equipment, a storm can threaten access to both electricity and essential health care. Flooding may also disrupt travel and local services, although the supplied study summary does not identify which disruptions explained the measured outcomes. The results point to a need for disaster planning that accounts for the location and needs of medically vulnerable residents, rather than relying only on broad county-level declarations.
The reported differences by race also matter for preparedness. Black participants had worse outcomes as flooding severity rose, according to the study summary. That finding identifies a disparity in the observed results; the report does not explain its causes. Local agencies and health systems can use further research to assess how emergency support, evacuation planning and access to backup power reach different communities.
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Two Storms, Two Exposure Measures
The study focused on older adults enrolled in Medicare in North Carolina who used electricity-dependent medical equipment. It followed outcomes connected with Hurricanes Matthew, which struck in 2016, and Florence, which affected the state in 2018. Its publication details identify the article as “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 in 2026 (DOI: 10.1111/jgs.70757).
The contrast between the exposure measures is central to interpreting the findings. A county disaster declaration gives a broad indication of disaster impact, while the Flood Extent Archive maps flooding at finer resolution. The stronger associations in the flood-based analysis suggest that broad geographic classifications may not capture the differences in actual flood exposure within a county. The study summary does not provide enough detail to quantify that difference.
“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
Limits of the Reported Findings
The available summary does not state the number of participants, size of the observed changes or statistical estimates. It also does not describe how the researchers accounted for other factors that may influence hospitalization and mortality, or whether individual outcomes could be tied to particular power outages, equipment failures or interruptions in care. The reported associations should not be read as proof of a direct cause-and-effect relationship.
It is also unclear from the summary why Black participants had worse outcomes as flooding severity increased, whether the pattern applied equally after both hurricanes, and how far the results can be generalized beyond older Medicare beneficiaries in North Carolina. Those questions require details from the full study and further research.
Further Research and Local Planning
Senior author Lund said the team intends to build on this work and partner with community organizations and local and state agencies to strengthen disaster preparedness and planning. The report does not name a specific next study, policy change or implementation schedule. Future research could test whether the observed associations hold in other storms and locations and clarify which forms of emergency support best protect people who rely on powered equipment.
For now, the study adds evidence that flood exposure deserves close attention when assessing hurricane-related health risks for older adults with medical-device dependence. More detailed results from the article would be needed to guide specific estimates of risk or recommendations for individual patients.
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 assessed outcomes following Hurricane Matthew in 2016 and Hurricane Florence in 2018.
Did the study find an immediate rise in hospitalizations or deaths?
Using county-level FEMA disaster declarations, the researchers found no significant immediate changes after either hurricane. They observed sustained increases during the year after Matthew, and stronger, more consistent associations when they used detailed flood mapping.
Does the study prove flooding caused the outcomes?
No. The report describes associations between hurricane exposure and health outcomes; it does not establish that flooding directly caused an individual hospitalization or death.
What remains unknown about the findings?
The supplied summary does not report effect sizes, participant counts or the reasons for the worse outcomes observed among Black individuals as flooding severity increased. It also does not specify which disruptions may have contributed to the outcomes.
Source: rss
