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Impact of Hurricanes and Floodings on Mental Health Outcomes Within the United States: A Systematic Review and Meta-Analysis

Part of: Hurricanes Collection

Published online by Cambridge University Press:  03 January 2025

Vanessa E. Miller Open the ORCID record for Vanessa E. Miller [Opens in a new window] ,
Kate Vinita Fitch ,
Monica E. Swilley-Martinez ,
Erum Agha ,
Ishrat Z. Alam ,
Andrew L. Kavee ,
Toska Cooper ,
Bradley N. Gaynes ,
Timothy S. Carey  and
David B. Goldston
...Show all authors
Vanessa E. Miller*
Affiliation:
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC
Kate Vinita Fitch
Affiliation:
Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
Monica E. Swilley-Martinez
Affiliation:
Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
Erum Agha
Affiliation:
Program on Integrative Medicine, University of North Carolina at Chapel Hill School of Medicine, University of North Carolina, Chapel Hill, NC
Ishrat Z. Alam
Affiliation:
Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
Andrew L. Kavee
Affiliation:
Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC
Toska Cooper
Affiliation:
Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, University of North Carolina, Chapel Hill, NC
Bradley N. Gaynes
Affiliation:
Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC Department of Psychiatry, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC
Timothy S. Carey
Affiliation:
Department of Internal Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
David B. Goldston
Affiliation:
Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
Shabbar I. Ranapurwala
Affiliation:
Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
Brian W. Pence
Affiliation:
Injury Prevention Research Center, University of North Carolina, Chapel Hill, NC Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
*
Corresponding author: Vanessa E. Miller; Email: vmiller@unc.edu
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Abstract

Objective

Given the US population concentration near coastal areas and increased flooding due to climate change, public health professionals must recognize the psychological burden resulting from exposure to natural hazards.

Methods

We performed a systematic search of databases to identify articles with a clearly defined comparison group consisting of either pre-exposure measurements in a disaster-exposed population or disaster-unexposed controls, and assessment of mental health, including but not limited to, depression, post-traumatic stress (PTS), and anxiety.

Results

Twenty-five studies, with a combined total of n =616 657 people were included in a systematic review, and 11 studies with a total of 2012 people were included in a meta-analysis of 3 mental health outcomes. Meta-analytic findings included a positive association between disaster exposure and PTS (n = 5, g = 0.44, 95% CI 0.04, 0.85), as well as depression (n = 9, g = 0.28, 95% CI 0.04, 0.53), and no meaningful effect size in studies assessing anxiety (n = 6, g = 0.05 95% CI −0.30, 0.19).

Conclusions

Hurricanes and flooding were consistently associated with increased depression and PTS in studies with comparison groups representing individuals unaffected by hazards.

Keywords

hurricanefloodpsychological distressmental healthsystematic reviewdepressionanxietyPTSD

Information

Type
Systematic Review
Information
Disaster Medicine and Public Health Preparedness , Volume 18 , 2024 , e335
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Society for Disaster Medicine and Public Health, Inc.

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