TL;DR
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A 2026 study of North Carolina Medicare beneficiaries aged 65 and older who relied on electricity-dependent medical equipment found that flood exposure was associated with hospitalizations and deaths. The researchers reported worse short- and long-term outcomes for Black participants as flooding severity increased; county-level disaster declarations showed less consistent results.
A study of Medicare beneficiaries aged 65 and older in North Carolina found that hurricane exposure, particularly flooding measured at a detailed local level, was associated with increased hospitalizations and deaths among people using electricity-dependent medical devices. Published in the Journal of the American Geriatrics Society, the research examined outcomes after Hurricanes Matthew and Florence and found that Black participants had worse short- and long-term outcomes as flooding severity increased.
The researchers assessed immediate and sustained health outcomes during the year after Hurricane Matthew in 2016 and Hurricane Florence in 2018. The study population consisted of North Carolina Medicare beneficiaries aged 65 or older who used electricity-dependent medical equipment, including devices such as ventilators, respirators and dialysis machines.
When the team measured exposure using county-level federal disaster declarations, it found no significant immediate changes after either storm. It did find sustained increases in hospitalizations and deaths over the year following Matthew. In analyses using the North Carolina Flood Extent Archive, a more geographically detailed measure of flood exposure, associations with hospitalizations and deaths were stronger and more consistent.
The authors also reported that Black individuals experienced worse outcomes in the short and long term as flooding severity rose. The source report does not provide effect sizes, counts of affected patients or details about the specific statistical estimates, so the scale of the associations cannot be stated from the available information. The findings describe associations, not proof that flooding alone caused each hospitalization or death.
Flood Exposure and Medical Device Users
People who depend on electricity-powered equipment may face particular risks when storms disrupt power, access to care or the ability to leave an affected area. The study draws attention to older adults with ongoing medical needs as a group whose health outcomes may worsen after hurricanes, including in the months following a storm rather than only during its immediate aftermath.
The contrast between the two exposure measures also matters for disaster planning and research. County disaster declarations did not capture the same associations as the more detailed flood mapping. This suggests that broad geographic categories may miss differences in actual flood exposure within counties. The reported racial disparity adds a further reason for preparedness efforts to examine who is most exposed and who has access to backup power, transport and continuing medical care. The study does not assess any particular intervention or establish which measures would reduce the risks.
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Two North Carolina Hurricanes Studied
The analysis focused on two storms that affected North Carolina: Matthew in 2016 and Florence in 2018. Rather than examining all residents, investigators studied Medicare beneficiaries aged 65 and older identified as using electricity-dependent medical equipment, then compared health outcomes with hurricane and flood exposure.
The report appeared 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.” Senior author Jennifer L. Lund, of the UNC Gillings School of Global Public Health, said the team had linked hurricane hazard and health care utilization data in North Carolina while working with affected communities to shape the research.
“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
Limits of the Available Findings
The information available does not give the number of participants, the size of the observed increases, confidence intervals or detailed comparisons for each hurricane. It also does not specify how researchers identified device users or account for possible differences in health, resources and storm exposure among participants. Those details would help readers judge the strength and scale of the reported associations.
The results do not establish a precise mechanism connecting flooding to each outcome. Power interruption, disrupted treatment, evacuation challenges and other storm-related disruptions are plausible concerns for people using these devices, but the supplied report does not say the study measured each pathway. It is also unclear whether the findings apply to older adults outside North Carolina, people under 65 or users of devices not represented in the study.
Further Research and Preparedness Planning
Lund said the research provides a basis for studying hurricane and flood impacts on medically vulnerable populations more broadly. The team also described working with community organizations and local and state agencies to strengthen disaster preparedness and planning. The report does not announce a specific policy change, new program or scheduled follow-up study.
Further research could clarify how outcomes vary by storm, flood intensity and patient circumstances, and whether preparedness measures make a measurable difference. For now, the study’s central finding is that more detailed flood exposure was associated with worse health outcomes among the older device users studied, while the scale, causes and generalizability of those associations remain to be established.
Key Questions
Who did the study examine?
It examined North Carolina Medicare beneficiaries aged 65 and older who used electricity-dependent medical devices, including ventilators, respirators and dialysis machines.
Which hurricanes were included?
The analysis examined health outcomes during the year after Hurricanes Matthew (2016) and Florence (2018).
What did the researchers find about flooding?
Flood exposure measured using the North Carolina Flood Extent Archive showed stronger and more consistent associations with hospitalizations and deaths than county-level federal disaster declarations. The study report does not provide effect sizes in the available material.
Did the study prove that hurricanes caused the deaths?
No. The report describes associations between hurricane or flood exposure and health outcomes. It does not establish that flooding alone caused individual hospitalizations or deaths.
What remains unknown?
The available report does not state the number of participants or the precise size of the observed effects, and it does not explain which storm-related pathways drove the associations. Whether the results apply beyond this North Carolina population also remains unclear.
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