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

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
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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References

World Health Organization. Health Topics: Floods. Accessed April 2023. https://www.who.int/health-topics/floodsGoogle Scholar
National Oceanic and Atmospheric Administration. Hurricane Costs. Updated June 4, 2024. Accessed June 5, 2024. https://www.coast.noaa.gov/states/fast-facts/hurricane-costs.htmlGoogle Scholar
Crowell, M, Coulton, K, Johnson, C, et al. An estimate of the US population living in 100-year coastal flood hazard areas. J Coast Res. 2010;26(2):201–211.CrossRefGoogle Scholar
Reidmiller, DR, Avery, CW, Easterling, DR, et al. Impacts, Risks, and Adaptation in the United States: Fourth National Climate Assessment, volume II. 2018 U.S. Global Change Research Program, Washington, DC, USA, 1515 pp. Doi:10.7930/NCA4.2018CrossRefGoogle Scholar
World Meteorological Association. State of the Global Climate 2022. 2023. 978-92-63-11316-0. Accessed April 2023.Google Scholar
Galea, S, Tracy, M, Norris, F, et al. Financial and social circumstances and the incidence and course of PTSD in Mississippi during the first two years after Hurricane Katrina. J Trauma Stress. 2008;21(4):357–368. Doi:10.1002/jts.20355CrossRefGoogle ScholarPubMed
Cénat, JM, McIntee, SE, Blais-Rochette, C. Symptoms of posttraumatic stress disorder, depression, anxiety and other mental health problems following the 2010 earthquake in Haiti: a systematic review and meta-analysis. J Affect Disord. 2020;273:55–85. Doi:10.1016/j.jad.2020.04.046CrossRefGoogle ScholarPubMed
Rezayat, AA, Sahebdel, S, Jafari, S, et al. Evaluating the pPrevalence of PTSD among children and adolescents after earthquakes and floods: a systematic review and meta-analysis. Psychiatr Q. 2020;91(4):1265–1290. Doi:10.1007/s11126-020-09840-4CrossRefGoogle Scholar
Fernandez, A, Black, J, Jones, M, et al. Flooding and mental health: a systematic mapping review. PloS One. 2015;10(4):e0119929. Doi:10.1371/journal.pone.0119929CrossRefGoogle ScholarPubMed
Neria, Y, Nandi, A, Galea, S. Post-traumatic stress disorder following disasters: a systematic review. Psychol Med. Apr 2008;38(4):467–480. Doi:10.1017/s0033291707001353CrossRefGoogle ScholarPubMed
Palinkas, LA, Wong, M. Global climate change and mental health. Curr Opin Psychol. 2020;32:12–16. Doi:10.1016/j.copsyc.2019.06.023CrossRefGoogle ScholarPubMed
Sharpe, I, Davison, CM. Climate change, climate-related disasters and mental disorder in low- and middle-income countries: a scoping review. BMJ Open. 2021;11(10):e051908. Doi:10.1136/bmjopen-2021-051908CrossRefGoogle ScholarPubMed
Rubens, SL, Felix, ED, Hambrick, EP. A meta-analysis of the impact of natural disasters on internalizing and externalizing problems in youth. J Trauma Stress. 2018;31(3):332–341. Doi:10.1002/jts.22292CrossRefGoogle ScholarPubMed
Beaglehole, B, Mulder, RT, Frampton, CM, et al. Psychological distress and psychiatric disorder after natural disasters: systematic review and meta-analysis. Br J Psychiatry. 2018;213(6):716–722.CrossRefGoogle ScholarPubMed
Schwartz, RM, Rasul, R, Gargano, LM, et al. Examining associations between Hurricane Sandy exposure and posttraumatic stress disorder by community of residence. J Trauma Stress. 2019;32(5):677–687. Doi:10.1002/jts.22445CrossRefGoogle ScholarPubMed
Lowe, SR, Sampson, L, Gruebner, O, et al. Psychological resilience after Hurricane Sandy: the influence of individual- and community-level factors on mental health after a large-scale natural disaster. PloS One. 2015;10(5):e0125761. Doi:10.1371/journal.pone.0125761CrossRefGoogle ScholarPubMed
Stroup, DF, Berlin, JA, Morton, SC, et al. Meta-analysis of observational studies in epidemiology: a proposal for reporting. JAMA. 2000;283(15):2008–2012.CrossRefGoogle ScholarPubMed
Page, MJ, McKenzie, JE, Bossuyt, PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. Doi:10.1136/bmj.n71CrossRefGoogle ScholarPubMed
Wells, GA, Shea, B, O’Connell, D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. Oxford; 2000.Google Scholar
Cohen, J. A power primer. Psychol Bull. 1992;112(1):155–159. Doi:10.1037//0033-2909.112.1.155CrossRefGoogle ScholarPubMed
Higgins, JPT, Thompson, SG, Deeks, JJ, et al. Measuring inconsistency in meta-analyses. BMJ. 2003;327(7414):557–560. Doi:10.1136/bmj.327.7414.557CrossRefGoogle ScholarPubMed
Borenstein, M, Higgins, JP, Hedges, LV, et al. Basics of meta-analysis: I2 is not an absolute measure of heterogeneity. Res Synth Methods. 2017;8(1):5–18.CrossRefGoogle Scholar
Borenstein, M, Hedges, LV, Higgins, JP, et al. Introduction to meta-analysis. John Wiley & Sons; 2021.CrossRefGoogle Scholar
Higgins, JP, Thompson, SG, Deeks, JJ, et al. Measuring inconsistency in meta-analyses. Bmj. 2003;327(7414):557–560. Doi:10.1136/bmj.327.7414.557CrossRefGoogle ScholarPubMed
Ioannidis, JPA, Trikalinos, TA. The appropriateness of asymmetry tests for publication bias in meta-analyses: a large survey. CMAJ. 2007;176(8):1091–1096.CrossRefGoogle ScholarPubMed
Cherry, KE, De Vito, AN, Calamia, MR, et al. Disaster stressors and psychological well-being in older adults after a flood. Psychology and Aging. 2021;36(5):660–666. Doi:10.1037/pag0000602CrossRefGoogle ScholarPubMed
Davis, TE, Grills-Taquechel, AE, Ollendick, TH. The psychological impact from hurricane Katrina: effects of displacement and trauma exposure on university students. Behav Ther. 2010;41(3):340–349. Doi:10.1016/j.beth.2009.09.004CrossRefGoogle ScholarPubMed
Ginexi, EM, Weihs, K, Simmens, SJ, et al. Natural disaster and depression: a prospective investigation of reactions to the 1993 midwest floods. Am J Community Psychol. 2000;28(4):495–518. Doi:10.1023/a:1005188515149CrossRefGoogle Scholar
Melick, ME, Logue, JN. The effect of disaster on the health and well-being of older women. Int J Aging Hum Dev. 1985;21(1):27–38. Doi:10.2190/qud0-yc8b-pgn8-ry6pCrossRefGoogle ScholarPubMed
Stanko, KE. Examining Successful Aging and Resilience After Disasters. Louisiana State University and Agricultural & Mechanical College; 2019.Google Scholar
Tucker, P, Pfefferbaum, B, Khan, Q, et al. Katrina survivors relocated to Oklahoma: a tale of two cities. Psychiatr Ann. 2008;38(2):125–127,129-130,132-133.CrossRefGoogle Scholar
Vigil, JM. Sex Differences in the Stress Responses of Children Affected by Hurricane Katrina [Ph.D. thesis]. Columbia, MO: University of Missouri — Columbia; 2007.CrossRefGoogle Scholar
Walling, E, Tucker, P, Pfefferbaum, B, et al. Neuropsychological outcomes of exposure to Hurricane Katrina and relocation. Disaster Med Public Health Prep. 2020;14(1):89–92. Doi:10.1017/dmp.2019.110CrossRefGoogle ScholarPubMed
Costa, NM, Weems, CF, Pina, AA. Hurricane Katrina and youth anxiety: the role of perceived attachment beliefs and parenting behaviors. J Anxiety Disord. 2009;23(7):935–941. Doi:10.1016/j.janxdis.2009.06.002CrossRefGoogle ScholarPubMed
Vu, L, Vanlandingham, MJ. Physical and mental health consequences of Katrina on Vietnamese immigrants in New Orleans: a pre- and post-disaster assessment. J Immigr Minor Health. 2012;14(3):386–394. Doi:10.1007/s10903-011-9504-3CrossRefGoogle ScholarPubMed
Kessler, RC, Galea, S, Jones, RT, et al. Mental illness and suicidality after Hurricane Katrina. Bull World Health Organ. 2006;84(12):930–939. Doi:10.2471/blt.06.033019CrossRefGoogle ScholarPubMed
Brown, JS, Cherry, KE, Marks, LD, et al. After Hurricanes Katrina and Rita: gender differences in health and religiosity in middle-aged and older adults. Health Care Women Int. 2010;31(11):997–1012. Doi:10.1080/07399332.2010.514085CrossRefGoogle ScholarPubMed
Abramson, DM, Park, YS, Stehling-Ariza, T, et al. Children as bellwethers of recovery: dysfunctional systems and the effects of parents, households, and neighborhoods on serious emotional disturbance in children after Hurricane Katrina. Disaster Med Public Health Prep. 2010;4 Suppl 1:S17–27. Doi:10.1001/dmp.2010.7CrossRefGoogle ScholarPubMed
Zahran, S, Peek, L, Snodgrass, JG, et al. Economics of disaster risk, social vulnerability, and mental health resilience. Risk anal. 2011;31(7):1107–1119. Doi:10.1111/j.1539-6924.2010.01580.xCrossRefGoogle ScholarPubMed
La Greca, AM, Silverman, WK, Wasserstein, SB. Children’s predisaster functioning as a predictor of posttraumatic stress following Hurricane Andrew. J Consult Clin Psychol. 1998;66(6):883–892. Doi:10.1037//0022-006x.66.6.883CrossRefGoogle ScholarPubMed
Ferraro, FR, Morton, M, Knutson, S, et al. Impact of the 1997 flood on cognitive performance in the elderly. Clinical Gerontologist. 1999;20(2):79–82.Google Scholar
Rhodes, J, Chan, C, Paxson, C, et al. The impact of Hurricane Katrina on the mental and physical health of low-income parents in New Orleans. Am J Orthopsychiatry. 2010;80(2):237–247. Doi:10.1111/j.1939-0025.2010.01027.xCrossRefGoogle ScholarPubMed
Fincham, FD, May, RW. Divine forgiveness protects against psychological distress following a natural disaster attributed to God. J Posit Psychol. 2021;16(1):20–26. Doi:10.1080/17439760.2019.1689411CrossRefGoogle Scholar
Weems, CF, Pina, AA, Costa, NM, et al. Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after hurricane Katrina. J Consult Clin Psychol. 2007;75(1):154–159. Doi:10.1037/0022-006X.75.1.154CrossRefGoogle ScholarPubMed
McLeish, AC, Del Ben, KS. Symptoms of depression and posttraumatic stress disorder in an outpatient population before and after Hurricane Katrina. Depress Anxiety. 2008;25(5):416–421. Doi:10.1002/da.20426CrossRefGoogle Scholar
Canino, G, Rubio-Stipec, M, Bravo, M, et al. The impact of disaster on mental health: prospective and retrospective analyses. Int J Ment Health 1990;19(Spring 90):51–69.CrossRefGoogle Scholar
Ruggiero, KJ, Ben, KD, Scotti, JR, et al. Psychometric properties of the PTSD checklist—civilian version. J Trauma Stress. 2003;16:495–502.CrossRefGoogle ScholarPubMed
Arkin, M, Lowe, SR, Poon, C, et al. Associations between religious coping and long-term mental health in survivors of Hurricane Katrina. Psycholog Relig Spiritual. 2022;16(1):63.CrossRefGoogle Scholar
An, R, Qiu, Y, Xiang, X, et al. Impact of Hurricane Katrina on mental health among US adults. Am J Health Behav. 2019;43(6):1186–1199. Doi:10.5993/AJHB.43.6.15CrossRefGoogle ScholarPubMed
Mukherjee, S, Canterberry, M, Yore, JB, et al. Assessing the relationship between mental distress and tobacco use in post-Katrina and Rita Louisiana. Subst Use Misuse. 2017;52(10):1275–1282. Doi:10.1080/10826084.2016.1273956CrossRefGoogle Scholar
Hutchins, GL, Norris, FH. Life change in the disaster recovery period. Environ Behav. 1989;21(1):33–56. Doi:10.1177/0013916589211003CrossRefGoogle Scholar
Flores, AB, Sullivan, JA, Yu, Y, et al. Health disparities in the aftermath of flood events: a review of physical and mental health outcomes with methodological considerations in the USA. Curr Environ Health Rep. 2024;11(2):238–254. Doi:10.1007/s40572-024-00446-7CrossRefGoogle ScholarPubMed
Huang, W, Gao, Y, Xu, R, et al. Health effects of cyclones: a systematic review and meta-analysis of epidemiological studies. Environ Health Perspect. 2023;131(8):86001. Doi:10.1289/ehp12158CrossRefGoogle ScholarPubMed
Deglon, M, Dalvie, MA, Abrams, A. The impact of extreme weather events on mental health in Africa: a scoping review of the evidence. Sci Total Environ. 2023;881:163420. Doi:10.1016/j.scitotenv.2023.163420CrossRefGoogle Scholar
Keya, TA, Leela, A, Habib, N, et al. Mental health disorders due to disaster exposure: a systematic review and meta-analysis. Cureus. Apr 2023;15(4):e37031. Doi:10.7759/cureus.37031Google ScholarPubMed
Powell, T, Wegmann, KM, Backode, E. Coping and post-traumatic stress in children and adolescents after an acute onset disaster: a systematic review. Int J Environ Res Public Health. 2021;18(9)doi:10.3390/ijerph18094865CrossRefGoogle ScholarPubMed
Felix, E, Rubens, S, Hambrick, E. The relationship between physical and mental health outcomes in children exposed to disasters. Curr Psychiatry Rep. 2020;22(7):33. Doi:10.1007/s11920-020-01157-0CrossRefGoogle ScholarPubMed
Lowe, SR, Bonumwezi, JL, Valdespino-Hayden, Z, et al. Posttraumatic stress and depression in the aftermath of environmental disasters: a review of quantitative studies published in 2018. Curr Environ Health Rep. 2019;6(4):344–360. Doi:10.1007/s40572-019-00245-5CrossRefGoogle ScholarPubMed
Golitaleb, M, Mazaheri, E, Bonyadi, M, et al. Prevalence of post-traumatic stress disorder after flood: a systematic review and meta-analysis. Front Psychiatry. 2022;13:890671. Doi:10.3389/fpsyt.2022.890671CrossRefGoogle Scholar
Norris, FH. Methods for Disaster Mental Health Research. Guilford Press; 2006.Google Scholar
Liu, A, Xu, B, Liu, M, et al. The reciprocal relations among self-compassion, posttraumatic stress disorder, and posttraumatic growth among adolescents after the Jiuzhaigou earthquake: a three-wave cross-lagged study. J Ment Health. 2023;32(3):634–642. Doi:10.1080/09638237.2023.2182411CrossRefGoogle ScholarPubMed
Hikichi, H, Taku, K, Aida, J, et al. Longitudinal associations between post-traumatic stress and post-traumatic growth among older adults 11 years after a disaster. Epidemiol Psychiatr Sci. 2024;33:e33. Doi:10.1017/s2045796024000362CrossRefGoogle ScholarPubMed
Mattei, J, Tamez, M, O’Neill, J, et al. Chronic diseases and associated risk factors among adults in Puerto Rico after Hurricane Maria. JAMA Netw Open. 2022;5(1):e2139986. Doi:10.1001/jamanetworkopen.2021.39986CrossRefGoogle ScholarPubMed
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