((SLB-048)) (SLB-048) Impact of Hurricanes and Related Extreme Weather Events on Health Outcomes: A Scoping Review

Background: Hurricanes are among the most destructive natural disasters, with their impacts intensifying due to anthropogenic climate change. Research on hurricane-related health outcomes has been an area of growing interest, with accumulating epidemiological evidence linking hurricanes to various health outcomes, including mental disorders, adverse birth outcomes, infectious disease, and cancer.

Objectives: We describe the breadth of epidemiological studies evaluating the impacts of hurricanes and extreme weather events on health outcomes and identify variations in how hurricanes exposures are defined.

Methods: We queried English-language articles from PubMed, EMBASE, and Environmental Complete using keywords of ‘hurricane, ‘cyclone, ‘typhoon’ and ‘extreme weather’ from January 2000 to June 2024. Extraction of key study features, including study design, global region, health outcome(s), and covariates, was conducted and independently validated to ensure accuracy and consistency.

Results: We identified 32,388 potentially eligible studies, of which 24,709 studies underwent title and abstract screening after duplicate removal. 24,347 articles were excluded for not reporting on a health outcome, and 70 more articles were excluded as systematic reviews, meta-analyses, or not original research articles (e.g., commentary/reflection articles). Our final eligible manuscripts consisted of 292 studies. The studies were largely conducted in mainland US (n=226), Puerto Rico (n=29), and Australia (n=4). Most investigations were cohort studies (n=149), followed by cross-sectional (n=128), and time-series studies (n=20). Study populations ranged in size from 5 to >69 million participants (median=593, IQR= 261-3,468). Hurricane Katrina was the most studied event (n=100), while exposure and outcome measures varied widely across studies. Exposure data was primarily defined based on self-report via surveys/questionnaires. Mental health (n=178), maternal health (n=36), and cardiovascular diseases (n=28) were the most studied outcomes. Only 9 studies utilized claims data, such as Medicare and Medicaid, to define health outcomes.

Conclusions: Our scoping review highlights that research on the health impacts of hurricanes has primarily focused on a limited number of health outcomes, leaving many potential negative health sequalae underexplored. Lack of standardized measures of exposure to hurricane hazards limited exposure ascertainment to self-report in many studies. Addressing these gaps is critical to understand the magnitude and the differential impact of hurricanes on health outcomes and to inform future preparedness and response operations.