Hurricane flooding linked to lingering risks for device-dependent seniors

Clinical takeaway: Identify patients who depend on electricity-powered medical equipment as a high-risk group during hurricane season, particularly those living in flood-prone areas, and ensure backup power, evacuation, and emergency care plans are in place.

Hurricanes can disrupt electricity, transportation, and healthcare access for older adults who rely on devices such as ventilators, oxygen equipment, and dialysis-related technologies. As extreme weather events become more frequent, understanding which patients face the greatest post-disaster risks can help clinicians and health systems target preparedness efforts.

Among Medicare beneficiaries aged 65 years and older in North Carolina who used electricity-dependent durable medical equipment, hurricane exposure was associated with increased risks of hospitalization or death, particularly when exposure was measured using detailed flooding data rather than county-level disaster designations.

Investigators analyzed Medicare claims from 2015-2019 and tracked more than 45,000 to 80,000 device-dependent beneficiaries across Hurricanes Matthew (2016) and Florence (2018). Most patients used ventilators or oxygen-related equipment, and approximately 55% were women with a median age of 73-74 years.

Using FEMA county-level disaster declarations, researchers found no significant immediate increase in 30-day all-cause hospitalization or death after either hurricane. However, Hurricane Matthew was associated with a sustained increase in hospitalization or death rates during the following year among residents of affected counties. Hurricane Florence showed no comparable long-term effect using the FEMA-based exposure definition.

A different picture emerged when exposure was defined by the extent of residential flooding. Areas with more severe flooding showed stronger and more consistent increases in hospitalization or death, with risks generally rising as flooding severity increased. The most pronounced effects were seen among Black beneficiaries, who experienced worsening short- and long-term outcomes as flood exposure increased. In contrast, associations among White beneficiaries were weaker and less consistent.

The findings suggest that broad county-level disaster classifications may underestimate health risks in medically vulnerable populations and miss important disparities related to flooding severity.

“Reliance on county-level disaster designations may be insufficient for identifying populations at highest risk, whereas more granular indicators of flooding and infrastructure disruption may improve targeting of emergency preparedness resources,” the authors wrote.

Source: Jackson BE, et al. (2026 Oct 21) J Am Geriatr Soc. Assessing the Effects of Hurricane Hazards on Hospitalization or Death Among Older Adults Using Electricity-Dependent Medical Devices