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A 2026 study of North Carolina Medicare beneficiaries aged 65 and older found that hurricane-related flooding was associated with hospitalizations and deaths among people using electricity-dependent medical devices. County-level disaster declarations showed no significant immediate changes after Hurricanes Matthew or Florence, while more detailed flood data showed stronger associations and worse outcomes for Black people as flood severity rose.
A study of North Carolina Medicare beneficiaries aged 65 and older found that hurricane exposure—particularly flooding measured with detailed local data—was associated with hospitalizations and deaths among people relying on electricity-dependent medical devices. Published in the Journal of the American Geriatrics Society in October 2026, the research examined outcomes after Hurricanes Matthew and Florence and found worse short- and long-term outcomes for Black participants as flooding severity increased.
The researchers assessed hospitalizations and deaths among Medicare beneficiaries who used devices such as ventilators, respirators and dialysis machines. They studied the immediate effects of Hurricanes Matthew in 2016 and Florence in 2018, as well as outcomes over the following year. The report describes associations between hurricane hazards and health outcomes; it does not establish that a storm or power loss directly caused any individual hospitalization or death.
When the team used county-level federal disaster declarations to classify exposure, it found no significant immediate changes after either hurricane. It did, however, identify sustained increases in hospitalizations and deaths over the year after Hurricane Matthew. The supplied report does not give numerical effect sizes or describe a comparable sustained increase after Florence.
Analyses using the North Carolina Flood Extent Archive, which captures flood exposure at higher resolution, showed stronger and more consistent associations between hurricane exposure and the outcomes. The report also says Black individuals had worse short- and long-term outcomes as flooding severity increased. It does not provide subgroup counts or quantify the size of those differences.
Flood Exposure and Medical Vulnerability
For people dependent on powered equipment, a storm can pose risks beyond immediate injury: flooding and related disruption may coincide with interruptions to electricity, transport, home care or access to treatment. This study focused on hospitalizations and deaths, not on the specific pathways that produced them, so it cannot show which disruptions mattered most. Its findings nevertheless point to older adults using these devices as a group whose health outcomes may be tied to the severity and location of flood exposure.
The results also suggest that how exposure is measured matters. A county-wide disaster designation did not show immediate changes, while more detailed flood mapping produced clearer associations. That distinction could matter for preparedness and response planning: broad declarations may not reflect the conditions experienced by particular residents or neighborhoods. The reported differences by race add a further reason to examine whether disaster planning and recovery support reach affected communities equitably; the study does not establish why those differences occurred.
electricity-dependent medical devices for seniors
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Matthew and Florence in North Carolina
The analysis covered two hurricanes that affected North Carolina: Matthew in 2016 and Florence in 2018. Investigators compared health outcomes among older Medicare beneficiaries using electricity-dependent equipment against hurricane exposure, using both FEMA presidential disaster declarations at the county level and the state’s higher-resolution flood archive.
The report says the research team linked hurricane hazard and health care utilization data while working with communities affected by storms. The study, titled “Assessing the effects of hurricane hazards on hospitalization or death among older adults using electricity-dependent medical devices,” appeared in the Journal of the American Geriatrics Society in 2026. Its findings are specific to the population, state and storms studied; the supplied material does not establish that the same outcome patterns apply to all older adults or other disasters.
“Over the past two years, our team has linked hurricane hazard and health care utilization data in North Carolina while working with impacted communities to shape this research.”
— Jennifer L. Lund, senior author and researcher at the UNC Gillings School of Global Public Health
Limits of the Available Findings
The report does not provide absolute numbers, effect sizes or confidence intervals, so readers cannot gauge the magnitude of the associations from the supplied material. It also does not spell out the mechanisms linking flood exposure to health outcomes, or whether power interruptions, evacuation, disrupted care, other storm impacts or a combination of factors account for the patterns.
It remains unclear why the county-declaration analysis found no significant immediate changes after either storm while the more detailed flood analysis showed stronger associations. The material also gives no detailed results for Florence beyond the absence of significant immediate changes in the declaration-based analysis, and does not explain the reasons for the worse outcomes reported among Black individuals as flooding severity rose. Because this was an observational analysis of two hurricanes in one state, the findings show associations, not proof of cause and effect.
Research and Preparedness Ahead
Lund said the work is intended to support broader study of hurricane and flood effects on medically vulnerable populations and collaboration with community organizations and local and state agencies. The supplied report does not announce a specific next study, policy change or implementation timeline.
Further research could clarify which storm-related disruptions are associated with the observed outcomes, quantify differences across groups and test how well local planning addresses the needs of people reliant on powered devices. For now, the published findings offer evidence from two North Carolina hurricanes, while the causes of the observed patterns and their relevance to other storms remain unsettled.
Key Questions
Who was included in the study?
The study examined North Carolina Medicare beneficiaries aged 65 and older who used electricity-dependent medical equipment.
Which hurricanes did researchers examine?
The researchers studied outcomes after Hurricane Matthew in 2016 and Hurricane Florence in 2018.
Did the study find an immediate rise in hospitalizations after both hurricanes?
No significant immediate changes were found in the analysis using county-level federal disaster declarations. More detailed flood-exposure analyses showed stronger associations with hospitalizations and deaths, but the report does not provide numerical estimates.
Did the researchers prove that flooding caused deaths?
No. The report describes associations between hurricane or flood exposure and health outcomes. It does not establish that flooding directly caused a particular hospitalization or death.
What did the study report about racial differences?
It reported that Black individuals experienced worse short- and long-term outcomes as flooding severity increased. The supplied report does not explain the reasons for the difference or quantify its size.
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