Sep 30, 2022 - Health

Hurricanes pose growing flood threat to U.S. hospitals

Share of hospitals at risk of flooding during a Category 2 hurricane
Data: Harvard T.H. Chan School of Public Health Chart: Tory Lysik/Axios

The evacuations of thousands of patients from hurricane-stricken Florida health facilities this week served as an ominous warning to hospitals along the Atlantic and Gulf Coast that researchers say could be swamped by surges from much weaker storms.

Driving the news: From Miami to Boston, hospitals along the East Coast face a growing risk from flooding, according to a study published Thursday in GeoHealth.

  • Rising sea levels and storms that are more violent and track further north are posing new kinds of threats that health systems have to confront.

What they're saying: "Where are the metro areas that have the most beds at risk proportional to the number of the people they serve? It turns out number one is Miami. But number two is New York and the New York area and number three is Boston," said Aaron Bernstein, a co-author of the study and interim director of the Center for Climate Health and the Global Environment at Harvard T.H. Chan School of Public Health.

  • "While the likelihood of a hurricane making landfall in the New York region or Boston is much less than places on the Gulf Coast, the consequences for access to hospital beds is, in fact, very high," he told Axios.

By the numbers: Researchers identified 682 acute care hospitals in 78 metropolitan statistical areas that were located within 10 miles of the Atlantic and Gulf Coasts.

  • Those hospitals cover a population of nearly 85 million people, or about one of every four Americans, they said.
  • The study found almost a third of those metro areas have half or more of their hospitals at risk of flooding from a Category 2 hurricane. A sea level rise of .82 meters, which is estimated to occur this century, would increase the odds of hospitals flooding by 22%.

Zoom in: The study also found in 18 metro areas, at least half of the roads within about one mile of hospitals were at risk of flooding from a Category 2 storm.

  • "Roads are critical. If you have a fully functional hospital but you can't get folks in or out, it's not going to save us," Bernstein said.

Limitations: The study did not take into account the actual amount of rainfall that might be delivered from any particular storm.

  • It also did not take into account specific infrastructure improvements or preparedness planning that has already taken place by the respective hospitals.
  • "This study gives people a more nuanced way to think about the risks and a way to plan for them," Bernstein said.

The big picture: It's not only access in the days around a storm, but in the weeks, if not months, after a hurricane has passed that are critical, Bernstein said.

  • For instance, a 2o19 study published in JAMA found the longer a disaster declaration persisted following a hurricane, the more likely lung cancer patients were to die because of a lack of access to care.
  • New York-area hospitals and other health facilities incurred billions of damages from Hurricane Sandy in 2012, leaving emergency departments at some facilities overflowing with patients.
  • There are also concerns of inequity as poorer neighborhoods and on poorer hospitals are disparately impacted by flooding and other climate impacts.

The bottom line: "We can't behave as if the world is stable. The climate is unstable and it absolutely matters to how we think about our ability to do our jobs," Bernstein said. "We can take steps that are not hugely expensive and, hopefully, pave a path toward being more resilient."

Go deeper: The climate-driven health crisis

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