On September 20, 2017, Hurricane Maria ravaged the island of Puerto Rico, restricting many people’s access to a number of critical resources, including water, electricity, and medical care. By December 2017, the official count of hurricane-related deaths was 64. However, other sources of information pointed to the possibility that there may, in fact, have been many more deaths attributable to the hurricane.
A new study, published on May 29, 2018 in The New England Journal of Medicine, confirms this possibility. The study, funded by the Harvard T.H. Chan School of Public Health, estimates mortality related to Hurricane Maria based on a random survey sample of 3,299 households.
The findings are stark: The authors estimate that deaths related to the hurricane are more than 70 times the official estimate (4,645 deaths compared to 64 deaths). The mortality rate from September 20 through December 31, 2017—the period immediately following Hurricane Maria—was 62 percent higher than the same period in 2016.
Other findings also underscore the health consequences of the U.S. government’s historical inattention to Puerto Rico’s infrastructure:
- Medical care interruptions were the primary cause of continued high mortality rates following the hurricane, representing one-third of hurricane-related deaths.
- 2.8 percent of the population surveyed left their homes due to the hurricane.
- Those living in remote locations were more likely to experience shortages of electricity, water, and cell phone connectivity.
- 31 percent of all households reported experiencing disruption of medical services.
The researchers conclude by pointing out that surveys are a useful way to estimate the death toll of a large disaster, especially given the shortcomings of doing so with death certificates alone. They add that health service interruption during natural disasters have an increasingly substantial impact on vulnerable populations such as the elderly or chronically ill. Therefore, rapid mortality estimation is important for both determining the scale of a disaster and appropriate recovery and aid efforts. Moving forward, the researchers advocate reviewing how disaster-related deaths will be counted following future natural disasters.
The data used in this study are publicly available for further analysis.
For those wishing to learn more, the Incubator’s online repository contains a number of resources related to natural disasters and public health, including a resource pack on Disaster Preparedness and Resilience.