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Journal Article Epublish 1 citation

PubMed: 40122917 DOI: 10.1038/s41467-025-58236-0

Floods and cause-specific mortality in the United States applying a triply robust approach.

Nat Commun 16(1):2853

Authors: Lingzhi Chu, Joshua L Warren, Erica S Spatz, Sarah Lowe, Yuan Lu, Xiaomei Ma, Joseph S Ross, Harlan M Krumholz, Kai Chen

Affiliations

  • Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, 06520, USA.
  • Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, 06520, USA.
  • Department of Biostatistics, Yale School of Public Health, New Haven, CT, 06520, USA.
  • Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, 06510, USA.
  • Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06520, USA.
  • Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, 06520, USA.
  • Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT, 06510, USA. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06520, USA. Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, 06520, USA. Department of Biomedical Informatics & Data Science, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, 06520, USA. Yale Cancer Outcomes, Public Policy, and Effectiveness Research Center, New Haven, CT, 06520, USA.
  • Section of General Medicine and the National Clinician Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, 06510, USA.
  • Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, 06520, USA.
  • Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, 06520, USA.
  • Yale Center on Climate Change and Health, Yale School of Public Health, New Haven, CT, 06520, USA.

Abstract

The health impact of floods has not been well characterized. This study evaluated long-term associations between cause-specific mortality rates and county-level monthly flood days (excluding coastal floods caused by tropical storms) in the post-flood year in the contiguous U.S., using a triply robust approach incorporating propensity score, counterfactual estimation, and confounder adjustment. Death records came from the CDC National Center for Health Statistics (2001-2020) and floods came from the NOAA Storm Events Database (2000-2020). We found that one flood day was associated with 8.3 (95% CI: 2.5 to 14.1) excess all-cause deaths per 10 million individuals, 3.1 due to myocardial infarction, 2.4 due to respiratory diseases, and 5.9 due to external causes. From 2001 to 2020, 22,376 (95% CI: 6,758 to 37,993) all-cause deaths were attributable to floods. Our findings highlight the long-term health risks after floods, and a need for measures to reduce these risks.

MeSH

Mortality, Biological Science Disciplines, Floods

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