Association between exposure to hurricane harvey and mortality among nursing home residents

Abstract Hurricane Harvey made landfall in Southeast Texas in August 2017, causing catastrophic flooding. We examined the association between exposure to Hurricane Harvey and rates of 30-and 90-day mortality among Texas nursing home residents. Using Medicare data, we compared a cohort of residents exposed to the storm in 2017 (n= 18,693) to a cohort of residents not exposed to the storm in 2015 (n=19,688). We fit generalized estimating equations with a sandwich estimator, adjusting for resident demographic and clinical characteristics. Exposure to Hurricane Harvey was not associated with 30-day rates of mortality. However, it was associated with a 15% increase in the odds of dying at 90 days holding resident characteristics constant (adjusted odds ratio: 1.15 [95% Confidence interval: 1.06, 1.25). Health effects due to severe flooding, such as those related to decreased ability to manage chronic conditions, may not be apparent until several weeks after the storm.