Impact of Hurricanes and Floodings on Mental Health Outcomes Within the United States: A Systematic Review and Meta-Analysis

Disaster Med Public Health Prep. 2025 Jan 3:18:e335. doi: 10.1017/dmp.2024.327.

Abstract

Objective: Given the US population concentration near coastal areas and increased flooding due to climate change, public health professionals must recognize the psychological burden resulting from exposure to natural hazards.

Methods: We performed a systematic search of databases to identify articles with a clearly defined comparison group consisting of either pre-exposure measurements in a disaster-exposed population or disaster-unexposed controls, and assessment of mental health, including but not limited to, depression, post-traumatic stress (PTS), and anxiety.

Results: Twenty-five studies, with a combined total of n =616 657 people were included in a systematic review, and 11 studies with a total of 2012 people were included in a meta-analysis of 3 mental health outcomes. Meta-analytic findings included a positive association between disaster exposure and PTS (n = 5, g = 0.44, 95% CI 0.04, 0.85), as well as depression (n = 9, g = 0.28, 95% CI 0.04, 0.53), and no meaningful effect size in studies assessing anxiety (n = 6, g = 0.05 95% CI -0.30, 0.19).

Conclusions: Hurricanes and flooding were consistently associated with increased depression and PTS in studies with comparison groups representing individuals unaffected by hazards.

Keywords: PTSD; anxiety; depression; flood; hurricane; mental health; psychological distress; systematic review.

Publication types

  • Systematic Review
  • Meta-Analysis
  • Review

MeSH terms

  • Anxiety / epidemiology
  • Anxiety / psychology
  • Cyclonic Storms* / statistics & numerical data
  • Depression / epidemiology
  • Depression / psychology
  • Floods* / statistics & numerical data
  • Humans
  • Mental Health / statistics & numerical data
  • Stress Disorders, Post-Traumatic / epidemiology
  • Stress Disorders, Post-Traumatic / etiology
  • Stress Disorders, Post-Traumatic / psychology
  • United States / epidemiology