Mortality of Puerto Ricans in the USA post Hurricane Maria: an interrupted time series analysis

Objectives To determine death occurrences of Puerto Ricans on the mainland USA following the arrival of Hurricane Maria in Puerto Rico in September 2017. Design Cross-sectional study. Participants Persons of Puerto Rican origin on the mainland USA. Exposures Hurricane Maria. Main outcome We use an interrupted time series design to analyse all-cause mortality of Puerto Ricans in the USA following the hurricane. Hispanic origin data from the National Vital Statistics System and from the Public Use Microdata Sample of the American Community Survey are used to estimate monthly origin-specific mortality rates for the period 2012-2018. We estimated log-linear regressions of monthly deaths of persons of Puerto Rican origin by age group, gender, and educational attainment. Results We found an increase in mortality for persons of Puerto Rican origin during the 6-month period following the hurricane (October 2017 through March 2018), suggesting that deaths among these persons were 3.7% (95% CI 0.025 to 0.049) higher than would have otherwise been expected. In absolute terms, we estimated 514 excess deaths (95% CI 346 to 681) of persons of Puerto Rican origin that occurred on the mainland USA, concentrated in those aged 65 years or older. Conclusions Our findings suggest an undercounting of previous deaths as a result of the hurricane due to the systematic effects on the displaced and resident populations in the mainland USA. Displaced populations are frequently overlooked in disaster relief and subsequent research. Ignoring these populations provides an incomplete understanding of the damages and loss of life.

Automated summary

This study aims to investigate the death occurrences of Puerto Ricans on the mainland USA following the arrival of Hurricane Maria in Puerto Rico. The study found an increase in mortality among Puerto Ricans in the six months following the hurricane, with over 500 excess deaths, primarily among those aged 65 and older.